Date published: 
18 June 2021
Media type: 
Transcript
Audience: 
General public

RAFAEL EPSTEIN:

The advice has changed. Let's find out why. Professor Paul Kelly is the nation's Chief Medical Officer. Thank you for joining us.

PAUL KELLY:       

Hi Raf, how are you going?

RAFAEL EPSTEIN:

I'm well. Can I just play you a little snippet? There are a lot of concerned people I'd like you to address, but just have a listen.

[Excerpt]

VOX POP:    

I feel like we've been gutted.

VOX POP:    

I tell you what, they move the goalpost all the time and it [indistinct] different frame of mind as to do you, don't you? Yeah.

VOX POP:    

I turned up to get vaccinated with AstraZeneca and I just got scared.

VOX POP:    

Now I'm wondering whether I'm sitting on a time bomb. Thanks for telling me now. I could've done with it two days ago. And if I'm feeling this, other people are.

[End of excerpt]

RAFAEL EPSTEIN:

Paul Kelly, those emotions are strongly felt. What can you say to people like that?

PAUL KELLY:       

Yes, look, I understand that people want certainty, and that's something we've been striving for the last 18 months with this pandemic and it's been difficult to find when we've thought we're on top of it. It appears as it has had and have been watching in a really very caring way- with you down in Melbourne the last couple of weeks has been a real reminder of last year. And I really understand that. The issue is the world doesn't stay still. And with this vaccine and with the virus more generally, we look at the data regularly. We find out new things each week, and we share that information with the Australian public through our expert committees who give us advice and we take action on the basis of that advice. So today was just another one of those days.

RAFAEL EPSTEIN:

What if I've lost faith? What would you say to me if I've lost faith because of that decision? A few people said that.

PAUL KELLY:       

Yeah, I heard that in the clips you played. The goalposts have moved. Yes, that's true. In terms of AstraZeneca, people- and I've addressed this in a press conference earlier, people that have had AstraZeneca in the last couple of weeks or months, it's not a time to be alarmed, but certainly to be alert if you're in that 50 to 59 age group. We have had an increase in cases in the last week, which led to a- the risk profile being reconsidered. But we need to put that in some context. So this is really very cautious advice. The rate in that age group jumped up to 2.7 cases of this strain-of this new clotting disorder; it's very rare-

RAFAEL EPSTEIN:

[Talks over] Sorry, is that 2.7 out of 100,000?

PAUL KELLY:       

Out of 100,000. Yes, so when we think of- if we think about the mortality rate from COVID just in Australia-so these are the real deaths of real people last year, the tragedy that we saw mostly in your state, Raf, with 910 people dying last year. There was a 14 per cent mortality rate. That's 14,000 of 100,000 for people aged over 60. 14,000 compared with 1.4 per 100,000 in that 60 to 69 age group. So, we've got to put this in context. People in- and that's that risk benefit analysis that the ATAGI have done, and they've come to the conclusion for that 50 to 59 age group where the mortality rate- is last year 0.4 per cent, that 2.7 was not acceptable. So that's where we've got to. But we- that's just the number of clots, that's not the mortality rate, [inaudible]…

RAFAEL EPSTEIN:

[Interrupts] Can I get onto a few other- I appreciate the numbers. I'm not always sure they make a difference. They make a difference to me.

PAUL KELLY:       

Sure.

RAFAEL EPSTEIN:

I'm not sure they make a difference to everyone. But Paul Kelly, a few questions looking ahead, does this mean if I'm under 40, I'm going to have to wait longer?

PAUL KELLY:       

So, we've opened up the Pfizer clinics and the Pfizer supply that we have, which is limited. We've been very upfront about that all the way along. We've had to wait for that to increase and it will increase in the coming months. But at the moment, we are still limited by that overseas supply of Pfizer. So, that will be shared with the larger group. That's true. There will be two million more people in that 50 to 59 age group who are now eligible for that particular vaccine.

RAFAEL EPSTEIN:

So it sounds like it does mean the under 40s will have to wait longer.

