Good afternoon everybody. I’m joined by Professor John Skerritt, head of the Therapeutic Goods Administration.
Very briefly, we want to give an update on a number of elements today, cases and significantly and sadly the loss of one life, an elderly 80 year old gentleman from Queensland to COVID, who had been in hotel quarantine and had likely acquired the condition overseas but was treated in Queensland and sadly, was the first case that Australia has had of an active life with COVID lost since the 19th of October 2020. In late December, there was a historic case that was identified.
So very briefly, there are zero cases of immunity transmission in Australia today and over 623,000 worldwide, and there’ve been 8530 lives have been lost but sadly, one of those lives lost, as I say, is an Australian life.
The details that we have – and Queensland Health will provide, consistent with the wishes of the family – is that this case was an Australian citizen who had returned from overseas, an 80-year-old male, tested positive on day five in hotel quarantine and was transferred to the Prince Charles Hospital on the 25th of March.
And as the case was diagnosed in Australia, it is appropriately recorded as an Australian life lost, making that the 910th life lost in Australia.
And whilst globally now, we see that we are approaching 3 million lives lost, each life lost is to be mourned. Each life lost is a reminder of the global challenge where an average of over 500,000 cases a day this year across the world, with 63 days of no cases here, reminds us of the extraordinary difference between Australia and overseas.
But it also reminds us that there is a global pandemic which continues to rage around the world, with cases having increased significantly in the last month after having reduced significantly since mid-January. This disease finds a way of coming back.
Against that background, I would note in particular that Professor Skerritt is here and he’ll address a second case which we believe has now been confirmed of thrombosis potentially linked with the AstraZeneca vaccine and I’ll let the professor deal with that in a moment.
In terms of vaccines, there have been 56,379 vaccines in the last 24 hours, given that some state programs have been paused or varied. We are particularly pleased about that. That makes a national total of 1,234,681 vaccines administered and 577,000 approximately through the states, with 16,000 in the last 24 hours, and 656,000 through the Commonwealth, with 40,000 delivered across primary care and aged care in the last 24 hours.
The aged care doses, we now have 1152 facilities that have had first doses and another 555 that have had second doses.
The other thing that I want to mention is that work is continuing very strongly with the states and with the primary care sector with regards to updating plans following the advice of the Therapeutic Goods Administration and the Australian Technical Advisory Group on Immunisation.
What continues? The vaccination program for the over 50s. That remains, as we know, as vital as ever. Vaccinations save lives. Vaccinations protect lives. Vaccinations are a fundamental part of the capacity for each individual to protect themselves but also to play their part in protecting everyone else in Australia, and today's news just simply reinforces that.
In terms of the work with the states and the Government's response to the advice of the Australian Technical Advisory Group on Immunisation, obviously we’re working now with regards to the under 50s and variations that we flagged last Friday.
That includes, of course, in particular, the immediate acquisition of an additional 20 million Pfizer vaccines. I met last Thursday evening with the health ministers. I will be meeting with health ministers tomorrow.
And in the meantime, we’ve already held one workshop with states and territories last week and there is a meeting today of the vaccine principles committee between Commonwealth and states. Tomorrow, the vaccine senior officials are meeting and then on Thursday health CEOs.
So all of that is about making sure we are preparing options for under 50s. So, the plan is clear but in that respect, it’s also being addressed and updated to deal with the particular needs of the under 50s.
But for the central part of phase 1B, which is the over 70s and 80s, and for the central part of Phase 2A, the over 50s and 60s, that remains, at its core, continuing in that same manner and process.
And at the same time, we’re working with the states on making sure that the plan is adapted to deal with the medical advice, as we’ve always done, for the under 50s.
I think, John, if I may turn to you with regards to the possible case and any other medical update.
Thanks, Minister. So I’ll talk to two things. So last night, our Vaccine Safety Investigation Group, which is an external group of experts including blood clotting experts, met to look at a second possible case of this rare condition of thrombosis with thrombocytopenia, and it confirmed that this case which occurred in a woman in her 40s, vaccinated in Western Australia, did fit the criteria.
So, we have a second confirmed case. The good news is – and I want to avoid getting into too much detail because of personal privacy issues – she is in a stable condition and the outlook looks pretty good.
So the committee looked at the case, all the information on the case. It was one that took a while to sort out because some of the initial imaging was a bit ambiguous and some of the blood tests were redone to confirm results.
