PAUL KELLY:
Good morning everyone, just a quick update on the COVID situation here in Australia. There's been quite a lot of interest and will continue of course to be a lot of interest in the vaccine strategy and our vaccine rollout for next year. My first point is we're on track. Things are working well. It's very good to see international developments around the Pfizer vaccine now being given that emergency use authorisation in Canada, UK and the US, and we're looking to see what the real world experience of that vaccine is as it rolls out in those three countries. And of course, we're in very close contact with those three countries in particular, and other regulators around the world looking at these new developments.
When you think about how extraordinary it is, it's only 11 months ago that we had the first understanding of the genetic sequence of this virus, and now we already have the Pfizer vaccine out in the field being used in priority populations in those three countries, as well as now the likelihood that Moderna, another MRNA vaccine may well get an emergency use authorisation in coming days. We've had the first trial results of the AstraZeneca vaccine which is being made here in Australia in Melbourne right now, and that's also looking promising. So we have the likelihood that there will be three vaccines ready for rollout next year. Two of those we have in pre-purchase agreements here in Australia, and one of those is being made in Australia. So these are all very positive.
Just in terms of who's going to get it first, I can understand everyone now, because it is being rolled out in the world, they want to see when it might happen in Australia. The first doses and who might get the first doses. We have our vaccine strategy that's been announced some time ago now, and we'll be following that strategy, which of course is based on the best medical advice. Our peak body, a peak group, they're advising us, the ATAGI group - the Australian Immunisation Advisory Group - met in a long session yesterday afternoon to work through some of the details of the prioritisation. That will go into our announcements in January about that in some detail about who will be prioritised for the first vaccines. And so, we know the general principles behind that. That's essentially those that are more likely to get serious illness, and we know that's mostly in the older age group, but also people with certain chronic diseases. So, they will be part of the priority, assuming that that is what the evidence about the vaccine itself which is presented to the TGA demonstrates that it is useful and works well and is safe in those age groups. So that's the first priority. The people that are getting the most severe disease, and we know that the vaccines that have shown their results in peer reviewed journals so far show very good results in terms of protection against severe disease, including in those that have the most likelihood of getting that severe disease.
The second priority will be people that are putting themselves in the front-line and caring for people that may have disease. So our healthcare workers and our aged care workers. They are the key. And then the third priority will be essential workers that are needed to keep our society going. And that's where that granularity will need to come out as to who is exactly the first in that queue. But I just really want to reiterate today that our aim for 2021 is to have anyone in Australia who wants to get this vaccine vaccinated. And so, yes, there will be a queue. This is an unusual event in our immunisation strategies, which we've had for many years. We usually start- we're having enough to roll vaccination out to anyone who needs it. This is a bit unusual, because of the nature of how this is developing. We will have a supply by March and we'll start that process in March. But after that, we will get more and more supply and we'll be able to roll out more broadly. So I think that information will come and it will be very clear to the Australian public when it's ready to be so, guided by the medical expertise and the regulatory process through our world class regulator, the Therapeutic Goods Administration.
The other larger piece of news over the last day or so has been around this new strain of the virus in the UK. We are in touch with our UK colleagues about that. First thing I would say, this coronavirus is very different to the influenza virus, which can change quite rapidly and quite markedly. The coronavirus, the novel coronavirus that we've been dealing with all year, is actually very stable and it hasn't changed a lot through that period. Of course, we're continuing to look at that closely, but our understanding of the information so far from the UK is that this is a minor change, not a major one, and not related either to increasing transmission from person-to-person, or severity of the illness that comes from the virus, nor does it appear to be in any way affect the effectiveness of the vaccines. So people should be reassured about that. Clearly, there are large spikes in the numbers of cases in the UK and many other countries right now. And we are in a very different situation here in Australia with very few cases over the last few weeks. And so, quite a different situation.
So I'm happy to take questions now, firstly from the room.
JOURNALIST QUESTION:
Professor Kelly, you were saying that we have the opportunity to build in the experience of these countries with emergency use of the vaccine - A lot of these vaccines at the moment require two doses. There's concern already in the States about how you get people to come back and get that second dose. What in that aspect will you be looking for and what kind of strategies will Australia potentially adopt to ensure that people get the full dosage of the vaccine?
