Minister Butler press conference in Canberra - 3 August 2022

Read the transcript of Minister Butler's press conference on Moderna vaccines for children, public awareness campaign, COVID modelling, monkeypox vaccine, lung cancer screening, voluntary assisted dying bill.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MARK BUTLER, MINISTER FOR HEALTH AND AGED CARE: Hello everyone. Thanks for coming along. I want to provide an update on the COVID vaccine program as it applies to under 5-year olds.  

If you recall, I announced some time ago, on the 19th of July, that the Therapeutic Goods Administration had provided provisional approval or granted provisional approval to the Moderna pediatric vaccine for six month old to 5 year olds, some two weeks ago, and I indicated then as usual with these vaccines that that would then be considered by the Technical Advisory Group on Immunisation (ATAGI). I received advice from ATAGI yesterday which had been reviewed and cleared by the Chief Medical Officer who considered it overnight and today decided to accept that advice. We've published that advice in the last few minutes.  

ATAGI's advice essentially is to recommend the Moderna pediatric vaccine be administered to children aged six months, up to 5 years of age, but only to a restricted cohort of that age group. I'll step through what that cohort is, in broad terms, ATAGI's recommended vaccination for children in that age group who are severely immunocompromised, who have disability, or other relevant multiple or complex health conditions. I will just go to the ATAGI advice on that to give a bit of a sense of the cohort that ATAGI has considered. In particular, it recommends vaccination for children in this age group with severe primary or secondary immunodeficiency, including those who are undergoing treatment for cancer or who are on immunosuppressive treatments, which have been provided in previous advice. Young children of that age group who have received a bone marrow or stem cell transplant or who are receiving Cart-T therapy, children in this age group who have complex congenital cardiac disease, structural airway anomalies, or chronic lung disease, children in this age group who have been diagnosed with type one diabetes, or who have chronic neurological or neuromuscular conditions, and for children in this age group with a disability that requires frequent assistance with activities of daily living, such as severe Cerebral Palsy, or Down Syndrome. That advice will be published. You might recall that this was the same approach that ATAGI took in relation to its advice around 12 to 15 year olds, after the TGA approval of vaccines for that age group was considered. Sometime later, ATAGI broadened that advice to the entire age group between 12 and 15. 

ATAGI has not recommended vaccination for children under 5 years of age, who do not fit one of those three categories of immunocompromised, complex health conditions or disability. ATAGI's reasons for that is that these children aged under 5 have a very low likelihood of severe illness from COVID-19. They go on to say, given that this is a very new vaccine, only been rolled out very few countries so far, that this is under ongoing consideration based on the data of the disease burden and epidemiology, vaccine supply, emerging data on vaccine use in this age group and the availability of new vaccines for the age group as well. The recommendation for this group is that they'd be provided with two doses of the vaccine 8 weeks apart. And for these children who are immunocompromised, that they'd be given a third dose as well. Our estimate is this covers around 70,000 young children at the most around half of whom will require three doses or are recommended to have three doses, which adds to a total of around 175,000 doses in total.  

As I've indicated before, we started discussions very early on with Moderna after the first approval was given by the Food and Drug Administration, the FDA in the United States, to find a way to secure supply for Australian families and we have secured that supply. 250,000 doses of the Moderna pediatric vaccine for under 5 year olds are in the air right now and are expected to land in Australia later tonight. A further 250,000 doses are contracted to be delivered later in September. So just to reiterate, on ATAGI advice that I've accepted, we calculate a maximum of 175,000 doses being required for the cohort recommended for vaccination and 250,000 doses will be landing later tonight in Australia.  

Australia will be one of the first countries in the world to roll out a vaccination program for children aged under 5. Notably the United States and Canada have been rolling out their program for some weeks. Now there are some other countries in South America and Asia who also have a vaccination program for this age group. As of yet, no country in Europe or the United Kingdom are rolling out vaccines for that age group though. I also want to stress that the program won't commence until the 5th of September. There is still a number of logistical arrangements that need to be put in place. If the vaccines arrive tonight, they still need to be batch tested by the TGA which will take some time. We also need to finalise our arrangements with state and territory governments because these vaccines will largely be rolled out to this cohort through pediatric hospitals that are operated obviously by state and territory governments. The majority of the doses we've contracted for with Moderna will be distributed to state and territories. We're also putting together around 500 additional primary care, vaccine points for families. The department for the last couple of weeks has been running an expression of interest process for GP clinics who are keen to roll out vaccines to this new group, as well as making arrangements to supply vaccines to Aboriginal Community Controlled Health Organisations and to the Royal Flying Doctor Service that provides vaccine arrangements for rural and remote Australia. We think that the vast majority of the doses will be provided to state and territory governments but we want to finalise arrangements for alternative points of vaccination for families that are convenient. As well as all these arrangements, training needs to be provided to health practitioners and the use of these vials and distribution arrangements put in place.  