But it did confirm that we have a second case of this syndrome which we call thrombosis clotting with thrombocytopenia, which is a shortage, a very low level of platelets, and that’s what unusual about this condition.
Now, just to put this in perspective, of the, I think it is, Minister, over 1.2 million now.
Doses of vaccine, 700,000 or more have been have been AstraZeneca. That means that two out of 700,000 is one in 350,000. And when you look at the British data which quoted about one in 250,000, we’re down, and that’s an extremely remote and unlikely event.
It’s a very rare finding. As I’ve said before, your chances of winning Lotto are much, much, much, much higher. But it does encourage, and we are saying to doctors and hospitals and so forth, if you have any suspicious cases, report them to us. We have a team of doctors and other specialists who will look into it.
Again, the Minister has emphasised the importance of vaccinating groups over 50 and the ATAGI advice. And just to put that advice in perspective, the sad announcement of a 910th death in Australia, the first one confirmed this calendar year even though we’re into mid-April.
Of those deaths, every single death except for five people were in people aged 50 and over, 99.5 per cent.
And that's why the importance of vaccination in that group is so important. Now, because of a respiratory condition, I happen to be in the group 1B group and I had my AstraZeneca vaccination last week, being aware of that risk, but I also knew I wasn’t going to win the Lotto last week. So I figured a one in 350,000 chance was a pretty good chance to take and I'm glad I did.
Just before I finish, one other thing which will provide a bit of greater flexibility is that after testing and submission of data to us, we have approved for the Pfizer vaccine to be able to be stored for up to two weeks in normal domestic freezer temperatures.
But it doesn't mean it can spend its whole time in Australia. It still requires that ultra-cold storage for the longer periods. But it does mean, that for example, a shipment could be made from Sydney to Broken Hill or other places like that at normal freezer temperatures.
Now, we also approved shorter periods of time but accept all periods of time at refrigerator temperatures. So while that vaccine does have particular storage requirements, the good news is that we have more flexibility than we thought we had with how it can be stored and transported.
I will start in the front with David and work my way across.
A question about the woman with the blood clots. Did she have any conditions? Are there other conditions that leave you more vulnerable to that clot?
Again, I don’t want to talk about that individual woman’s case for privacy reasons. Her diagnosis was complicated a little bit by some other conditions.
Can you say what they are? I know there’s a privacy concerns, however, there’s also a public health interest here in having information available.
So again, if people have had a thing known as Heparin induced thrombocytopenia with thrombosis, having the vaccine is not recommended.
On the other hand, if you have thrombosis, and unfortunately DVT and other forms of clotting are extremely common, it's not overtly contraindicated.
So it's only if you've had a similar condition, which is also rare, related to an anticoagulant called heparin, that people are saying do not vaccinate those people.
So just on the individual case. It’s a matter for the family via NT Health to provide any details. We’ve released everything that we’re authorised to.
Thank you. So would the Government set clear reopening milestones such as the reopening of international borders against vaccine outcomes?
And does Australia risk falling behind economically considering other nations are more progressed in their rollout, and some have indicated that they plan on reopening by the middle of this year?
So firstly, with regards to the second question, absolutely not, with regards to falling behind others. Ours has been one of the standout health outcomes, globally, as well as being one of the standout economic outcomes.
And when you bring the two together, we have been rated repeatedly, I think, right at the top of the global situation and the economic updates, which obviously the Treasurer is better placed than I am to give, have consistently outperformed the budget expectations which had been laid out.
Then in terms of opening up. Opening up, as has been set out by the Prime Minister and the Chief Medical Officer, is based on a series of factors. Vaccination alone is no guarantee that you can open up. And this was a discussion that in fact I had with Professor Murphy in just the last 24 hours, that if the whole country were vaccinated, you couldn't just open the borders.
We still have to look at a series of different factors: transmission, longevity and the global impact. And those are factors which the world is learning about. But we are opening up internationally to New Zealand, within the coming days for two-way travel. We’re already opened to New Zealand.
We’re then looking at other countries within the Pacific and within the region that are potentially low-transmission environments, and therefore Australia can do that.
And as we've said, this year will be about progressively opening up. And that’s what the Prime Minister has tasked his Department to work on, with all of the states and territories. So a series of safety milestones as we progress forward, which allow us to open up.
Given this is the second case of this rare clotting disorder, and there’s been talks for a number of years about it, why doesn't Australia have a no-fault vaccine injury compensation scheme?
