‘Confused’ may be the best word to describe Australia’s vaccine rollout. 

Amid a cloud of recommendations, bold claims and ‘horizons’, experts have weighed in on the current vaccine choices and who should be making them. 

It comes just days after the Australian Medical Association (AMA) publicly disagreed with Prime Minister Scott Morrison’s decision to make the AstraZeneca vaccine available to under-40s.

“Doctors don’t want to be exposed to negligence claims and lawsuits, and so the AMA prefers to recommend that doctors line up with ATAGI’s advice,” says Professor Christine Jenkins - a respiratory physician. 

“This means they defer to a higher authority and it protects them at the same time. 

“However, it doesn’t mean that it is in patients’ best interests nor in the wider community’s interests. 

“A different assessment of risk could be done using a different risk profile – one not based on comparing probability of ICU admission vs TTS [rare, sometimes fatal blood clots]. 

“This risk analysis would compare the risk of transmission, getting the disease at all, losing time from work and infecting your family and friends to risk of TTS. 

“These are far more likely events than ICU admission which is rare and an uncommon event for people under 50 years old. 

“An analysis that includes more common but troubling events for under 50 year olds, weighs up wider community benefit and is not shackled by the issues ATAGI has said it has taken into account would be likely to demonstrate a far more persuasive case for the AZ [AstraZeneca] vaccine.”

Professor Robert Booy is an infectious diseases and vaccine expert with an honorary professorship at the University of Sydney, is a director of the Immunisation Coalition and is a consultant to vaccine manufacturers.

He says Australians need more tools to make their decision, particularly for young people. 

“What is needed is a way in which to calculate a risk-benefit ratio that’s relevant to you, as a young person,” Dr Booys said.  

“Such a calculator is available on the web from the UK. It was set up by the Oxford group. It’s extremely helpful if you live in the UK where disease is common but we need a risk calculator for Australian circumstances. 

“Several groups are working on just that. For example, the immunization coalition is in discussion with the Oxford group to quickly adapt their instrument to Australia. 

Many young Australians are considering whether to have Pfizer, having to wait for some weeks and months, or getting AZ quite quickly. 

“She/he would take into account that there is an imminent risk of transmission if living in the eastern suburbs of Sydney, but a very low risk in many other parts of Australia,” Dr Booy said.

“And understandably would be concerned that there is a risk of clotting syndrome (TTS) in the order of 1 in 25,000 after the first dose of AstraZeneca. 

“The clot problem would probably require hospitalisation but only about one in 25 people hospitalised might die from it, giving a risk of less than 1 in 500,000 of dying from a clot due to the vaccine. 

“That’s about the same risk as being struck by lightning. Also the risk of being killed from a motor vehicle accident is much higher, and the risk of getting a serious clot in a 25-year-old woman on the oral contraceptive pill is quite a bit higher. 

“No vaccine or medicine is without some risk, albeit rare, or even very rare. Reports from the United States suggest that the Pfizer jab may result in a risk of myocarditis/pericarditis in one out of 100,000 vaccine recipients, with a higher rate if you are young and male. 

“Also, about one in 100,000 people given an mRNA vaccine is at risk of anaphylaxis but the allergic reaction is most unlikely to cause death. 

“There’s a lot to consider. Experts are working on it, and these calculators will hopefully be available soon.

“In the meantime, GPs are well equipped to answer people’s questions, their opinions are respected and the government is supporting GPs to have enough time to undertake meaningful discussions with their patients about vaccinations.”