PAUL KELLY:       

Well, we're having- at the same time, Raf, we're having an increase in the supply over the next couple of months. So we will eventually have enough for well and truly the whole of Australia to get Pfizer. We've already had now close to four million people who have had AstraZeneca first dose. And I've been- I'm absolutely saying to people if they've had the first dose of AstraZeneca, they should have the second dose. The second dose has not been associated in anywhere near the numbers recognised [indistinct].

RAFAEL EPSTEIN:

[Talks over] Not the same as the first one. Sorry, can I just try and pin you down please, as the Chief Medical Officer? I'm not sure- I'm not sure if you don't know, and that's okay, too, because the drug supply is not- you don't know what you're going to get in a month's time. Is this going to slow down the rollout? Can we say it's going to affect the speed of the rollout?

PAUL KELLY:       

I think for the next couple of months, it will inevitably do that. But we've done our modelling to the end of the year and we've always had this plan for a large sprint towards the end of the year when we know Pfizer have been giving us small amounts of the vaccine in relative terms to the AstraZeneca, which has been making [indistinct]-

RAFAEL EPSTEIN:

[Talks over] Okay, so it will be slower over the next few months.

PAUL KELLY:       

We'll- yeah, but we'll get there and we think we'll get there in the same sort of time period.

RAFAEL EPSTEIN:

A lot of people are asking- and to be honest, I'm in this category as well. But it's an often repeated question, why can't I have the AstraZeneca first and Pfizer second?

PAUL KELLY:       

Yes, that's come up a lot today. Of course, so the reason is fairly- it's pretty blunt. The reason is we've had millions, tens of millions of doses, tens of millions of people have had two doses of AstraZeneca. We know that it works, we know that it works really well. It's a very effective vaccine against severe infection. It's effective against symptomatic infection and it's effective against blocking transmission from other- to others. So, it's a very good vaccine from that point of view. We know the safety profile. We know this particular rare but sometimes serious clotting issue. But other than that, it's safe. We have no data, really, on mixing and matching of vaccines. There are trials going on now. We will get that data in [indistinct] time in the future.

RAFAEL EPSTEIN:

[Talks over] I thought- forgive me, I thought there was significant information on that coming out of Britain. Is that not correct?

PAUL KELLY:       

No. They've had a small study looking at- in the laboratory. So, looking at whether- you know, mixing the blood essentially of people that have had the vaccine with the virus and seeing if it works, the antibodies that have been produced. And that's positive. There's also been a small study in Spain and also in the UK looking at what happens in the real world when people get- have had AstraZeneca and have Pfizer as the second dose. They actually get the symptoms of the first 24 hours more severely, actually, which probably goes with that immunity. But we don't have that longer term…

RAFAEL EPSTEIN:

[Talks over] Not enough info, I guess.

PAUL KELLY:       

… we don't have the large numbers. So, at the moment the safest and most effective is definitely the two doses of the same vaccine. And we'll get that information in due course.

RAFAEL EPSTEIN:

If I'm under 60 and I'm completely happy to take the AstraZeneca, can I get it? Because I get flooded with those as well, people saying I don't care, I'm happy to accept that risk. Will those people who are under 60 be eligible to get AstraZeneca? Can they rock up and get it?

PAUL KELLY:       

Yes. Yep. We haven't banned anything- we've- it's an advice. The pref- It's a preference, is how it's been written by the ATAGI advisors. The preference, the preference is to have Pfizer for those 59 and under, or 18 to 59, so- or, 16 to 59 for Pfizer. But no, if that is, if that is what you need to do…

RAFAEL EPSTEIN:

[Talks over] That's what he's saying.

PAUL KELLY:       

… yeah, you can definitely do that. If- You need to have a very close look at it, and talk to your, talk to your GP, and work through that way. But it certainly is available for people of all ages over the age of 18 for AstraZeneca.