And secondly, separately, how many aged care and disability care workers have been vaccinated now?
Sure, sure. So firstly, in relation to the indemnities, I can't speak for the past. I apologise. I can say that we have done as part of our vaccine contracts is build in indemnities.
And so those indemnities against any side effects from the vaccines, I think, provide that equivalent protection to Australians, so I think that that’s extremely important.
But why did we decide to go for indemnities rather than a no-fault compensation scheme?
Well, what we went for, what we were able to do during the course the contracting, and that meant both the Government and the purpose of the vaccine partners. I think for those partners it was a very important part in many cases of their certainty. And in turn, that provides certainty for the Australian public, and in addition to that, for our medical work force.
With regards to aged care workers, this is one of the areas which we are now replanning. And so I’ll come back to you on the detail with that. This is, to be completely frank, we were right at that moment of expanding out with AstraZeneca, to a workforce which is, I believe, an average age of 46.
And so right now, we will redo that assessment, and that’s in fact what we’re meeting with the states and territories about. I spoke with Pat Sparrow, Patricia Sparrow, the head of one of the leading aged care organisations, ACSA, earlier today.
Thanks, Minister. Yesterday, or last night, the weekly COVID vaccination data was released following the decision at National Cabinet. It showed that the estimated dose utilisation by Commonwealth primary care was at 61 per cent.
What areas of the primary health system are we seeing this underutilisation in and why? And just secondly also on that data, I understand wastage was taken into consideration in some of that data. What level of wastage are we expecting in the rollout?
Sure. So there’s a standard international figure which is used, which is 10 per cent. And so that had been factored in as the standard. It's not a, it’s a figure which is going to continue to be verified as we go through the program, but that is a presumption which is common.
Are we seeing that already in Australia?
We think it may be lower, but we don't yet have sufficient reports back from all of the primary care and the states. What we are seeing is that we are getting higher rates where we have very clear line of sight of Pfizer doses per vial through the aged care centre than may have been presumed, so that is likely to be a higher figure, but we’ve taken a conservative estimate.
Then in terms of primary care, what that represents though is the fact that we've got very significant forward positioning of inventory within primary care, which we expect to be used, and therefore that rate to increase as we go forward.
So primary care represents the three areas: general practices, GP respiratory clinics or Commonwealth clinics, and Aboriginal community controlled health organisations.
Early this year, the Government said it started laying the groundwork for a transition towards the recording of cases in hospitals and intensive care as opposed to total number of cases in the community.
Is that still a transition that we will see this year in terms of how we approach recording of the coronavirus and how we approach its handling? Or is that unrealistic and we’re going to retain this zero cases total mentality?
Well, I think- two things. The public at this time understandably wants clarity. And I know that the states want to make sure that that’s available.
So it’s ultimately a decision that National Cabinet would make. I think it would need to be a common approach of the states and territories through their leaders, along with the Commonwealth. So that’s a possible path. And certainly, as we normalise on the disease, then that would become more likely.
Two questions. So Professor Skerritt, firstly, the new approvals for the Pfizer refrigeration that you mentioned, is that enough to counter any delay in the rollout that we might see, given the fact that only health workers in very remote parts of Australia, especially WA, can receive the Pfizer jab now?
And also, Minister Hunt, the COVID infected ship off Karratha, when did federal authorities know there were symptoms on board? Why was the public only told about it yesterday? And could that ship be forced to leave?
I apologise I don't have any details on that. We'll have to come back to you through Home Affairs.
On the shipments, it will again be up to the individual systems to work out how they distribute those vaccines. Now they have the extra flexibility, so that will be a decision not only for the aged care systems, but also for the state and territory systems.
What it can mean though is that shipments will be possible to places where they weren’t possible before. And the Government is working through the re-phasing, and I know it's an area that my colleagues have been working with the Minister and his team as recently as today.
I’ve also got one for each. But Professor Skerritt, could I please ask, how many other cases of thrombosis are under investigation that’s possibly linked to the AstraZeneca vaccine?
And for the Minister, it's been five days since the warning on the recommendation for under 50s was applied to AstraZeneca. Is there now data on the rates of cancellation by the patient and an increase in hesitancy as ATAGI said was very likely for all ages?
You go first, John.
On the first one, we don't have a case that looks like thrombosis with thrombocytopenia in front of us at the moment. We have reports and we’re encouraging people to report.
