Date published: 
30 April 2021
Media event date: 
29 April 2021
Media type: 
Transcript
Audience: 
General public

ERIC YOUNG:

Good afternoon everybody, I am Commodore Eric Young, the Operations Coordinator of the Vaccine Operations Centre and today I'm joined by Professor John Skerritt from the Therapeutic Goods Administration. Before Professor Skerritt speaks, I'll provide a short operational update. Again, I'll do that in three parts focusing on supply of the vaccine, the distribution of the vaccine and the administration of the vaccine.

In terms of supply, today we are finalising the batch release and sample testing for 173,000 doses of the offshore produced Pfizer vaccine and today we completed batch release and sample testing for 707,000 doses of the CSL onshore produced AstraZeneca vaccine.

In terms of distribution, as I mentioned yesterday with the short week with the majority of the country having a public holiday on Monday, we still have more than half a million doses of the vaccine being distributed across the country. Up until yesterday we had 280,000 doses of that vaccine successfully distributed. Today, we have another 113,000 doses of vaccine being distributed to more than 830 locations across the country.

In terms of the administration of the vaccine, yesterday we recorded 82,741 doses of vaccine administered, taking our total now to 2,112,285 doses of vaccine administered. That includes more than 67,000 doses of vaccine administered by more than 4600 primary care sites across the country, taking the total number of state, territory and Commonwealth sites now to over 5100.

In terms of our vaccine administrative service providers, our focus continues to be on those most at risk; the older Australians in our residential aged care facilities. Yesterday we conducted 36 first dose visits to residential aged care facilities, taking our total now to 1590 first dose visits. We completed 50 second dose visits, now taking our total to 960 second dose visits. That's more than 2500 visits now to residential aged care facilities. In addition to those most at risk, we also continue to focus on other vulnerable cohorts, including the disability sector. And again, with a number of sites conducted yesterday, we now have 101 first site visits and 19 second site visits. Again following the direction from National Cabinet last week, which predominantly limited the Pfizer vaccine to those under 50, our focus for this week is on ensuring that all eligible Australians know how and where to access a vaccine. But again, every single day we're focussed on making sure that the vaccines we have are available across the country when and where required to protect those vulnerable Australians.

I'll now hand over to Professor Skerritt.

JOHN SKERRITT:

Thank you, Eric. I'm just going to reflect on some of the reporting and broader discussion on adverse events, particularly relating to clotting events after AstraZeneca vaccine. And I'd strongly caution the public and the media, in reaching any conclusion on the two fatality cases that have been mentioned in the media. We have 11,000 adverse event reports in front of us. Now that sounds like a massive number, but they range, of course, from a sore arm through to people having a heart attack a week after having a vaccine through to clotting events and a number of other things. Now, for the serious events, we certainly look at every case in detail. We discuss them with global counterparts and we also look to see, most importantly, whether there's any evidence of cause and effect. And, of course, the current evidence on those two cases, although those cases are still under investigation and for privacy reasons, I don't want to go into details of individual patient tests and results and other conditions they may or may not have had. But the current evidence doesn't suggest a likely association.

We do have to remember, pardon me, that sadly, every week in Australia, 3000 people die of all sorts of causes. Now, in the weeks before they die, particularly if they're older people or if they're hospitalised, they may have had a number of medical interventions of all different types. That may or may not include COVID vaccination. And, of course, in our community, again, often the most tragic cases are those of sudden death where people have done all the different normal activities of daily living. That may or may not again have included a vaccination, but it could have included a lot of things.

We also have to remember that in reporting cases of people presenting at hospitals with clots or to their GP, 50 Australians a day report to hospitals or their doctors with serious blood clots from a range of activities or coming for no reason at all. And almost all of them have no relationship to vaccination, 50 cases a day. And while attribution is hard because sometimes a blood clot can kill you within minutes, other times it may kill you weeks later if it's a very serious and potentially fatal one.