RAFAEL EPSTEIN:

If I want to know how far we are away from whatever post-COVID normal looks like, I want to know how many people have had a second dose of the vaccine - there is still no clear information coming from the Federal Government every day saying how many people have had two doses of which vaccine. As the Chief Medical Officer, can you tell us when we're going to get that sort of daily data? Or weekly data?

PAUL KELLY:       

Look, that's, that's a decision for others - I'm not involved with that element of the programme. But what I can say that we- we're, we're at this point where we would, we would've been expecting people to really start to rock up in large numbers over the coming weeks to get their, get their dose of Astra, AstraZeneca.

RAFAEL EPSTEIN:

[Talks over] Do you think that transparency's important?

PAUL KELLY:       

Well, Well, the point is that it's, it's actually about first doses at the moment, because two thirds of the doses have been AstraZeneca and we know that 12 week lag between the first dose and the second dose - so that's, that's- the twelfth week was this week or last week. So, that's-

RAFAEL EPSTEIN:

[Interrupts] I- am I, am I hung up on the wrong detail. It seems to me to be quite important to know how many Australians are fully vaccinated. Is that not something that would be good to tell everyone?

PAUL KELLY:       

No. It will become, it will become more important, Raf, it's true, but at the moment the majority is- it's actually the doses going out because, because there's, there's very few people that have been eligible for a second dose until, until this last week.

RAFAEL EPSTEIN:

Sure.

PAUL KELLY:       

So, there's the Pfizer, the Pfizer doses, we've got those, but it's a relatively small number compared with the AstraZeneca, because that's where our supply has been. In the future there'll be, there'll be more, be more Pfizer, we'll be able to really look closely at that, that second dose as well.

RAFAEL EPSTEIN:

How did you feel when you knew the advice was actually going to change? And it's complicated, and it makes your life harder. How do you feel when you heard that and realised that?

PAUL KELLY:       

Well look, I, I'm very grateful for having such an amazing group of experts as we have on, on that ATAGI group - they, they really are world leaders, actually, certainly they're leaders in Australia around immunisation and vaccination. They're very linked in, all of them, with international colleagues, so they, they absolutely had their finger on the pulse on this. We also have our TGA, who are, who are doing an enorm- Therapeutic Goods Administration, doing enormously good work in gathering that information about safety. And so having them together, I have full trust in their, in their advice.

RAFAEL EPSTEIN:

No. It's not about that. I, I mean, Brendan Murphy in references today, you know, that the more we talk about these things it actually- sometimes it makes it worse, and sometimes increases vaccine hesitancy. I'm sure you can anticipate these conversations. Did you feel a bit of…

PAUL KELLY:       

[Talks over] Absolutely. Yeah.

RAFAEL EPSTEIN:

… impending doom when you realised this was going to be the advice?

PAUL KELLY:       

Yeah, look - impending doom. I knew it was going to be a busy, a difficult day. I knew it was going to be a busy couple of weeks while we recalibrate yet again. And when you think about what's happened in the vaccine rollout since the beginning, we're getting, we're getting these knocks quite often. So, you know, we didn't get the supply we thought we'd get from overseas and in a timely manner of the AstraZeneca. You know, the Pfizer, it's been a little slower coming, coming through - although it's coming through every week it's a relatively small number. Then we had the April announcement about the 50s. Now we've got this one. So every time we're getting that momentum, and we've huge momentum, particularly in Victoria and it's been amazing to see how, how people have rolled up to, to all of our points of contact, contact over the last couple of weeks.

RAFAEL EPSTEIN:

[Talks over] So, you don't think AstraZeneca's dead as an option? I've heard some public health people privately say they're just really worried - people just won't take it. I know we've got empty cubicles in Melbourne at the mass vax centres for some of the AstraZeneca. You're not worried that it's becoming too hard to persuade people to have AstraZeneca?

