Tight vaccine supply spells ‘very vulnerable’ winter for Victorians

Victorians face three vulnerable months during which vaccine supply will be heavily constrained, as experts warn outbreaks of more infectious variants of the disease in winter could pose a serious problem to the state’s largely unvaccinated population.

The warning comes as restrictions imposed during the recent lockdown are set to ease further, with an announcement expected on Wednesday morning that people will be able to gather in groups of more than 20 outdoors, bigger crowds will be permitted at football games and companies will be allowed to operate with 75 per cent of their workforce in the office.

Victorians face a vulnerable three months, with vaccine supply heavily constrained over the winter,Credit:Getty Images

Victoria recorded no new local cases on Tuesday as the cluster in Sydney almost doubled to 21 cases and acting Premier James Merlino again accused the Commonwealth of a botched vaccine rollout after Monday’s meeting of national cabinet failed to guarantee the increased supply that Victoria had sought.

University of Melbourne epidemiologist Tony Blakely said the decision last week by the Australian Technical Advisory Group on Immunisation (ATAGI) to limit the AstraZeneca vaccine to those over 60, will set back the vaccine rollout by several months, before it ramps up again as more Pfizer and Moderna doses arrive in Australia from overseas later in the year.

“The problem is that it is winter now and if the more infectious Delta [variant] gets out somewhere it could cause a serious problem,” Professor Blakely said.

“We’re going to have lower vaccine coverage rates than expected, which makes us more vulnerable, and we’re going to have a very vulnerable window here for about three months before things really pick up again.”

Mr Merlino said he did not leave the discussions confident Australia’s vaccine supply would substantially improve to meet demand, telling reporters he was disappointed that in “the depths of winter we’re going to see a reduction in the vaccine.“

In his strongest swipe yet at the federal government, Mr Merlino said the Commonwealth had missed its “sliding doors moment” last year when Australia reportedly failed to take up an offer of 40 million doses of the Pfizer vaccine.

“The fact that so little of our population is fully vaccinated, is a problem,” Mr Merlino said.

Federal Health Department assistant secretary Lisa Schofield rubbished this suggestion on Monday, maintaining that no formal offer was put on the table until later in the year, despite there being an initial meeting between Health Department officials and Pfizer in July 2020.

La Trobe University epidemiologist Hassan Vally said a combination of cooler weather, people huddled indoors and the emergence of more infectious variants of the virus all combined to increase the risk of outbreaks spreading more rapidly.

“If you look at other respiratory viruses, all the evidence suggests that it spreads more easily during winter as people spend more time indoors,” Professor Vally said. “There is also the suggestion that the virus may like the cooler weather and may survive better and therefore it is transmitted more easily.”

However, Tony Cunningham, an infectious diseases physician at the Westmead Institute for Medical Research, said that while the cooler months increased the likelihood of people congregating indoors, which in turn elevated the risk of airborne spread, coronavirus outbreaks could happen at any time.

“I am more concerned about the new Delta strain and other emerging variants than I am about winter,” Professor Cunningham said.

“We need to get 80 per cent of the populace immunised in order to have an effect on spread. The next thing we need to be very wary of is the various strains escaping quarantine because we need to ensure that the strains that we’re dealing with are not able to evade our vaccines.”

A third of elderly Victorians and almost half of over-50s still have not been immunised against coronavirus, as tensions over vaccine supplies simmer between states and the federal government.

Professor Cunningham said he remained “very concerned” about older people who were yet to be immunised and strongly encouraged anyone over the age of 60 to be vaccinated as soon as they could.

He said older people must balance the rare risk of developing the rare complication called thrombosis (blood clots) with thrombocytopenia (low platelets) linked to the AstraZeneca vaccine against the “really rapidly rise in likelihood of death if you do get COVID over the age of 60”.

“We need to somehow get the important message across to people who are more sceptical and more scared of the very rare side effects that this is a real issue,” the virologist said.

“There’s no point getting immunised after you’ve been infected with the virus and become ill or even the week before there is an outbreak in your neighbourhood. You need to have enough time to develop immunity and so I think the public really needs to plan for the next outbreak now.”