We think about a third of those 50, so that's still 16 or 17, we think about a third of those 50 do lead to death. And so that's a rather sobering statistic, it's not quite one per hour of fatal blood clots in Australia. It's one of the more significant causes of death in this country. It's also important to realise that we are not seeing a flood of these serious cases. Each case is rare, looked in at detail. And there's debate about whether the frequency is one in 100,000, one in 200,000 depending on the group. But throughout the world, we are seeing a small number of cases each week associated with the vaccines. But it's also important, and I was speaking with them as recently as 11pm last night, that the US FDA, the US Centre for Disease Control and the European Medicines Agency have all in the last few days confirmed with either or both the AstraZeneca and Janssen vaccine, which are very similar in nature, that the benefits dramatically exceed the risks.

So knowing that there's a small background risk of rare blood clots is something to not hide. But all medicines, all treatments, all medical procedures, all activities of daily living; driving in a car, flying in an aeroplane, have some risk. And in the case of these vaccines, the benefits exceed the risk.

So we are looking at every case that's reported to us. We are looking at these two cases that have been in the media today, and some others that have been reported in great detail. Now I know that the questions often asked: well, when are you going to tell us what the answer is? Sometimes, the testing is quite clear, whether it's a definite association or whether it's definitely not associated. And we can reach a conclusion within hours and report that. Other times, we realise that we have to wait for particular tests to be done, and some of these tests are only done in one hospital in all of Australia. And there's a line up for those tests. Or if someone sadly dies, it may be too late to get some of the normal tests that you do on a living human being in a hospital. And so every case is different. And so sometimes, it does take several days and even then it might require a post-mortem if it has been a case to definitively conclude or exclude an event. But our commitment is that as soon as we have the data, as soon as we have the test results from our hospital systems, we make a determination. If it's one that requires medical specialists outside our organisation - although we're fortunate to have some of Australia's best doctors in the civil service - we get their advice. And we will make a decision and announce that decision. So that's essentially where we stand with the assessment and reporting of clotting cases. I think that why it's important to emphasise but sadly, 3000 people die every week, sadly, 50 people get serious clotting disorders every day, and perhaps a third of them die either immediately or soon after, is to put this in perspective in terms of a shared responsibility we all have. We have a shared responsibility, whether we're Government, whether we're civil servants, whether we're the community, or whether we have a media for providing accurate, unbiased information on benefits, and also on risks. We shouldn't sweep risks under the carpet. But the benefits, as I've said before, especially in the over 50 group, who, if they do contract COVID, become seriously ill or die, with the percentage of those increasing in every decade of age, it means the benefits significantly outweigh the risks. And I think that's what we've got to remember. And we have a shared responsibility to communicate that. Vaccination in this country is not compulsory. Individuals will reach their own decisions. But we have to make sure that they are informed by the best and most balanced information.

Thank you. I think Commodore Young and I can now take questions. Yes, so I think we've got Rosie first.

QUESTION:

Hi there, thanks very much. I wondered if you could confirm, Dr Skerritt, what the vaccines were that the two gentlemen had in the latest reporting, whether it was AstraZeneca. And I just wanted to know how you reassure the public that the AstraZeneca vaccine is safe particularly those Australians aged close to 50, in their 50s and 60s, who might see the media reporting and decide they don't want the vaccine anymore.

JOHN SKERRITT:

Thank you. Again, we're still- and you've raised the issue that even pinning down what vaccine the individual had is sometimes challenging. We believe the two individuals so mentioned did have the AstraZeneca, but we are still doing investigations with them. On the broader issue of safety and whether to have a vaccination, it's an individual decision. I mean, I've had the AstraZeneca vaccine, because I have a chronic respiratory condition and I know I would become extremely ill, almost certainly end up in intensive care if I got COVID. So these are individual decisions. But I guess the importance of transparency is to say: look, there is this rare thing, one in 100,000, one in 200,000, and we're getting better at monitoring it and treating it very quickly if it does appear, versus the situation that unless if we decide to live in a country that will never open our borders, unless if we decide never to return to our normal activities of daily living, but the vaccine still remains, along with other measures, the best way out of this pandemic. And of course, we also have to remember that individuals have a shared responsibility. So even if you're a fit 52-year-old, it may well be at that age you still have elderly parents. And so I wouldn't want to be a 52-year- old who ends up infecting my 85-year-old mother. So these are all decisions people have to take into context.