PAUL KELLY:       

Look, I'm worried, yes. I'm worried that this will- not confidence, absolutely. But I think it's important that we're giving information when we get it, and getting the advice from the right people, and sharing that in a timely fashion. And, and I think Australians, once they get over the shock, will, will see that they'll understand it, and, and will recalibrate. That's, that's what happened after the first announcement - there was a lot of, well, that's the end of that, and it wasn't. And we've, we've had a large, large numbers of coming for AstraZeneca, and particularly in Victoria, but around Australia over the last few weeks, and it's- there's many opportunities for that.

But people, you know, should have, if they're worried they should have that discussion with their GP's. I've written to GP's again today, to all GPS in Australia, to give them the information and to, and to assist them with the information they need to have this conversation with, with their patients about, about what this is. It's a very effective vaccine, it's mostly safe but there is this unusual but sometimes severe clotting issue. Now, we- we're doing much better than the rest of the world in terms of diagnosing this and treating it correctly, and so most people, even with this clotting, even with that rare clotting, they…

RAFAEL EPSTEIN:

[Talks over] They're okay.

PAUL KELLY:       

… they are doing okay. But there's- there are these who haven't done so.

RAFAEL EPSTEIN:

[Talks over] Can I just squeeze in, can I squeeze in one other quite large question? I realise your time is really valuable and limited. People expect that once we're all vaccinated, it's less likely that we do things like lockdowns, and have restrictions, and we can travel. Can you explain why you can't really tell people at what point we can travel again? No longer worry about a lockdown? Why is it hard to give an answer about how many people need to be vaccinated for us to relax?

PAUL KELLY:       

So, Raf, I'm a Infectious Epi- Infectious Disease Epidemiologist by training, and so epidemiologists - as I'm sure you know because you've interviewed quite a lot - always start with, it depends. And with this- that question, it really does depend. It depends a lot on the situation; it depends on the situation overseas if we're talking about international- people leaving to go internationally and coming back, or people from international destinations coming back; and, and then will depend on the vaccination coverage in Australia.

It also depends on some things we just don't know about yet - the variants, and you've had a couple of them, variants of concern recently in Melbourne. We know that some of those do interfere with the vaccine efficacy, and that's, that's a concern. We're, we're getting new variants all the time - that Delta one the most…

RAFAEL EPSTEIN:

Yes.

PAUL KELLY:       

… concerning at the moment. But there'll be new ones. And, you know, we're not going to see the old, the old virus much anymore, if at all. These are, these are viruses that are more transmissible, and the way that evolution works they'll be the ones that will be circulating in the world. So, there's a lot of uncertainty there.

RAFAEL EPSTEIN:

[Talks over] Bit does a vaccine make a lockdown- does it make a lockdown less likely, do you think?

PAUL KELLY:       

Eventually. Yes. And I think, you know, we're getting modelling done by that. Your, your fantastic people who are at Doherty down there in Melbourne, Jodie McVernon and others who have been wonderful partners right throughout this are doing some excellent work on exactly that question. And that's what the Australian Health Protection Committee, that I'm, that I'm the Chair of with Brett Sutton from, from W- from Victoria, and others from all around Australia, all the CHO's - we've been asked to, to bring advice back to the National Cabinet over the coming months to answer exactly those questions. And it's- we're developing that right now.

RAFAEL EPSTEIN:

[Talks over] [Indistinct]

PAUL KELLY:       

But as I say, it's not an easy question.

RAFAEL EPSTEIN:

I understand.

PAUL KELLY:       

It's not even a matter of just one, one number. but it's a, it's a journey we're all on and we're all committed to make sure that people can get vaccinated as quickly as we can and safely as we can.

RAFAEL EPSTEIN:

We look forward to the answers. Thanks for your time.

PAUL KELLY:       

You're welcome, Raf. Bye.

RAFAEL EPSTEIN:

Professor Paul Kelly there, the nation's Chief Medical Officer, the top adviser to the Prime Minister and to the Health Minister. Yes, he is worried about the impact on things like vaccine hesitancy. Yes, it likely will be slower if you're under 40 before you get access to a vaccine over the next few months. But he also thinks we'll get over it.

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