Good advice only good when taken

By Megan Brodie 3 years ago | In Comment, Vaccines
  • 3 years ago

26 May 2021

When it comes to vaccines, it seems Aussies are just as informed about Covid jabs as a vaccinologist. We are all critics, capable of assessing adverse events, efficacy, even the manufacturing processes for different types of vaccines, many of us happily espousing the benefits of one over another, or talking with authority about the respective risks.

This high level of health literacy surrounding COVID-19 vaccines is both a blessing and a curse, as the Federal Government is finding.

Having a community highly versed in the benefits of vaccines, and desperately waiting for them to come through clinical trial development phases, was a blessing last year. Now that so many are here, offering different benefits and risks for different age brackets, society is almost struck by the curse of indecision.

Our overwhelmed and overstimulated brains were already struggling to decide on the best smartphone, television or even streaming service to watch, and now we have to make a decision on which Covid vaccine is best. For many of us, the decision to do nothing seems the easiest answer.

This national dilemma has not been helped by some mixed messages from the top.

Last year, Health Minister Greg Hunt continually referred to the advice of “the experts” for government decision making but with Labor putting increasing pressure on the Government over the vaccine rollout, Hunt has veered away from this comfortable path and found himself bush-bashing along a bumpy sidetrack, flicking between messages of ‘get a vaccine as soon as you can’ to ‘if you wait, you will get whichever one you want’.

The Australian Technical Advisory Group on Immunisation (ATAGI) is the panel of vaccine experts that has guided Australia’s vaccine options over the past year. It traditionally meets six times a year to advise the Minister on the National Immunisation Program (NIP) and other related issues but has met as needed throughout Covid.

It was ATAGI that decided only Australians 50 years and older should get the AstraZeneca vaccine, so what of ATAGI’s advice in other areas? Has the Government been as committed to following its advice in the past as it has throughout Covid?

In November 2018, the PBAC considered ATAGI’s advice in regard to GSK’s shingles vaccine SHINGRIX. At that time, the ‘experts’ supported the efficacy of the vaccine based on immunogenicity data, yet the vaccine was rejected due to cost, leaving Australians with a cheaper, older and less effective option in ZOSTERVAX. This is just one example of a safe and effective vaccine being offered to Australia but being rejected due to price.

The NIP is tipped in the Budget to stay at the same level over the next four years, meaning in real terms Australia expects to spend less on non-Covid vaccines in the future than it does today despite other innovative vaccines coming through the pipeline.

So why were we prepared to pay whatever it took for multiple options in Covid (enough to vaccinate the population four times over) yet not prepared to pay for effective vaccines to protect against other viruses? Would Australians have been satisfied with a cheaper Covid vaccine that offered around half the efficacy of another vaccine, or would the Government have ignored the advice of its ‘experts’ and chosen its Covid vaccines purely on price rather than safety and efficacy?

It seems while the advice of the experts is important in a pandemic, it is less so in everyday life. Good advice is only good when it is taken.

When it came to Covid vaccines, the Government threw out its standard vaccine rulebook. Covid vaccines did not have to go through the PBAC. They did not have to go through the same rigorous appraisal that has resulted in so few new vaccines being recommended and reimbursed on the NIP, and yet Australians know more about mRNA vaccines than the flu shots they annually get injected with.

Shingrix returns to Australia this year. It won’t be listed on the NIP. It will only be available on private script, most likely costing several hundred dollars. I will be queuing up for my vaccine and I’m telling everyone I know to do the same.

I’m also happily receiving the AstraZeneca vaccine, just as I received my Seqirus flu shot last week.

Vaccines save lives. All vaccines, not just Covid vaccines.

The main difference between Covid and non-Covid vaccines in Australia is that while the Covid ones were given a free pass, purchased in bulk by the Government enabling some companies to make billions in profit from their sale, the other had to pass through the needle eye of the PBAC’s rigorous appraisal system not designed to properly value these important health measures.

If anything comes out of Covid, let’s hope it is that we learn to truly value our vaccines and that our heightened awareness about their safety and efficacy converts into a societal push for the Government to value all vaccines based on their true value, not just their price tag.

Leave a Reply