What really is going on with the tit for tat over Pfizer?

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The Andrews government this week halted all walk-ins for Pfizer at its mass vaccination hubs, citing supply constraints.

The Commonwealth has disputed the state’s claims, while the Victorian government has maintained it cannot keep up with the rate of demand at the current level of supply. So what is really going on?

People wait to be vaccinated at Melbourne’s Royal Exhibition Building.Credit:Getty

There has been an increased demand for vaccines since the Whittlesea COVID-19 cluster emerged in late May, and the Andrews government rolled out Pfizer to Victorians aged in their 40s from May 28.

That means people who received their first shot of Pfizer around that time are due for their second dose, and this is creating a vaccine crunch. Australia’s expert immunisation panel is now recommending AstraZeneca should be given to people over the age of 60 – up from the current recommendation of 50. This is set to add further strains on the country’s, and Victoria’s, vaccination efforts.

On May 26, the federal government announced Victoria would receive a one-off additional 150,000 doses of vaccine under the condition the state uses all the jabs, and, crucially, catches up on its second-dose schedule.

Under the Commonwealth’s vaccine rollout program, the federal government was providing 71,000 Pfizer doses a week to Victoria – about half were to be used as first doses, and the other half as second doses. When it provided a temporary uplift in late May, Victoria’s Pfizer allocation had been raised to 105,000 every week for three weeks (until July 5).

While a significant amount of the weekly allocation was meant to be given as first doses, the Commonwealth believed most would be given to people due for their second doses and would get the state back in sync with its first and second dose schedule.

It appears the state government continued administering first doses and the already out-of-sync first and second-dose schedule was exacerbated as demand for the vaccine increased and thousands of people turned out to get vaccinated.

Health Minister Martin Foley on Monday said the vaccine rollout was being hampered by limited doses arriving from the federal government. “If more doses are delivered by the Commonwealth, we will be able to increase the number of bookings for first doses as well,” he said.

The Victorian government has decided to hold back first-dose appointments so people can receive their second dose (required between three and six weeks after their initial jab).

The Commonwealth has demanded the states use up all their vaccines and not hold back any second doses, insisting the federal government is reserving those supplies.

The Victorian government is arguing if the state used up all the 105,000 doses provided each week, by the time the supply drops to 83,000 from July 5, there would be a deficit of 20,000 doses and the government would struggle to fully inoculate Victorians.

“The Commonwealth made it very clear to all states and territories at the last national cabinet that we don’t need to make provisions for second doses because they will retain them. If they can’t do that, then they shouldn’t be publicly scolding states for holding doses back,” Mr Merlino said.

“Victorians have turned out in their thousands to get vaccinated, but we can’t maintain this rate without certainty about supply from the Commonwealth.”

Until June 7, the Commonwealth allocated about 71,000 doses of Pfizer a week to Victoria. This increased to 105,300 doses for the week of June 14. The federal government has advised Victoria it will receive 104,130 doses next week, and 104,130 doses the week after.

On the week of July 5, Victoria’s supply will drop to 83,070 doses and remain at that level. NSW has been advised it will receive 101,790 doses a week from July 5.

Acting Premier James Merlino told the Commonwealth to stop “publicly scolding” states if they can’t guarantee second dose supplies. Credit:Jason South

The Commonwealth say beyond global supply issues, there are no supply constraints. They say the additional doses were to assist with catching up with second doses.

“Victoria’s allocation of Pfizer vaccines has actually increased from 71,370 per week in June to 83,070 per week in July,” said a spokesman for federal Health Minister Greg Hunt.

“At the Victorian government’s request, we provided an additional 150,930 doses to the Victorian government to assist them in meeting demand and managing their second doses.

“This has provided an immediate increase to Victoria above their population allocation and we note they provided written confirmation that they understood this is a temporary one-off allocation, not a continous increase.”

The Age on Wednesday evening revealed Mr Foley wrote to his federal counterpart on Monday thanking him for providing an additional 130,000 doses of AstraZeneca and 100,000 doses of Pfizer vaccine to meet the increased demand for vaccine uptake in Victoria.

He said he was encouraged by the possibility of the Commonwealth providing another additional one-off allocation of about 50,000 Pfizer vaccines, and acknowledged that the supply would revert back to the usual allocations in line with the latest timetable provided by the federal government – about 80,000 doses a week.

Mr Foley also said it was incumbent upon his department to ensure that supply was available for second doses.

Like most of Australia’s vaccine data, it is impossible to get a state-by-state/territory breakdown of second doses that have been administered. But of the publicly available information, which only the the NSW, Victorian and West Australian governments provide, WA has fully vaccinated 3.2 per cent of its population, NSW 2.4 per cent and Victoria 1.7 per cent.

The true percentage is likely to be higher for all three because about half of each states doses are administered by the federal government, which does not provide data on second doses.

So, Victoria has been lagging behind NSW and Western Australia in terms of people who have been fully inoculated. Victoria has had a significant surge in demand for vaccines because of the latest COVID-19 scare, but even before the outbreak, it had a higher percentage of people who had received their first dose than the other two states.

The federal government has been pushing for Victoria to adopt a booking system, which allows people to simultaneously book in for their first and second dose. They have argued this would assist the state in proper planning and foreshadowing how many second doses are necessary in the near future.

The Victorian government did not respond to whether or not it would adopt such a booking system, but said Victorians have been showing up in record numbers to be vaccinated – the state delivered 40 per cent of all vaccines nationwide.

And according to the federal government’s own data, Victoria’s utilisation rate of the vaccine is the highest across the country, with the state using up 91 per cent of the supply it has received from the Commonwealth.

“It is simply a fact, that with a 20,000 cut to our supply, it will mean less Victorians getting vaccinated – and it is entirely appropriate to call that out,” a Victorian government spokesman said.

“Every step of this vaccine rollout, we have advocated to have the supply, to meet the demand we have …

“If the Commonwealth now want to turn around, cut Victoria’s supply, and think we will accept it, they are wrong. Acknowledging your supply is about to be cut, is not the same as accepting it.”

Deakin University chair of epidemiology Catherine Bennett.Credit:Jason South

Deakin University chair of epidemiology Catherine Bennett has also recommended the Victorian government adopt a booking system that allows people to simultaneously book in first and second doses.

“It’ll work two ways: by allowing people to book in both their appointments, you increase the chance people are given their second dose within their preferred timing, and it gives the state that better planning as we’re not yet in sync with our first and second doses,” Professor Bennett said.

“And the third level of benefit is that the individuals know if they have that appointment in the system that’s going to be honoured.”

While you will have people who cancel appointments at the 11th hour, it’ll be “so far on the edges”, Professor Bennett says, that the benefits of a renewed, more efficient booking system will outweigh any risks arising from late cancellations.

With Craig Butt

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