I think we've got Rachel next.

QUESTION:

Thank you, Professor. A question for the Commodore. You were speaking about the plan for the vaccinations and disability and aged care facilities. Can I ask about the plan? Is it to do both of those sectors as quickly as possible at the same time, or is there a different approach for each sector? And secondly, if I could ask Professor Skerritt a question as well after that, on the blood clotting, or on the vaccine deaths. Did the men have both have clotting and are you still whether that was linked to the vaccines? Thanks.

ERIC YOUNG:

Thanks, Rachel. As I said in my comments, we have a primary focus at the moment on those most at risk. And those most at risk in our society at the moment are those older Australians in residential aged care facilities. And we're using the majority of our vaccine administration service providers' capacity to get those done as soon as possible. We are in parallel looking at a number of other bondable cohorts, including the disability sector, and using a similar capacity for those vaccine administrative service providers. And we'll continue to trial out the way that we are administering those vaccines with the disability service providers. And we'll continue to increase the rate of those over the coming weeks and months.

JOHN SKERRITT:

So your question again. I don't want to talk about what individual patients had, but both of the two patients had various clotting disorders. And of course, there's a range of different clotting disorders from DVT, deep vein thrombosis, that is most infamously associated with in the days when we could do our airplane trips to London, through to pulmonary embolisms, which are clots in the lung through to clots in the intestines, and clots in the brain. Now, I don't want to comment on the specific diagnoses of those patients for confidentiality reasons. I would return to the fact that of those serious types of clots - and I'm not talking about a minor blood clot that goes away with fairly standard treatment - but we have 50 serious blood clots a day in Australia. It's a major cause of hospitalisation, going to emergency departments and seeing your doctor in a hurry, and probably then being referred straight into emergency. So a lot of people are getting clots. Our job is, of course, to unravel whether or not there's any association with vaccination. And so far, globally, there is not an overall association with clotting with vaccination, other than this rare syndrome called thrombocytopenia or thrombosis with thrombocytopenia. So it's a very rare and specific syndrome, but sadly we'll continue in most countries of the world to see clotting as a significant cause of hospitalisation and emergency department presentation. Jacob? Have we got- do we have any- I had Jacob written here. Sorry.

QUESTION:

Sorry. Professor, could you answer why is it hard to actually pinpoint what vaccines these people have received? Isn't- aren't these recorded on the immunisation register or through doctors' records? Why is it hard?

JOHN SKERRITT:

Well, there is a little bit of a time lag to getting the AIR data, and so what we'll often hear - and this is where I say we have a shared responsibility. So you might hear from a family who is obviously distressed, and in small towns or in regional or rural towns especially, their(*) local people say XYZ has been taken to emergency department with a clot. Their family says they had a vaccination a couple of days ago. We have to go to the data that's in the record or data that's come through the state and territory health system. Sometimes that's only a delay of a few hours, but there is still a delay in just confirming not only the vaccine but the batch number.

QUESTION:

You've also made the point it's about recording responsibly and sensibly on these issues. You said there's obviously nothing to that [indistinct]… car crashes and that sort of thing. Could you reflect on whether other common drugs have similar sort of rates of clots or other issues than what we're seeing here with vaccines?

JOHN SKERRITT:

Well, as has been mentioned before, the oral contraceptive pill actually has a higher rate of clots, although, while, again, some of the clots have proven fatal and others have been debilitating, and also the oral contraceptive pill, some of the older ones and some of them that are still used for things such as excess facial hair growth rather than just straight out contraception do carry a risk, especially in association, say, on long plane journeys. And so there are certain pills that you have a conversation with your doctor whether to change if you're about to fly to London. So those rates are often somewhat higher. And, you know, up in the one in 1000, one in 10,000 rate. Now, the fatality rates from those - and that also reflects that they're generally given to young, healthy women as opposed to a lot of the clotting fatalities and serious clotting incidences are in older people, including men. So there are a number of drugs that do lead to very significant clotting problems. It's also important to realise that anti-coagulant drugs are among the most commonly prescribed medications. If you've had significant heart surgery or if you've had a cardiac stent put in, you're basically put on anticoagulant antiplatelet drugs for the rest of your life. If you've had even a minor clotting, you use- you're put on a group of drugs called novel oral anticoagulant drugs, and warfarin is a long-term standby. So clotting conditions- blood clots for a reason. Otherwise, we'd all bleed to death if we cut ourself with a paper cut. But the downside of what nature has given us is that the propensity to clotting actually brings with it risk. And so, look, there's other drugs that are rarer and more associated with clotting. But unfortunately, clotting is a very significant source of having to go to your doctor or be put in the emergency department.

QUESTION:

Couple for the Commodore, if I may, on logistics. You talked about the batch testing of the 707,000 CSL AstraZeneca doses. Do you have any oversight of when we're expecting them to be able to achieve that benchmark of 1 million doses being produced and sent to batch testing a week? Is that imminent?

ERIC YOUNG:

I think the Minister's on the record as saying that he expects that to continue to slowly increase as they refine their processes over the coming weeks. So at the moment, that figure that we reported today is the same figure that we're planning on in the coming weeks.

QUESTION:

And today, for the first time in the vaccine rollout, Victoria actually overtook New South Wales as the most number of vaccines administered through their state system. They also had several mass AstraZeneca clinics come online this week. Is that something you're looking at if they've managed to dramatically increase their vaccination rate for your own purposes with the logistics going forward?

ERIC YOUNG:

As we talked about yesterday, the states and territories and Commonwealth sites all have an important role to play. We are looking every day at what the states do, but it's only with the partnership between the primary here - primary care facilities, what the states do, that we're going to reach the number that we need to.

QUESTION:

But are you looking to it as a lesson that they've obviously been able to dramatically increase their output?

ERIC YOUNG:

Again, how the states administer their vaccines is up to the states. And anything the states can do to increase that throughput is fantastic. We'll continue to work with them in whatever they can do, and we'll be doing similar things in the future.

QUESTION:

The RACGP told a Senate hearing this week that they were worried about some what they call bizarre decisions around distribution of vaccines - you know, a large number of smaller clinics, small number to large clinics. Is that something that you're looking at as part of your role? Is that something that might be sort of rejigged, reorganised?

ERIC YOUNG:

We look at allocations every single week. Again, the Minister and others are on the record as talking about where we're at with supply at the moment. Because we don't have the supply we would like, we're required to make decisions on allocations, try to make that as fair and equitable as we can to make sure that there's a maximum number of primary care facilities on board, and again, that is fair and equitable across the country, and it's agreed on a weekly basis. So-

QUESTION: 

[Interrupts] Sorry. Has that been something that you've, I guess, identified or started working on in terms of the work that you do, in terms of looking at one place and saying, okay, they're not getting out as many as they should be. This place has far higher demand than the number they're given? Is that something that you've already identified in some of your working?

ERIC YOUNG:

Absolutely. There's a big team that looks at each of the primary care facilities, look at what the states and territories are administering. And every single week we look at where there's opportunity to get a better distribution.

QUESTION:

How many- you mentioned we're over 2.11 million, I think, vaccinations. Now, do you know how many people have actually had two doses of that vaccine, been fully vaccinated now?

ERIC YOUNG:

Again, I'm on the record. Yesterday I was talking about what we produce publicly. Publicly, I'll say 2,112,285 doses have been administered. The National Cabinet has agreed on what we make public, and what we make public at the moment is the number of doses administered.

QUESTION:

Why is It- I know it's out of your purview, but why is it that we don't have that number?

ERIC YOUNG:

Again, I talked about it yesterday. There's nothing to hide. It's simply a matter of working collaboratively with the states and territories from the outset of the pandemic. And we've been doing so all the way through. We take very careful considered approaches with the states and territories all the way through to agreeing what is actually published. And what is published is available on the website every single day.

Thank you, ladies and gents.

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