Aged care facilities are a particular concern. It is only a matter of time before the virus is introduced into an aged care facility with the inevitable consequences of severe COVID-19.
Britain, the United States and the European Union, among others, have already started vaccination programs, using targeted campaigns to protect those most at risk of infection and severe disease. Admittedly, this is against a background of alarmingly high infection rates and the emergence of even more infectious strains compared with Australia’s relatively good position.
However, their rapid move to vaccinate does not mean their vaccine programs are being rolled out precipitously or that moving swiftly comes with increased risk.
Vaccine development for COVID-19 has been fast and efficient. The Pfizer/BioNTech, Moderna, Sinopharm, Gamelaya Research Institute and AstraZeneca/Oxford vaccines have received approval in various countries after successful phase 3 trials demonstrated efficacy ranging from 62 per cent to 95 per cent.
They were developed rapidly but this is a result of a combination of factors including large monetary investments, and a global collaborative effort with parallel approaches to vaccine development using a variety of technologies, old and new. It has not compromised safety.
Two additional factors enabled the rapid development of COVID-19 vaccines without putting a question mark over quality. Phase 3 trials typically take years to accumulate sufficient infections to determine vaccine efficacy and safety and involve tens of thousands of participants. For example, the RV144 trial to evaluate a HIV vaccine candidate in 16,395 volunteers ran for 42 months.
But because of the high rates of infection in Britain, the US, Brazil and other trial sites, phase 3 COVID-19 studies involving approximately 40,000 people per trial were completed within months with rapid assessment of efficacy and safety.
The second factor is that humans readily develop a robust immune response to the components of COVID-19 vaccines, the antigens of SARS-CoV-2. By contrast, after more than 30 years of intense research, we are not even close to a vaccine for HIV that could match even the lower end of COVID-19 vaccine efficacy.
The rapid development of vaccines for COVID-19 is a result of outstanding scientific endeavour, the ability to rapidly assess efficacy and safety, and the inherent characteristics of SARS-CoV-2 antigens.
No doubt, questions remain. Do these vaccines block transmission? Will we need to be revaccinated every year or two with new vaccines? These questions will take time to understand as we observe the effects of vaccination around the world and monitor long-term safety and efficacy.
What we do know is that the vaccines work at preventing severe disease. Approvals from the US Food and Drug Administration, the European Medicines Agency and Britain’s Medicines and Healthcare products Regulatory Agency are testament to their safety and efficacy. On January 1, the World Health Organisation approved the Pfizer/BioNTech vaccine for emergency use to accelerate vaccine programs in the developing world.
If the TGA would move more rapidly, we could bring forward Australia’s vaccine timetable with confidence. Perhaps the question is which vaccines does Australia have available now, as well as how many doses and when will we have sufficient doses to vaccinate the broader population?
The vaccines are a result of an incredible international scientific effort and are our only hope at beginning our “post-COVID normal”, the quicker the better.
Adjunct Professor Heidi Drummer is program director for disease elimination at the Burnet Institute.
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