The COVID-19 vaccine wars: The vacuum that needs filling
There is much we still need to learn and be made aware of before the legal profession starts to debate the legalities of workplaces mandating the COVID-19 vaccination, writes Ian McGarrity.
I recently had a possum in my roof at home. I did nothing about it until one Friday night recently another possum got in. They are very territorial animals. A fight broke out and in the course of it electrical wires shorted out in my roof and I was plunged into darkness.
Nothing a possum catcher and subsequently an electrician could not fix but I should have acted earlier and avoided the subsequent expense.
I feel the Australian government and its Department of Health have been guilty of the same ennui regarding its COVID-19 vaccine choices and roll-out.
It should have realised that if it left a vacuum for all sorts of 1st XI media epidemiologists and “experts” to fill then, just as nature abhors vacuums such people would fill the vaccine vacuum with all sorts of variable information.
Now, the Australian government has a full-scale “vaccine war” on its hands.
The problem started way back in October when positive noises were coming out of three competing (commercially and for bragging rights) vaccine phase three studies.
In November “efficacy rates” of around 95 per cent were announced by Pfizer and Moderna. Later Oxford-AstraZeneca scratched up a speculative 90 per cent efficacy rate but really its real phase three study result was 62 per cent.
These numbers partially filled a public vacuum. A public that has for months feared the virus and longed for the safety image reflected by a vaccine.
Words like “herd immunity” and “immunity” get thrown around. The terms “efficacy” and “efficiency” got interchanged with gay abandon when they mean very different things.
“Safety” is around the corner for the public, and businesses see such “safety” as meaning – at last we can open up and stay open. Businesses then turn its mind to such “down the track” issues as “what to do with staff refusing to get vaccinated”.
This is where the government and the Health Department should have been filling out the vacuum with real qualifying facts.
The Pfizer and Moderna 95 per cent efficacy related to protection against serious or symptomatic COVID-19. Hence theoretically 19 out of every 20 people getting both doses would be protected against knowing they had the disease – but not necessarily from getting asymptomatic COVID-19 and being unknowingly infectious to others.
With the AstraZenica vaccine the only valid efficacy rate to use was 62 per cent That was the efficacy reported from its phase three studies in the UK and Brazil related to its two standard dose regimen. The 90 per cent reported from a small sample within the UK part of the trial as a result of vaccine strength measurement errors, has not been accepted by the UK regulator and only the two standard dose regimen can be used in the UK.
Once again, the 62 per cent efficacy is only against “symptomatic” COVID-19.
Put in its crudest form, that means that two out of every five people receiving the approved dosing for the AstraZeneca vaccine are not protected against symptomatic COVID-19. Compared with only one in 20 for those receiving Pfizer or Moderna.
But AstraZeneca to its credit did include some systemic testing of its vaccine against “asymptomatic” COVID-19. But unfortunately the results of that were unimpressive.
Of the UK participant cohort receiving the now approved two standard dose regimen, 22 contracted asymptomatic COVID-19 and just one more, 23, in the placebo group.
It would appear therefore on current published and peer review information that only two out of every five people receiving the AstraZeneca approved dosing regimen would be protected against contracting COVID-19 per se (symptomatic or asymptomatic).
Neither Moderna nor Pfizer can give you equivalent information on their “asymptomatic” performance.
Now in my view the Australian government and its Health Department should have been explaining all this to the public from 1 December 2020.
Now they are having to explain it to the public and business groups after a lot of misconceived public hopes have been unleashed.
Further both should have been saying that no one knows yet very much at all about how long any vaccine protection lasts. It is most unlikely it will be for life. Possibly more like the annual influenza vaccine duration of protection. About a year.
The government and Health Department should have been debunking any medium-term concepts of “herd immunity” as a consequence of vaccination.
Apart from anything else the Moderna and AstraZeneca vaccines have not been trialled in anyone under 18. The Pfizer study did not involve anyone under 16.
About 20 per cent of the Australian population is under 18.
In all likelihood, another 5 per cent of our population will not be recommended for vaccination for a range of other medical reasons.
One example of the consequences of the vacuum left by our federal political and bureaucratic leaders, is the unknown and misunderstood real circumstances surrounding issues such as “standing down employees who refuse a direction to get vaccinated” and or the legality of making such a direction.
Just think. The two vaccines most likely to be involved early in our vaccine roll-out, Pfizer and AstraZeneca, are very different. Could the same “be vaccinated” rule and consequences apply to both?
Are vaccinated employees still likely to be infectious to other employees and customers? Given it is likely that most COVID-19 infections for vaccinated people will be asymptomatic, how can you protect your customers and workforce from being infected and be just as likely to get symptomatic COVID-19 as now?
The standard instruction to “stay away from work if you have any symptoms” becomes increasingly meaningless because increasingly as the vaccine rolls out infections will be asymptomatic. The current proportion of asymptomatic COVID-19 (about 40 per cent of all infections) will increase.
What could you say to employees under 18?
There is a great deal of things to know about COVID-19 vaccines, and for the Australian government and its Health Department to tell us, before anyone can safely or even productively progress legal issues such as enforcing COVID-19 vaccinations and standing down employees who for one reason or another can’t or won’t get them.
Ian McGarrity is a freelance journalist and former deputy to the head of ABC TV and former head of SBS TV.