PAUL KELLY:
So that second dose does appear crucial. Certainly almost all of the over 200 vaccines that are now in development and the tens of vaccines that are in clinical trials do rely on a second or booster dose usually about three weeks after the first dose. So it will be absolutely important to get both doses. The Pfizer vaccine, for example, does show some evidence that it gives partial protection after the first dose, but the maximum protection, that 95 per cent effectiveness, is only after about a week after the second dose. So it's absolutely crucial that once people start on this journey, they complete it. And we're looking in many ways as how we could best do that to ensure that, that will happen.
Again, we're in a very different situation to the US. For example, we have a very well-coordinated health system in Australia and the ways we're going to roll this vaccine out will absolutely depend on that reliability. We're looking at ways that the Australian Immunisation Register can be used to record that first dose. Hopefully to look at a reminder to come for the second dose and record that second dose. So people will know exactly the dates that they had that vaccine, which vaccine they had, which batch of vaccine they had. And that will also be crucial as we look at the development of any rare side effects that might come as we roll the vaccine out, which is again an advantage of having other countries going first.
JOURNALIST QUESTION:
Professor Kelly, Australians who get a full dose of that vaccine overseas, say in the UK or the US, be able to come home to Australia without going into quarantine? And if you haven't made that decision yet, when are you likely to make that decision?
PAUL KELLY:
So, a lot of interest in that, of course. That's something that- again, a decision that will be guided by the best medical advice. I spoke to one of the chairs of ATAGI this morning specifically on that matter, and looking at what modelling we should be doing now to assist us with that question. It sounds simple, but it's not simple. I think it will rely very much on where people have come from, what vaccine they've had, whether they've had the two doses, when they had those two doses, what is the situation here in Australia? Because at the moment, unfortunately, the vaccines that we know most about don't appear to demonstrate any protection from transmission of the virus.
They are very effective at stopping disease from the virus in an individual person, but it may well be that that transmission might continue. So we need to really think that through very carefully. But certainly, it will have some protection and we will look at that amongst many other things over the coming month or so and give strong and clear advice.
JOURNALIST QUESTION:
Where do airline crews sit on the priority list?
PAUL KELLY:
So, airline crew- so, if we go back to those first principles, those that are elderly or have a chronic disease they would certainly come towards the beginning. Airline crew - those that are involved with international travel, in particular - would be those putting themselves in danger for the good of the country. So, on that line, they may well be up the top. But as I said, we'll be guided by the medical advice and those specifics will come later.
JOURNALIST QUESTION:
On the transmission point, that we don't have the data around the vaccines protecting from people transmitting the disease. Is there a concern that, say, halfway through next year when, perhaps, half the population is vaccinated that there's, I guess, the sense of people being very complacent because they think that they're vaccinated, they're fine, but they still pose a risk to other people that aren't vaccinated?
PAUL KELLY:
Yes. And that's why we need modelling to consider that, very carefully. So, for example the AstraZeneca vaccine that did- has already looked at, whether that vaccine protects against asymptomatic illness. So at the moment, from that interim analysis that was published in the Lancet Journal last week, it demonstrates it probably doesn't. So, it could be that people may have asymptomatic disease after having had the vaccine, and not know it. And that, as we know, can transmit to others. It's less likely than if you have symptomatic disease, and the AstraZeneca vaccine and the Pfizer vaccine, and we've only seen very minimal results so far from Moderna, but all of those show very strong effectiveness against severe illness or illness at all. And so, that is an issue. Yes, absolutely we need to consider that as we go forward.
JOURNALIST QUESTION:
How does that transmission issue play into the border- international border considerations? Do you expect that many people would either think they could get vaccinated here, travel abroad? Or the people overseas would expect once vaccinated they could, you know, reopen borders, have tourism migration, all those things happening again. Is there going to be- I know you're doing modelling, but is there going to be, maybe a tiered system of what travel is and isn't allowed, that's expanded beyond the current restriction? Or will it be either open or closed, once you make the call?
PAUL KELLY:
So I think, you know, vaccination is clearly a very new and emerging component of our risk mitigation for overseas travel. So, it's too early for me to say one way or the other how that's going to affect it. We're certainly looking at how that might affect both incoming travel and people going overseas. But they're matters that we need to work through, get the best medical advice in relation to that. Modelling may be part of that, as well as what we get from the pharmaceutical companies themselves, and through to our regulator, the TGA, who will give us some advice on that.
JOURNALIST QUESTION:
Professor Kelly, would you give us your reflections on the rapid antigen test from Brisbane that's been approved for the US. Also interested to know, do you expect they'll become a common product in Australia, perhaps in 2021? Do you expect a wider use here?