I want to stress to families there are not arrangements in place right now to book a vaccination. I'm asking families not to seek to book an appointment yet for a vaccination of your young child under 5. Information will be distributed over the course of the next couple of weeks about the way in which those booking arrangements can be made. And finally, in relation to this age group of under 5 year olds, the TGA has also announced today that it has commenced evaluation of the Pfizer vaccine for under 5 year olds. That will take obviously some time but in the event that the TGA provides a provisional approval of that vaccine as well which has already been approved in the US, then that would potentially provide an alternative or additional supply options for Australia in the event, although this is obviously up to ATAGI, in the event that in due course a broader recommendation is made for this age group.  

Before I take questions can I just take the opportunity to provide a bit of an update about where we are in relation to the vaccine program for over 5s. As a Government we’ve been particularly focused on getting through this third Omicron wave, in trying to protect vulnerable Australians who are at particular risk of severe illness from this very large wave that we're still going through across Australia.  

A few weeks ago we were able to successfully expand the eligibility for fourth doses for the COVID vaccine and that expansion has been enormously successful. Over 1.5 million Australians have received their fourth dose in the past three weeks. More than half a million in each of those weeks and we're now at a point where almost two thirds of over 65 who are particularly vulnerable to severe illness have already received their fourth dose.  

When we came to government, Anika Wells and I sought to re-energise the fourth dose vaccination program in aged care which was languishing behind the general population percentage. Only about 50 per cent of aged care residents at that time several weeks ago had received their fourth dose. We're now up to almost 80 per cent of aged care residents getting that vital extra protection from the fourth dose and although we haven't received the prescription numbers from last week yet, as soon as we were able to successfully to expand eligibility for the highly effective antiviral treatments as well, we saw an almost tripling of prescription rates which continued through the first couple of weeks again. Providing some incredibly important protection for older Australians in particular or younger Australians who are immunocompromised from the risk of severe illness which helps alleviate the pressure on our hospital systems.  

Lastly, can I say yesterday we started to roll out our third public health advertising campaign. The first one we put in place very quickly after coming to government, which was to reinforce the importance particularly of getting your third dose through this difficult winter which we know has been so difficult because of this third Omicron wave. After expanding eligibility for antivirals, we then rolled out an information campaign seeking to raise awareness in the community, particularly for older Australians about the availability of this highly effective treatment in the event that they test positive and the importance of making a plan if possible, with your GP so that you will be able to get a script filled very quickly in the event of a positive test. And yesterday, we launched a more general public information campaign, reminding Australians of the public health advice around good COVID safe behaviour. The most important of which right now is to wear a mask. Wear a mask indoors, where you cannot socially distance and this is an incredibly important and pretty simple way in which to reduce transmission of this highly infectious variant that is now sweeping through Australia. I really do hope that Australians listen to the public health advice that's been provided by all Chief Health Officers and by the Federal Chief Medical Officer. Good levels of mask wearing as well as the usual behaviours around hand hygiene socially distancing, can reduce transmission, can prevent high numbers of severe disease and can alleviate pressures on our public hospital system. Thanks for that. I'll take questions. 

JOURNALIST: The Prime Minister said about three weeks ago that the government was going to release the modelling for the Omicron waves and still hasn't been released. So we're just wondering whether the government is going to release it and when? 

BUTLER: We want to make sure that there are different pieces of modelling that have been commissioned by different governments including the Federal Government. We're in good discussions with the state and territories to make sure that the release of modelling is done by all jurisdictions in a coordinated way. We don't want to see an uncoordinated release of modelling that potentially contradicts modelling released by other jurisdictions. So, we'll have more to say about that in due course. 

JOURNALIST: In the last week, I think nationally COVID cases, there was a day with 50,000 and today's 30,000. Numbers are bouncing around a little bit, but are you sort of confident that we're on the crest of this wave or are there any predictions you have for the next few weeks?  

BUTLER: The advice that I've gotten and I've seen this reflected in some of the commentary from the States as well is that we're hopeful that we've seen an earlier peak than was predicted a little while ago, but we're also conscious that there has through the course of this pandemic been a bit of a school holiday effect where transmission does dip because of the different types of activities through school holidays, which have only just completed. I think generally health authorities are really just holding their nerve and waiting to see whether this reduction in case numbers and also a bit of a reduction in hospitalisation numbers. We're still at 5,000 hospital beds filled with Australians with COVID, which is about one in 12 public hospital beds but it's down from the peak we saw about 5,400. We're not willing to call it yet, I don't think is the general proposition, but we're very hopeful this might have peaked a little earlier.. 