He said people over the age of 60 who are infected with coronavirus face a 10 percent chance of dying, a figure that rises to between 15 per cent and 20 percent for over-80s.

According to the latest Therapeutic Goods Administration data, 60 people in Australia have developed the rare, but potentially fatal, clotting disorder, out of more than 3.8 million AstraZeneca doses administered. Of those cases, two women have died.

The guidance changed due to “a higher risk and observed severity” of the blood clot syndrome in 50- to 59-year-olds than reported internationally and initially estimated in Australia, ATAGI said in a statement last week.

From early April to June 16, 60 cases of confirmed or probable blood clots have been reported in Australia, including seven in the past week in that were in people aged 50 to 59.

The rate of clots for that age group has risen to 2.7 per 100,000 AstraZeneca vaccine doses – very close to the risk for those under 50 (3.1 per 100,000) and almost double the risk for those aged between 60 and 69 (1.4 per 100,000).

A spokesperson for federal Health Minister Greg Hunt revealed on Monday night Victoria’s allocation of the Pfizer vaccine is set to jump by almost 40 per cent next month.

Victoria’s allocation of Pfizer would increase from 407,000 doses in June to more than 560,000 in July. But that emergency increase in supply is expected to end in July, Mr Merlino said.

“We want to see a sense of urgency,” Mr Merlino said, adding there will be a “mad rush” for the Pfizer vaccine at the end of the year.

Meanwhile, Victoria’s Chief Health Officer Brett Sutton revealed there were still tens of thousands of Pfizer vaccine recipients across the state who are due for their second dose, but are yet to book it in.

“Last week we had 50,000 people hit the three-week mark for their second dose, and 30,000 people booked,” Professor Sutton said.

“This week, we’ve got about 95,000 first dose Pfizer recipients who will be hitting the three-week mark, and around 50,000 bookings in the system as of yesterday.”

He said the first dose of the Pfizer vaccine offered recipients between 60 and 70 per cent protection, but the second shot “finishes the job,” providing upwards of 95 per cent protection from severe illness and death.

It is recommended that second doses of the Pfizer vaccine are administered between three and six weeks after the first dose.

Last week, ATGAI revealed a number of mitigation strategies to increase vaccination uptake in Australia were being actively considered by the expert panel.

This included the possibility of widely distributing first doses of the Pfizer vaccine and delaying the second dose, a strategy that had been used overseas, including in Britain, to quicken the pace of providing partial protection and immunity.

However, University of Melbourne vaccine expert Fiona Russell said Australia was not in a similar situation to Britain, which was trying to divert a disastrous third wave when it began fast-tracking first doses. She believed focusing on fully immunising people should remain the priority for now.

“We are in a different situation because we don’t really have any community transmission at the moment, so we don’t have to really make those difficult decisions yet,” she said. “But, of course, this could change if there was a major outbreak situation.“

A federal government spokesman said Victoria’s supply of Pfizer continues to increase from a base of 71,000 each week in June to 83,000 each week in July, as well as an additional 150,000 Pfizer doses that the Commonwealth will distribute to Victoria in June.

“Victoria’s supply is also supplemented by almost 200,000 Pfizer doses that will be rolled out to GPs in Victoria in July,” he said.

The government will on Wednesday announce a further easing of restrictions, taking Victoria to settings mirroring those in regional Victoria. Hospitality venues will move to a looser one-per-four-square-metre density limit and a probable cap of about 300 people.

People will be able to gather outdoors in numbers greater than 20 and companies will be allowed to operate with 75 per cent of their workforce in the office.

The government will finalise the plans on Wednesday morning and detail the easing of public health rules at a press conference on the same day, government sources confirmed.

The government is weighing up how many fans it will allow in stadiums, with the A-League grand final and a Saturday night blockbuster between Essendon and Melbourne to be hosted in Melbourne over the weekend. Crowd caps may differ depending on the capacity of the stadium.

The ministers will also assess advice from Professor Sutton on whether to allow more than two people to visit another household. Professor Sutton said on Tuesday he expected “good news” for those wanting to host weddings this weekend.

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