One of the things that happens when you have an issue like this - and we want people to err on the side of caution – is tell us if there’s any funny thing happening with clotting.
Now most of the time, sadly, it's just coincidental because clotting disorders are just so common. So we’ve got a very large number of reports of clotting but at least as of the time I left my office an hour ago, there weren’t any that looked highly suspicious.
Now, that could change in the next 10 minutes, we don't know. But we are encouraging as many doctors and as many clinics to report anything suspicious and we will do the detective work on them. But we don't have a third case sitting there in the sidelines ready to be looked at.
Sure. Now, in terms of changed behaviours, what we do know is that understandably people under 50 are following the medical advice, and accepting ATAGI's advice that did say preferred vaccine- preferred for people under 50 to have Pfizer.
And then after that, because the vaccinations are proceeding, and as I say with 56,000 in the last 24 hours, we had anticipated potentially a significant drop, that’s not what we have seen at this stage. But there will have been individuals and there will have been practices that will find some over 50, if they’re in the health worker or other groups that are available to get it as a 1A or a 1B.
And then over 70, I've had reports from some practices, a very, very high uptake, and some that have said that they’ve had some questions and a couple of hesitations. So that will come through at the practice level.
We look at the overall national data on the vaccinations and what we’ve been surprised at is the level and perhaps the point in all of this is, we know that our over 70s are most at risk and they know that they’re most at risk, and they want to keep being vaccinated.
I won’t be able to stay too long as I have a Cabinet committee so I’ll go Jonathon.
Minister, we heard some pretty emotive evidence from Christine Holgate, the former CEO of Australia Post this morning, who said she was humiliated when the Prime Minister stood up in the Parliament and said if she doesn't like it, she can go.
You were in Parliament on that day, was it humiliating? What do you make of Christine Holgate’s comments?
Look I apologise, I haven't heard directly Christine Holgate’s comments so it's probably not appropriate of me to speak that.
I will just say that if there are any emotional or other issues that any person suffers, we feel for them, no matter what the circumstances.
So my response would be one for anybody who has emotional or other forms of challenge. That's all that I know, that there were issues raised. So it's just support and care, without being in a position to comment not having heard the specific words.
Was the Prime Minister humiliating though, in his description of her in the Parliament?
Look, I haven’t heard her language. The Prime Minister's focus obviously was on ensuring that there was a process to assess integrity and that was integrity and appropriateness. So that was his focus.
Why isn’t the Federal Government purchasing doses of Johnson & Johnson vaccine? Are you looking at Moderna? And Professor, how close are you to approving Novavax, when could we expect that to come up online?
On Novavax, they still have to complete their trials but there are some very promising early results. They also have not only the clinical trials to complete but they have to establish large-scale manufacturing arrangements. So I think that we probably are still, sadly, a couple of months away, June, before we will get the Novavax data.
We talk to them regularly, I was talking with them yesterday and we’re talking with them in a big meeting on Thursday and we’re obviously trying to hurry them up. But clearly you can’t make things like clinical trials go faster.
Yeah, so that is consistent with, I think, the advice that I gave last week with regards to Novavax that subject to clinical trials, subject to regulatory approval, they are looking at a third-quarter commencement in Australia. All of these things have to be confirmed.
With regards to other vaccines, as we have done right throughout in purchasing 170 million vaccines for 25 million Australians, we’ve followed the advice of the scientific and technical advisory group which looks at the prospectivity of vaccines, looks at the effectiveness, and the safety and the reliability of supply. And they provided advice on five different contracts across four different vaccines and three different platforms.
And they are, obviously, as we know, the now 40 million Pfizer mRNA, the 53.8 million AstraZeneca which is an adenovirus or viral vector vaccine. J&J is another viral vector vaccine. And we have no advice recommending, at this point, that the Government purchase any additional viral vector vaccines.
That’s not a reflection, that’s just simply an observation and then obviously they provided the advice on the two different protein vaccines; the University of Queensland and also, of course, the Novavax vaccine.
And so we’ll continue to follow the advice and we’ve said if they recommend more but they recently recommended the purchase of an additional 20 million Pfizer which brings the total number of vaccines in Australia, or in Australia’s inventory to 170.
I’ll take one at the back. One there, one here and then I will have to go, David.
Just on WA, have you spoken to the health authorities or the Premier in WA about this blood clot? Is there any, have they spoken about potentially pausing their rollout as Victoria did for more training?