JOURNALIST: Of the 5,000 people in hospital, how many are children? 

BUTLER: I don't have that number. We've seen around 60 per cent of hospitalisations for Influenza have been children. It's just reminding us of the importance of vaccination for particularly young children. Our hospitalisation rates for young children with COVID is a very, very small percentage. Very, very small percentage. I'm sorry, I don't have that number. It changes every day, but it is a very small percentage. As I said, particularly for under 5s, the ATAGI advice is that the risk for under 5s broadly, of severe diseases is very slim, from COVID. Unless you have a young child and one of those three categories I've outlined. 

JOURNALIST: You mentioned previously that this new Moderna vaccine for kids there was an incredibly, incredibly short supply globally. Are you able to provide a ballpark figure of what it cost taxpayers to buy 500,000 doses? 

BUTLER: Those are commercial arrangements. I think the market is developing quickly as we've seen this vaccine be approved, particularly in North America, a very big market and been considered by the European authorities as well. Our advice early on was that the market was very constrained but this is changing quite quickly. We have been able to secure as I said, 500,000 doses, 250,000 of which will land tonight and more than cover the cohort that has been recommended for vaccination by target so far. 

JOURNALIST: Is there any modelling or any indication of how many children within that 70,000 cohort will be taking up the vaccine given that for other cohorts of children for instance, it hasn't been 100 per cent for example. And did ATAGI also give any indication thresholds about what the situation would be if the vaccine rollout for six month olds, 5 year olds will be expanded out more broadly to every child in that cohort? 

BUTLER: To your last point, as I read out, ATAGI has said it will continue to monitor developments overseas and points particularly to the fact that two big markets, the United States and Canada are rolling out this vaccine to a broad number of under 5 year olds, so there will be increasing pieces of data to analyse about this and they're going to continue to monitor that. I can't really say any more than that at this stage. Sorry, I forgot the first question. 

JOURNALIST: Is there any modelling? 

BUTLER: We know we have a very high vaccination uptake for under 5 year olds. Some of the world's best uptake of the general vaccine programs for under 5 year olds. And in particular, given that there's quite a limited cohort here of children who are particularly vulnerable to severe illness, we're confident that there will be a reasonable uptake but this obviously is a matter for parents to decide. And I encourage them if they have any questions to consult with their treating medical practitioners. 

JOURNALIST: Actually, almost half of 5 to 11 year olds haven't had one a single dose in the COVID vaccine. And the hesitancy is even more pronounced among parents of children who have a disability. Disability advocates have raised concerns in some cases, children require sedation to be able to access the vaccine. What's your message to those parents and to our health providers to make sure that these children are vaccinated? 

BUTLER: You are right. The rates for 5 to 11 year old vaccinations have really been quite flat for a while. Only about 40 per cent of that age cohort have received two doses and only a little more than 50 per cent have received their first dose only. There is more work to do there. In relation to parents of children with a disability we've seen through this pandemic that extra care and attention needs to be provided to children and adults frankly, for people with living with a disability, about making them feel comfortable and receptive to the vaccination programs. I'm not going to put myself into the shoes of those clinicians, those service providers and particularly those parents. This is obviously advice from ATAGI that reflects the vulnerability to severe illness of this age cohort. It's advice provided to parents in the interest of the health of their children. In the vast majority of cases of this age cohort, they would be in pretty regular contact with health providers. I'd encourage parents with any questions about this, to have a conversation with their treating health practitioners 

JOURNALIST: Could I get an update on efforts to buy third generation MVA and monkey pox vaccines in terms of how soon we will get those and are we on track to get enough for the at risk populations? 

BUTLER: Thank you for that question. We've been working very hard with peak providers in this area, particularly groups like a FAO, the Federation of AIDS Organisations. But the clinicians in this area and many others who have a particular interest in the Monkeypox outbreak across the world. Chief Health Officers have been in regular discussion about our response to that and we've been considering the recommendations from the World Health Organization which provided almost two weeks ago, obviously, I've announced previously that we're in discussions to try to secure a pretty hotly contested supplies of the third generation vaccine which can be used pre exposure or post exposure, and it's certainly a much more moderate vaccine and the second generation vaccine of which we do have substantial supplies now and it's particularly useful for patients who have compromised immunity for example, potentially HIV. So we've been working very hard on both of those in close dialogue with the peaks. And I'll have more to say about that in the next 24 hours. 

