AstraZeneca creator says Australias mixed messages on vaccine may cost lives

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London: The scientist who created the AstraZeneca vaccine fears mixed messaging in Australia over who should take the jab may cost lives, and says wealthy nations have a moral duty to not prioritise children for vaccination.

Dame Sarah Gilbert, who was given a standing ovation at Wimbledon for her role as co-architect of the vaccine, weighed in to the intensifying debate in Australia over whether the wider use of AstraZeneca could have shortened or even prevented lockdowns in Sydney and Melbourne.

Professor Dame Sarah Gilbert says public health messaging needs to be clear.Credit:John Cairns

Professor Greg Dore, an infectious diseases expert with Sydney’s Kirby Institute, this week said Australia would look back at “anti-AstraZenecism” as one of the greatest public health failings in many years.

Asked whether she agreed with that view, Gilbert said in an interview: “I think we need to look back on that in time to come and see where Australia gets to.

“If it’s now possible to accelerate vaccination in Australia and save lives by getting people vaccinated quickly, then it won’t be the greatest public health disaster that the country’s ever seen.

“But the concern is that if people have received the wrong message and are just too worried about going to get the vaccine now, that could really have very long term effects and we could see a lot of lives lost because of it.”

AstraZeneca was to be the backbone of Australia’s vaccination program but faith in the jab was damaged by medical advice recommending against its use among under 60s due the risk of an exceptionally rare blood clotting condition.

Prime Minister Scott Morrison has urged any adult who wants the vaccine regardless of their age to get it after consulting a GP.

Asked whether it was a mistake to withhold AstraZeneca from under 60s earlier this year when transmission was low, Gilbert said: “Well, that’s something obviously much easier to comment on in hindsight.

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“But I think the problem is the messaging around the vaccination, because if you’re telling people at some stage, ‘oh you shouldn’t have this vaccine, it’s probably not the best thing for you’ and then you want to change that message and say ‘oh, no we’ve changed our mind, it is good’, I think that makes it difficult for people who are considering whether to get vaccinated and when to get vaccinated.

“Public health messaging needs to be really clear and when it changes, it can be difficult for people to deal with and have effects that were not intended and that may be what’s happened in Australia.

Royals and spectators stand for Sarah Gilbert, seated at bottom right, at Wimbledon’s Centre Court. Credit:Getty

“A few years ago, in the UK, we had this kind of pushback against experts. Nobody [apparently] wants to hear from experts anymore. Well, I don’t think that’s necessarily true.

“But I think people don’t want the sound bites where one expert says one thing and then another expert says another thing, and nobody understands what any of it means.”

The Australian Technical Advisory Group on Immunisation has made three key changes to its position on the best use of the AstraZeneca vaccine, first recommending that Pfizer was preferred for those under 50, and then those under 60.

Last week, as the Delta outbreak in Sydney grew, the expert group said any adult in the city should “strongly consider getting vaccinated with any available vaccine”. But their position remained unchanged for the rest of the country.

“We have emphasised that our advice is specific to the context, which obviously has changed significantly since April and was very different to that in the UK,” ATAGI co-chair Professor Alan Cheng said on Friday afternoon in response to Gilbert’s remarks.

“We have been in constant communication with our colleagues in the UK, who made similar recommendations specific to their context.”

UK health authorities also recommended that an alternative vaccine be used for people under 40, as its Joint Committee on Vaccination and Immunisation similarly changed its advice.

Margie Danchin, a Murdoch Children’s Research Institute vaccine uptake expert and non-voting member of ATAGI, said Gilbert was expressing “understandable frustration” with the public messaging on vaccines.

“But the critical element that’s been missed is that medical advice and the ATAGI advice has to be subject to change depending on what’s happening during the pandemic. And that is where potentially we’ve failed in the public messaging,” Associate Professor Danchin said.

“Unfortunately this situation has been made unbelievably difficult by supply constraints. If we had a free supply of an alternative, this decision making would not be so difficult and so subject to change.

“But at the moment AstraZeneca is the main vaccine we’ve got, and when the threat of severe disease increases then of course the advice is going to change to try protect people from getting really sick.”

Gilbert and her University of Oxford colleague Catherine Green developed the AstraZeneca vaccine in record time last year and have written a book to explain their endeavour and the science behind it.

The vaccine is being produced at cost for the duration of the pandemic under Oxford’s agreement with pharmaceutical giant AstraZeneca.

Oxford and AstraZeneca announced on Thursday local-time that one billion doses had now been released to 170 countries.

Gilbert, who was made a dame in June for her work, said she understood countries with low transmission had to consider the risk of rare vaccine side-effects but welcomed renewed debate in Australia over whether it should be made more widely available.

“If you have an increasing risk of COVID infections in Australia, with the Delta variant that is so transmissible, then I think it’s right to re-evaluate the recommendations for use of the AstraZeneca vaccine,” she said.

“We also now have more information about how to deal with these rare adverse events when they do occur, like how to give people warnings and then to treat people when these events do happen. So I think that situation has changed as well.”

She also said people who took part in weekend protests needed to know vaccines were the way out: “I can fully understand people not wanting to be in a lockdown - nobody wants to be locked down. But the way to avoid lockdowns for the long-term is to get the vaccination rates high.”

Sir Andrew Pollard, the director of the Oxford Vaccine Group and chief investigator of its clinical trials, said explaining the concept of risk had been a serious failure during the pandemic.

“It’s much more dangerous this summer to be out on the roads driving your car in the UK than it ever was of getting a clot,” he said.

“Most people are not too worried about going on our staycations here in the UK but people are worried about vaccination.

“You mentioned Australia. [Well] across Europe this has been an absolute nightmare with changing of age recommendations over the course of the past six months that’s really left some people without vaccine when they could have been vaccinated...and that’s a huge risk to our populations around the world if we get that wrong.”

Gilbert also used the interview to restate her personal view that children should not be vaccinated in wealthy countries ahead of at-risk adults in developing nations.

“For me, when we still do not have enough vaccines to supply the whole world, the priority is getting to those health care workers - particularly in other parts of the world that don’t have access to vaccines yet that are constantly at risk,” she said.

“That doesn’t mean to say that we shouldn’t ever vaccinate children. But I think the top priority is to get vaccines out to other parts of the world where only 1 per cent of the population so far is vaccinated.”

National cabinet will meet on Friday to discuss Australia’s latest COVID-19 outbreak.

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Bevan Shields is the Europe correspondent for The Sydney Morning Herald and The Age.

Aisha Dow is health editor with The Age and a former city reporter.

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