Oxford, Russian, homegrown: regardless of the vaccine, Australia ‘needs a distribution plan’

The Australian Medical Association (AMA) wants Australia to quickly develop a national plan to distribute COVID-19 vaccination.

AMA president Dr Omar Khorshid said it was pleasing to see that efforts of the medical and scientific community to fast track a safe and effective vaccine were going well and that the Government has a plan to make a vaccine available to all Australians but he added: “The greatest challenge is likely to be accessing enough doses of an approved vaccine and we expect that it will take some time to provide enough vaccine for the whole population.”

The AMA said Australia needs to develop a plan for a Therapeutics Goods Administration endorsed vaccine to be distributed to at risk groups first, particularly older adults and those with health conditions leaving them at increased risk.

“After vulnerable groups have been provided with the vaccine, it should then be rolled out to other groups. All frontline health care workers should be allowed early access to an approved vaccine.”

Khorshid said he’d be one of the first to roll up his own sleeve to receive a dose. He added he’s not likely to be the only one ready and willing as Australians know “it’s the only to get back to the lives we led before COVID-19”.

“There are of course implementation issues yet to be tackled about how to distribute a vaccine to those who need it,” he added.

“We know there are often distribution problems in getting the influenza vaccination distributed on time and to those who need it first.

“To ensure Australia is ready and able to get a vaccination out, be it the Oxford vaccination or any other vaccine approved for use by Australian authorities, we need a national COVID-19 vaccine distribution plan.”

Last week, the Federal Government inked a deal to produce the Oxford-AstraZeneca vaccine locally, should trials succeed.

Prime Minister Scott Morrison said he is "hopeful but also naturally cautious" that it will be safe and effective.

"We are not putting everything in the AstraZeneca basket but it is one of the most advanced and the most likely, based on the expert advice we have," Morrison said.

If it proves successful, the government would manufacture it and provide it to Australians for free.

Writing for The Conversation, Professor Katie Louise Flanagan, an infectious diseases specialist at the University of Tasmania, and Magdalena Plebanski, a Professor of Immunology at RMIT University, reminded Australians that the Oxford vaccine hasn't completed phase 3 trials, “so we can't be sure it will be safe and effective for all”.

“All the signs are promising so far, as the vaccine has been shown to provoke an immune response in humans and hasn’t yet caused serious side effects,” the pair wrote. “But there’s a risk the vaccine may not fully protect against COVID-19 in humans.

“It still needs to pass through phase 3 trials, which are currently recruiting and expecting results at the end of the year. So we can’t get too excited yet.”

The virus has mostly been tested on young, health individuals, the experts added. “It may still produce serious side effects we don’t yet know about.”

Currently, there are more than 160 candidate vaccines in development, dozens of which have entered human clinical trials, including Russia’s ‘Sputnik V’ vaccine, which was controversially granted regulatory approval after less than two months of human testing.

In a separate Conversation article, University of Sydney Associate professor Adam Kamradt-Scott, a global health security scholar and former RN, said even if the Oxford or Russian candidate and others are proven to be safe and effective, developing the vaccine is just the first step. “Some of the biggest challenges in getting everyone vaccinated still lie ahead.”

Kamradt-Scott said initial supplies are going to be extremely limited.

“The first major challenge after a vaccine is developed is to produce enough of it to start vaccination programs.

“It has been estimated that to achieve sufficient levels of immunity among the global population with a two-dose vaccine, we would need between 12 billion and 15 billion doses – roughly twice the world’s current total vaccine manufacturing capacity.

“Shifting to exclusively manufacture a COVID-19 vaccine will also mean shortages of other vaccines such as those for preventable childhood diseases such as measles, mumps and rubella. So prioritising COVID-19 could cost many other lives.”

He added that without substantial investment to strengthen international and national supply chains, it will be years before vaccines reach everyone who needs them.

Kamdadt-Scott predicted a long wait before the world is vaccinated and the borders are open as before.

If they become available sooner than expected it will “only be because countries have agreed to work together like never before”.

“Let’s hope they can do it.”