JOURNALIST: In terms of the logistics of this rollout as you mentioned pediatric hospitals. And we have seen through the life of this pandemic difficulties in accessing vaccines at times in regional or rural areas. In a state like Queensland, the pediatric hospital is based in Brisbane. What are you planning to do to ensure that even in the regions and in remote areas children are able to access that vaccine? 

BUTLER: Thank you. We're very conscious of that. In the major cities, families will have access to a local pediatric hospital which they might have a pretty close relationship with, but outside of the major cities, we have been conscious of the need to put in place several 100 other vaccine points. So as I indicated, we've had an expression of interest out for some time now through the department for primary care points, particularly GP clinics who have an interest in providing this service. We've also rolled out arrangements with the Royal Flying Doctors service and with ACCHOs. Aboriginal Community Controlled Health Organisations who have been doing a terrific job running vaccination programs for the communities that they serve as well. And we're confident that across the state and territory systems and those 500 Primary Care points as well as the RFDS we're going to be able to support regional, rural and regional Australia as well. 

JOURNALIST: Do you welcome the fact that the Territories' ban on assisted dying looks like it’s in its dying day. Pardon me for that expression. Is it appropriate that there's equal access to assisted dying around the country with some of the concern about euthanasia in Australia, overblown? 

BUTLER: I've said that I thought the Andrews legislation for many years ago was overreach by this parliament. I have a strong view that citizens of the two territories have the same right to have their representatives consider legislation around voluntary assisted dying as those citizens who live in one of the six states. I think whatever your views about euthanasia or voluntary assisted dying, I think that was overreach by this parliament and an abrogation of the rights of citizens in the Northern Territory in the ACT. I'm very pleased that legislation passed today. And now the ACT and the Northern Territory assemblies if they wish are free to consider some of the legislative reforms that we've seen sweep the country really over the last several years. It's been extraordinary how quickly all of the state parliaments have considered and then passed voluntary assisted dying legislation over the past several years, and I welcome the democratic opportunity now that the people and the representatives in the Northern Territory and ACT assemblies have to do the same.  

JOURNALIST: Minister, it has been shown from the lung cancer foundation, they have been in Parliament today, to point to the fact that lung cancer is the biggest killer of Australians among other cancers that are highlighted in your report, which calls for a national screening program to be included in the upcoming budget as well as 100 specialist nurses. Is that something your government would give consideration to? 

BUTLER: I really welcome the opportunity to talk to patients with the Lung Foundation today and I've had discussions with them before today, obviously. Lung cancer screening is a really exciting opportunity to build on our really proud record of cancer screening in cervical cancer, breast cancer and bowel cancer as well. We know that those screening programs pick up cancers much earlier and not only change lives, but save lives as well. And there's been a proposal that Cancer Australia has been very heavily involved in before the Medicare Services Advisory Council, which is the advisory council that provides recommendations to government about what can be listed on the MBS. I know that that at their most recent meeting, they considered the Cancer Australia proposal for a lung cancer screening program again, and I'm told that that I should expect advice in late September, early October about that. This is a relatively new area of screening. And I've been watching closely and talking with the foundation in Cancer Australia about developments overseas in this. We know that if an effective screening program were put in place, it has the potential to save thousands of lives. And so this is a really exciting area of potential development. I'm keen to continue discussions with the Foundation but I don't yet have advice before me about the outcome of their deliberations. 

JOURNALIST: (inaudible) - Extended the shelf life of some of the COVID antivirals. How many doses did that apply to and is there still a risk that some of those might not be used? They might be wasted. 

BUTLER: I don't have those numbers off the top of my head. We were very keen to make sure that we would get the best possible use out of the supplies that were ordered by the former government. As I think I've said we had about 1.3 million doses. I think we've only haven't got last week's figures yet but before last week we'd only had about 150,000 of those 1.3 million distributed and administered so there's still plenty in out the warehouses ready to go out and prevent severe disease. I don't have those numbers, I'm sorry, before me but I think we'll get much better use of the supplies that the former government secured. As you know, though, I've also asked Jane Halton to conduct a review about the adequacy of our procurement arrangements of vaccines and treatments for the future. And I expect her report on that over the coming weeks. 

JOURNALIST: Where is the government in terms of pre-emptive discussions with Pfizer to get us a pediatric vaccine and also the TGA had recommended the Moderna vaccine be two doses 28 days apart. What was the ATAGIs rationale for three doses eight weeks apart? 

