All The Confusing AstraZeneca Vaccine Info For Under 40s, Explained
There have been a number of conflicting statements made about the safety of AstraZeneca for young people.
In a panicked 8pm press conference on Monday night, Scott Morrison announced that people under 40 could now request the AstraZeneca vaccine from their local GPs if they didn’t want to wait for Pfizer.
However, since that announcement, there have been a number of conflicting statements made about the safety of AstraZeneca for young people.
So here’s a rundown of everything you need to know before you book in your AstraZeneca shot:
What Did Scott Morrison Say?
During a press conference held late Monday night — following a National Cabinet emergency meeting on the new wave of COVID-19 hitting Australia — Scott Morrison announced a new no-fault indemnity scheme for GPs to allow young people to get vaccinated faster.
The scheme makes it easier for general practitioners to administer AstraZeneca to those under 40 years of age, who accept the risk of potential blood clotting that has been associated with the vaccine.
“If you wish to get the AstraZeneca vaccine, then we would encourage you to go and have that discussion with your GP, and we’ve already made announcements to support those additional consultations with the GPs so you can have that conversation,” Scott Morrison said during the press conference.
“We are also providing the indemnity scheme for those general practitioners, so they can actively engage with you, and you can make the best decision for your health.”
“To get access to AstraZeneca, if they’re willing to take on that risk, if they wish to go and speak to their job or their doctor and have access to the AstraZeneca vaccine, they can do so,” the Prime Minister continued.
While exact details of the no-fault indemnity scheme aren’t known yet, it should cover GPs if someone under 40 has an adverse reaction to AstraZeneca after deciding to take on the known risks.
Scott Morrison also explained that with most vaccines being administered by GPs, the vaccination rollout falls heavily in their hands hence the recent push for GP vaccinations.
“The significant majority of vaccines are being delivered by GPs, not state and territory clinics,” the Prime Minister added. “About 60 per cent and above of the vaccinations are being done by GPs. And so we’re not about to go and take vaccines out of GP clinics just to put them in state clinics.”
What Have Other MPs Said In Response?
After Scott Morrison announced that AstraZeneca would be available for under 40s from local GPs, there was immediate backlash and conflicting messaging being shared with the public.
In a press conference early today, Federal Health Minister Greg Hunt reaffirmed that medical advice hasn’t changed in Pfizer being the preferred vaccine for under 60s, but noted that Prime Minister’s announcement was designed to give young Australians more choice.
“There has always been the capacity for informed consent. That has existed throughout the process, and that remains the case,” Hunt said. “The difference here is that the access — given the fact that there is a large supply, that some GPs have reported that they have excess supply and excess spaces.”
“And so if there are people who wish to access it, via informed consent, via the existing ATAGI rules, then that’s simply being enabled, because we know there’s been demand. We know there’s supply. We know that there are existing rules. So no change on that particular front.”
Professor Paul Kelly, Australia’s Chief Health Officer, added that while “there’s a preference for Pfizer up to the age of 60… that preference is a preference”.
“It’s a discussion for doctors to have with their own patients and work through their own risk and benefit in relation to that.”
Scott Morrison: under 40s can get AstraZeneca
State premiers: hmm not sure about that, ATAGI says preferably nah
ATAGI: health advice hasn't changed
Greg Hunt: health advice hasn't changed
AMA: not sure about this
RACGP: we found out about this from the TV
— Josh Butler (@JoshButler) June 29, 2021
However, individual states and territories have pushed back on the Prime Minister’s comments.
In a COVID-19 briefing earlier today, Queensland Premier Annastacia Palaszczuk shared that the National Cabinet “did not make that decision” to have AstraZeneca be made more widely available to Australians under 40.
Seemingly against the Prime Minister’s suggestions, Palaszczuk noted that while she “wants Queenslanders to get vaccinated” there are already “some clear guidelines that have been put in place by the chief health officer, the ATAGI, and the Australia Medical Association”.
“We follow medical advice and the medical advice is very clear. At the moment, the advice is for people aged 40 to 59 to get Pfizer, and people 60 and over to get AstraZeneca,” the Queensland Premier said. “There has been no National Cabinet decision about AstraZeneca being given to under-40s.”