And secondly, do you ever envisage that Australia will be able to domestically produce any other vaccine but AstraZeneca, given that obviously it’s not preferred for people under 50? How does that affect our domestic manufacturing sphere? Do you hope one day we’ll produce something else?
I’m engaging with states and territories on this particular one. I’ll let John answer that.
So we’ve worked closely and, again, this is out in the media. The patient was actually admitted to Royal Darwin Hospital because often patients from the far north of WA are a lot closer to Darwin than they are to Perth. Everywhere is a lot closer than being to Perth.
So we’ve worked closely with both the Northern Territory and the West Australian authorities. I have not heard that the Western Australians are deciding on a pause but that will obviously be their decision. But they’ve been kept closely informed throughout.
Yeah. So we’ve been engaging but because it is a vaccine safety question with a patient issue it is being done through the officials. But we’ve already made this decision about under 50s. That’s the important thing.
That national decision was taken through ATAGI and endorsed by the TGA so that has already been taken and as everybody in this room would be aware, was announced in this room last Thursday evening.
Just quickly, why are Pfizer doses still being administered to people over 50? Should they be reserved for younger Australians to, you know, help out later on with the rollout? And how keen are you to strike the deal with Moderna?
On individual companies we have never speculated in the past, but what we do do is follow, and there’s a reason for this, follow the advice of what I think is probably the best regulatory and scientific set of advisors, or as good as anyone in the world.
And sometimes people say, gosh, we would like you to purchase this vaccine or that vaccine and my response is, our set of advice comes from the chief scientist, the head of the CSIRO, the Chief Medical Officer, the head of the Scientific and Technical Advisory Group, Professor Murphy. Where is yours coming?
And to follow that advice I think is the only option. Now that does not mean we don’t ask questions. We continuously look at that. But if they advise, we will procure and through that process we’ve procured over 170 million. Sorry you had one other element to that, I apologise.
Just on Pfizer, why are Pfizer doses still being administered to people over 50?
Well this is primarily within the residential aged care facility program and one of the critical things is that it’s a three-week turnaround. Our most vulnerable residents, the most vulnerable Australians are the oldest, and within that group the most vulnerable are the residential aged care facility residents.
Of these 910 cases, 685 who have passed, have been in residential aged care facilities. And so that rapid turnaround time of three weeks and, again, I legitimately asked this question myself just to reaffirm what we were doing, and the medical advice was crystal clear, that making sure those residents are vaccinated with a three-week turnaround time offers the maximum protection to the most vulnerable and frail Australians. A perfectly reasonable question.
I apologise, I actually do have a cabinet committee.
It’s a very, very quick question on supply.
Paul Kelly said yesterday we’re getting about 100,000 Pfizer doses per week. Obviously we need more than that. I wonder if you can update us on whether that’s going to be able to ramp up and in terms of what you think the numbers could get to?
And also is there any update on CSL's capacity and it’s supply at the moment?
Such a quick question, David. I will tell the Prime Minister who is waiting for me that Mr Crowe kept me waiting.
But firstly in terms of Pfizer we’ve received 1.172 million doses. Secondly in terms of Pfizer, the company has asked us not to foreshadow the increases in exact numbers but we are increasing from what we have had, that approximately 130,000 plus so far. That will increase over the course of April. It will then significantly increase again during the course of May.
It will then hold until the start of July and then we will have very significant numbers during the course of July, those three months. And then the same thing, an almost similar number during the last quarter.
The additional 20 million at this stage, are scheduled for the final quarter. That would mean a significant sprint for those that hadn’t been vaccinated by then. It means enough vaccines for everyone.
But that’s the timeframe at the moment and, again, I apologise for not providing the specifics. It’s just that that’s the request of the company on a global basis.
And so let me finish here. Today, of course, with the loss of life, reminds us of the challenge we’ve faced with the likely case which Professor Skerritt has advised reminds us of why, why the medical advice was received.
That medical advice means for the under 50s, we do have to do some replanning. That’s a challenge. But every day, every day in this pandemic we’ve had to follow and adapt. But we’ve done that.
And those global comparisons of now one case, sadly, of a life lost this year, in a world which has seen over 10,000 lives lost a day this year, reminds us of where we’re at in this country. So we’re going to keep fighting. But we’re going to vaccinate everyone who wants to be vaccinated.
Thank you very much.