PAUL KELLY:
So, yes, I very much welcome the news for that Brisbane-based company, Ellume, who has an emergency use authorisation in the- from the FDA in the US. So again, just to really reiterate - here in Australia, we don't have that emergency that they have in the US. They're clearly looking to give this emergency use authorisation, which is not full regulatory approval, for this particular test. We have some tests like that on our Australian register of therapeutic goods, so are licensed for use in Australia. That particular product is not licensed. They have not applied for a license here in Australia. But I wish them well from that perspective. The other thing that's different here in Australia is, we have a very large, and deliberately expanded laboratory network using the gold standard of PCR testing. We have plenty of capacity there. And for us, that's still our gold standard. We continue to look, and we've got a specific committee that's advising the Australian Health Protection Committee, and myself, as the chair of that committee. With- they're tasked with looking at any emerging technology in diagnostics, and this is on their list, so we'll see what happens throughout next year. But for the moment, we have the PCR test, that's the one we're relying on. We've got some people on the phone, I'd like to go to them first. I think, Melissa?
JOURNALIST QUESTION:
Yes, thank you, thank you for that. I've just got two questions; I think you've mostly covered one of them so that's good. Can you tell me what work is being done to devise the public health campaign to support the rollout of the vaccines? Can you talk us through what preparation is being done to get adequate information to people for vaccine?
PAUL KELLY:
Yes, and as I said at the beginning, a lot of interest in- all over Australia, as there should be. This is a remarkably new and different thing that we're doing in terms of the COVID-19 response and control piece. So yes, we're in the field at the moment looking at various options, in terms of what people want to know and what we feel is absolutely necessary to get out there. It's quite clear there's a great thirst for that knowledge and we'll make sure that our messages are attuned to what people are looking to find out about it. As well as the key messages as they emerge about which vaccine, where to get it, all of those practical things. Who should be applying first and how to apply, et cetera, all of those very important messages will be out there. But yes, there will be a lot of communications where at the moment, as we did at the start of this pandemic, getting as much information out as possible through press conferences like this. But there will be a lot of communication material developed over the coming weeks and right throughout next year as this rolls out. Josh next?
JOURNALIST QUESTION:
Yeah thank you, professor. I wanted to ask something on a different topic. The reports into the guidance regarding the aged care outbreaks, those are still to be released properly, I believe. But can I ask - have you seen them yourself? And what lessons do you think that the Health Department and the Federal Government should be taking from those reports?
PAUL KELLY:
So, those reports have been completed. They've been completed by two experts. Actually, the same group that did the Newmarch report early on from New South Wales. And we continue to learn from all of those aged care issues, particularly the ones that happened in Victoria. So St Basil's and Epping Gardens were two of the larger outbreaks early on, in the community transmission event in Victoria. And so, we absolutely need to learn the lessons from that. We will be looking at those in great detail. I'd like to say also that there's a lot that we can learn from within aged care, where we haven't seen those sort of episodes. So most remarkably, I'd say, the aged care facility that was involved in the recent event in South Australia where they had 33 community cases - many all linked to each other in various ways. There were four aged care workers in one aged care facility in Adelaide related to that outbreak. There was not a single resident, not a single resident got sick. It just really demonstrates what we've learnt in terms of how to control these things quickly. How to protect our most vulnerable people, and of course, the vaccination rollout will also assist with that. I think Reid was next?
JOURNALIST QUESTION:
Hi there, thanks for taking my question. I just- after a comment on the reports today that it could be- I know it's final details still to be announced, but is it realistic to say that we can expect the virus rollout to be done in five-year age increments over the course of next year?
PAUL KELLY:
The vaccine rollout, I think you're referring to there, is… so that's what the UK have done. They've very specifically and similarly to us looked at who were the people that were the most at risk and that's the most elderly in our community, particularly those in residential aged care and health care workers. That's where they've started. I had an email on the weekend from an old friend of mine who said his daughter was working in intensive care in the UK and already had their first dose and they were asking can they come home without quarantine. So that was an interesting thing two days after the start of the rollout. So, the UK have started with that same sort of prioritisation. They've gone to that more granular detail about who will be second and third and fourth and they've used age ranges. We haven't made that decision yet. We'll be based, as always, on the best medical advice through that ATAGI group and they'll be looking at that in some detail, but it's too early at the moment to say that specifically. I think Bianca was next. Sorry Reid, go ahead.