Taking a harder stance against the Prime Minister opening up AstraZeneca to young people, Queensland Chief Health Officer Dr Jeannette Young said she does “not want under-40s to get AstraZeneca because they are at increased risk of getting the rare clotting syndrome”.
“We’ve seen up to 49 deaths in the UK from that syndrome. I don’t want an 18-year-old in Queensland dying from a clotting illness who, if they got COVID, probably wouldn’t die,” Dr Young added. “We’ve had very few deaths due to COVID-19 in Australia in people under the age of 50.”
“Wouldn’t it be terrible that our first 18-year-old in Queensland who dies related to this pandemic died because of the vaccine?”
Let me be clear: there has been no National Cabinet decision about providing AstraZeneca to people under 40.
This is not the time to risk the safety of our young Australians. pic.twitter.com/FFXbL6DTIx
— Annastacia Palaszczuk (@AnnastaciaMP) June 30, 2021
NSW Premier Gladys Berejiklian also confirmed that the National Cabinet never made any decisions on giving under-40s AstraZeneca, instead, she shared that they had agreed that GPs wouldn’t face legal consequences for the side effects people may have from these vaccinations.
“What National Cabinet agreed to, which is on the public record, is that GPs would not face any legal consequences if they administered the vaccine to anybody, to make sure that they can administer the vaccine with confidence depending on their health advice,” Berejiklian clarified.
“I won’t comment beyond that but to say that if you’re under 60 and you want the AstraZeneca, you should have a conversation with your GP,” she continued. “What the NSW government will continue to do is follow the health advice of the federal regulators. The federal regulatory bodies are the ones that provide advice.”
“The NSW government always follows the health advice and the health advice from the federal regulatory bodies is that those over 60 should be getting AstraZeneca.”
So, What Does Australia’s Health Body Say?
On April 8, following a number of reports that the AstraZeneca vaccine had caused blot clots, The Australian Technical Advisory Group on Immunisation (ATAGI) announced that Pfizer was the “preferred” vaccine for people under 50.
While AstraZeneca was never “banned” for younger people, the ATAGI decided to recommend against it as the risk of clots outweighed the benefit of vaccination as there was very little community transmission of COVID-19 in Australia at that point.
“ATAGI recommends that all adults are vaccinated against COVID-19. The AstraZeneca vaccine is highly effective at reducing the risk of death or severe disease from COVID-19 across all adult age groups,” the ATAGI noted at the time.
It is worth pointing out the standing medical advice from ATAGI is that Pfizer remains the 'preferred' vaccine for everyone under 60.
That advice hasn't changed.
— Michael Rowland (@mjrowland68) June 28, 2021
“The risk of ongoing health issues and death from COVID-19 is highest in older age groups, particularly rising from 50 years of age,” the ATAGI continued. “By comparison, the rate, and thus possibility of disability and death from thrombosis with thrombocytopenia syndrome (TTS) may be higher in younger people.”
“COVID-19 Vaccine AstraZeneca can be used in adults aged under 50 years where the benefits are likely to outweigh the risks for that individual and the person has made an informed decision based on an understanding of the risks and benefits.”
A month later, the age of recommendation increased to include under 60s as the ATAGI found there was a higher risk of clotting found in the 50 to 59 age group than what was “reported internationally and initially estimated in Australia”.
However, ATAGI stressed that AstraZeneca could still be used if Pfizer wasn’t available if the benefit outweighed the risk.
And What Are Doctors Saying?
GPs have said that they were blindsided by Scott Morrison’s AstraZeneca comments on Monday night.
Dr Karen Price, president of The Royal Australian College of General Practitioners (MACGP), has said that that doctors were given “no warning” and were left “scrambling” to figure out how to deal with patients.
“Phones are ringing off the hook at GP clinics,” Dr Price said. “We had no warning of last night’s announcements and this isn’t the first time this has happened to general practice. It’s vital that government provides significant support to GPs to implement these changes to the vaccine rollout.”