BUTLER: The decision will be published, and their view was that eight weeks would provide the best protection for the very young children who will be provided with this vaccination. They do provide in their advice, as you'll read, for the possibility of four weeks between two doses in particular circumstances when there's a demonstrated clinical need but that's obviously a matter for relevant clinicians. In terms of Pfizer, as I've indicated before, there are substantial purchasing or supply arrangements that the former government secured with Pfizer for large numbers of vaccines over the course of the rest of this year and into next year. We have been having fruitful negotiations with Pfizer to make sure that those numbers suit our needs. There is obviously that the question of the pediatric vaccine that the TGA is now evaluating but also the variant vaccine that Pfizer has developed and is already going through an FDA process, which is an adult or over 5 year old vaccine that is particularly targeted at the Omicron variant, so those negotiations are continuing.  

JOURNALIST: (Inaudible) COVID on Monday the flag national approach, sorry, national response was in the works. Is there a timeframe that we can expect that to be released? 

BUTLER: No, I don't have a particular timeframe, but I don't have anything to add to what I said on Monday. 

JOURNALIST: Your new colleague Marion Scrymgour raised some concerns about whether they should look at education campaign for, I guess, remote indigenous communities if the access to euthanasia was expanded. Was it something the Commonwealth might have played a part in? Some other critics of the bill have raised concerns that expanding access might have been discouraging effect on people in remote communities from showing up for health care appointments and that sort of thing. Could you speak to that a little bit? 

BUTLER: As you know, the voluntary assisted dying regimes that are already in place, are in place of state and territory. level. And, you know, those Parliament's and those governments have had to consider the particular needs of different cohorts in the population of culturally and linguistically diverse populations, First Nations communities and so on and so forth. That will be a particular issue for the Northern Territory, if the Northern Territory Parliament chooses to go down this path and debate legislation. I'm sure that the Northern Territory Government will be alive to that. In the event that they consider the Commonwealth can add some value to ensuring that all communities including First Nations communities in Australia, understand the operation of voluntary assisted dying laws in Australia or in particular parts of Australia like the NT, then I'd be open to that discussion, but I've not received anything formal from any of the state and territory governments.  

JOURNALIST: You mentioned earlier that the modelling from the states needed to come out at the same time as the national modeling. Is that because you worry that the modelling might be conflicting with the National modelling done for National Cabinet? 

BUTLER: What I said is we want to make sure that this is done in a coordinated way. 

JOURNALIST: So will it be coming out soon or? 

BUTLER: We're having discussions with state and territory Health Ministers. They have a particular focus right now on securing the operation of their hospital systems, but those discussions are ongoing. 

JOURNALIST: Just on the ATAGI advice to restrict pediatric doses to those specific cohorts - is that based on evidence not being clear for the wider age group, or is it based on the availability of doses? 

BUTLER: No, I think it's clearly based on what ATAGI says is a lack of evidence. Still about the benefits of the wider cohort - this is a new vaccine, and particularly as I read their statement, the fact that children of this age have a very low likelihood of severe illness from COVID 19. So I'll let you read the ATAGI’s statement in full but in its broadest sense, ATAGI, I think, has taken the view that there is no substantial benefit of this vaccine for this age cohort to warrant being administered right now given the relative scarcity of information that exists or data about the operation of this vaccine in this age cohort. They say though, that that will remain under consideration as we get more data particularly from the vaccination programs in the US and Canada. 

JOURNALIST: Minister, will there be a tailored communication campaign to explain to parents of children aged six months to 5 years that can get this vaccine? 

BUTLER: Yeah, as I said, over the next couple of weeks, we'll be rolling out that information campaign not just about the availability but also about the nature of the advice from ATAGI and advice to have a good discussion with their health practitioners if they've got any questions about that. 

JOURNALIST: There's been several reports of toddlers dying from COVID-19 in recent weeks, are you hopeful that this will put a stop to that?  

BUTLER: We know that vaccination and other age cohorts is the best protection against severe illness and death. We know that, and that is precisely why ATAGI has recommended vaccination for vulnerable children in this age cohort. The official data I have is that around nine children aged six months to 5 years. Because the data is not completely up to date. ATAGI says that up until - I'll get the date right - I think from the 17th of June, from the first of December to the 17th of June, around 350,000 children in this age cohort had contracted COVID officially, probably many more who had not been tested. So around 350,000 had contracted COVID between six months and 5 years and eight of those children had died. 

JOURNALIST: How advanced is the TGA in assessing the Moderna’s Omicron specific booster. 

BUTLER: I can't answer that. They're taking the usual course in making sure that before any provisional approval is provided. They're confident it's safe, I don't have an update as to when that process might finish. 

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