JOURNALIST QUESTION:
I just also really wanted to quickly ask you about the New South Wales case, the fact that it occurred during the transport of international flight crew. Is that something that was concerning to you when you did a- Melbourne for instance has just started accepting international arrivals and things like that. Is there more that needs to be done in terms of PPE for those drivers who are driving the SkyBus or driving a van or something like that with these high-risk people on board?
PAUL KELLY:
So I'm aware of the case and I spoke to Dr Kerry Chant just before this press conference. I believe she's giving one at the same time, possibly with more details. But look, we're aware that aircrew is an issue. It was raised at National Cabinet last week and there's a specific piece of work to look at how we can protect the wider public, including those that are close to international air crew into the future. We, of course, rely on international air crew and international flights, not only for bringing Australians home from overseas, but also for freight. It is an emerging issue. It's one of the ways that we need to tighten up our controls. And so I'll be working closely with the Chief Health Officer in New South Wales, particularly in the coming days on that. We discussed it at AHPPC again on Monday and we'll continue to look at ways we can improve that.
I will say that we're aware of only 134 cases in air crew since the beginning of the pandemic out of over 28,000 here in Australia. So it's not been a major issue. But as we've got less and less cases elsewhere, it's one of those things that we're aware of that needs to be improved.
Bianca's next.
JOURNALIST QUESTION:
Thank you, Professor. Yeah, this is just a continuing on when we were saying about the new case in New South Wales linked to international flight crew. So what- you said that you'll be looking at tightening protocols around that. What would that look like?
PAUL KELLY:
Well, I think we need to look at anywhere we can protect in the whole chain of transmission. I think we need to think about how to protect, not only the air crew, but people that are closely associated with them. We've seen- this is the second issue we've seen in air crew in recent weeks in New South Wales. So the worker in the hotel in in Darling Harbour was also… appears to have been associated with a contact with an air crew member. Let's think about the air crew, particularly international air crew. They are really putting themselves in harm's way. When we look at particularly our local Qantas air crew, they've been doing this from the beginning. They were the ones that volunteered to go to Wuhan to pick up Australians to bring them back. We had those evacuations from the Diamond Princess continuing to go into countries with large outbreaks and bring Australians home as well as important freight.
So, we need to get the balance right. They need to be able to keep working and want to keep working, but we also need to protect what we've gained in terms of the very few cases, almost no cases in the community right throughout Australia.
Can I have one more question?
JOURNALIST QUESTION:
Professor Kelly, can you just explain when the Pfizer vaccine arrives in Australia, where will it go? Which state do you believe it will go to first? How will it be stored? Is it GP's, hospitals that will be administering this vaccine and how will it be transported around the country?
PAUL KELLY:
So our contract with Pfizer is that they will be in charge of logistics. The cold chain of keeping these vaccines at minus 70 is not to be understated. It's a new thing for us, and we're really learning from what's happening around the US and the UK as well as Canada right now about those logistics. But Pfizer, as part of their contract, has guaranteed that they will sort out delivering these vaccines safely, making sure that they remain frozen at that very low temperature so that they're then ready for use.
Where those first vaccines will go to or how they will be delivered, that's still being worked out, and we'll have more information about that in January. We are working very closely with states and territories for now to look at how they might be involved. We're talking to GPP groups and so forth. But this will be, you know, a large, very large logistic exercise, starting with mass vaccination. And one particular issue with the Pfizer vaccine is that they, indeed all of the vaccines so far, come in multi dose vials. You need to have a group of people to vaccinate. And particularly for the Pfizer one, you need to do that fairly quickly because of that cold chain issue. So we'll be looking for places where we can vaccinate a reasonable number of people. And of course, we want to get out to people as quickly as possible, particularly in those high risk groups of severe infection and those frontline workers that are at most risk.
JOURNALIST QUESTION:
Are you confident that it will be able to be delivered in remote Australia?
PAUL KELLY:
So that would be a challenge but we've done that before. We have very high rates of vaccination in Australia, including and in particular in remote Aboriginal communities as well as other rural communities. And so, we're used to the challenges of those logistics and also to a cold chain element to that. So most vaccines need to be kept at least refrigerated, if not colder. And so, we're used to that as a concept. The minus 70 is a challenge because, as I say, the Pfizer - and that's the only vaccine at the moment that has that particular issue for stability of the vaccine - they've guaranteed that they have the technology and the infrastructure and the logistics sorted. So we will hold them to that contract, and we'll start probably centrally and then move out rapidly to those high risk groups, as I've mentioned.
Thanks very much.
Contact