Please remember that us GPs are still trying to get our heads around last night's announcement concerning #AstraZeneca too and what it means for our patients. A reminder to treat all nurses, receptionists and administrative workers with respect. We are doing our best #COVID19Aus
— RACGP President (@RACGPPresident) June 29, 2021
Meanwhile, the Australian Medical Association (AMA) refuses to endorse the idea that under-40s should get the AstraZeneca jab, according to The Guardian.
President of the AMA, Dr Omar Khorshid, explained that the Australian Medical Association’s recommendation is still “for patients to follow the ATAGI advice”.
“It took us by surprise, and it’s hard to know how to take that announcement because I think it’s going to be a limited number of people to take it up, given that they would be going against the expert Atagi recommendation,” Dr Khorshid told The Guardian.
“Our recommendation is still really for patients to follow the ATAGI advice. Be patient and have the ATAGI-recommended vaccine when it’s available. I am certainly still backing the expert advice at this stage.”
With the Delta strain of coronavirus spreading through Australia’s severely under-vaccinated community, Dr Khorshid did add that speeding up the vaccination program by using the vaccines available is “wise”.
“We do have surplus doses that are currently not being used so there is some capacity to bump up the delivery,” Dr Khorshid said. “Of course, if Delta really does ingrain itself in our community and the lockdowns aren’t successful or they’re too slow, then speeding up the vaccination program by using more options on the table is wise.”
Literally just broke the news to my gp that under 40s can get AstraZeneca two days after the announcement. How can the advice be “talk to your gp” if they don’t even know what’s going on?
— Dee Salmin (@dariya_salmin) June 30, 2021
Ultimately, the decision of whether someone under 40 is able to be vaccinated at their local doctor’s office comes under the GP’s discretion as the messaging from the government has been murky over the last few days.
While many young people have been excited to be able to call up their local GP to book their dose of AstraZeneca, some have been pushed back with doctors choosing to stay with ATAGI advice. However, all GP’s agreed that if you’ve already had your first dose of AstraZeneca, you should stick with the same vaccine for your second shot at 12 weeks apart, in line with ATAGI recommendation.
So Is It Safe To Get The AstraZeneca Vaccine As An Under 40?
Really, the decision to book in for the AstraZeneca vaccine as someone under 40, as many people have said, comes down to personal preference which you should decide based on your own risk-benefit assessment, in dialogue with your GP.
After a study with over one million Australians who have been vaccinated — including 362,000 who have taken AstraZeneca so far — AusVaxSafety reports that common side effects of both shots regularly include injection site pain, fatigue, headache, muscle and body aches, and less often chills, joint aches, and fevers.
When it comes to the risk of TTS blood clots, in a low exposure risk situation for the 18 to 39 age group, the number of potential blood clots are about equal to the amount of coronavirus-related hospitalisations it could prevent, according to the Department of Health.
In higher exposure situations, this risk of clotting stays the same but the benefits of fewer deaths, less ICU admissions, and prevented hospitalisations increases for every age group. However, these risk estimates are uncertain as so few young people have actually received the AstraZeneca vaccine in Australia to make a fair assessment.
Regardless, just like the Pfizer vaccine, AstraZeneca is provisionally approved by Australia’s Therapeutic Goods Administration for use on people 18 and older. And the Department of Health has this handy guide that can help you weigh up the potential benefits against the risk of harm for AstraZeneca by age group.
As of June 24, there were only 64 reported cases of TTS in Australia that were likely linked to AstraZeneca in the 6.5 million doses that have been administered so far. That is a 0.00097 percent likelihood of developing blood clots from the AstraZeneca vaccine. More specifically, the ATAGI estimate that the risk of TTS with AstraZeneca for people under 50 is around 3.1 per 100,000 compared to 1.4 to 1.9 in those aged 60 and above.
But if you’re still worried about the associated risks of getting AstraZeneca, you can now book an appointment with your GP to discuss your own benefit-to-risk balance to make your own decision.
Michelle Rennex is a senior writer at Junkee. She tweets at @michellerennex.