COVID-19 vaccination in Australia

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COVID-19 vaccination programme
Vaccination Map of Australia.png
COVID-19 fully vaccination map of Australia (as of 15 August 2021) [1]
Date22 February 2021 (2021-02-22) – present
(190 days ago)
Location Australia
CauseCOVID-19 pandemic in Australia
TargetImmunisation of Australians against COVID-19
BudgetA$1.87 billion[2]
Organised byFederal, state and territory health departments
Participants
Outcome
  • 59% of the eligible Australian population has received at least one dose.[a]
  • 35% of the eligible Australian population has received both doses.[a]
Websiteaustralia.gov.au/covid19vaccines
An advertisement poster released in March 2021, part of the Australian Government's COVID-19 vaccination rollout.
A poster from the government's vaccination campaign rolled out in July 2021, titled "Arm yourself against COVID-19"

The general COVID-19 vaccination in Australia programme began on 22 February 2021 in response to the COVID-19 pandemic, and will continue with the goal of vaccinating all willing Australians before 2022. Front-line workers[b] and aged care staff and residents will be the first Australians to be inoculated, before a gradual phased release to less-vulnerable and lower-risk population groups throughout 2021. The Therapeutic Goods Administration (TGA) approved four vaccines for Australian use: the Pfizer–BioNTech vaccine on 25 January, Janssen vaccine on 25 June 2021, Moderna vaccine on 9 August and the Oxford–AstraZeneca vaccine on 16 February.[4][5][6][7] The third vaccine approved for Australia is the Janssen vaccine but it is not included in the vaccination program.[8]

As of 30 August 2021, Australia has administered 19,362,666 vaccine doses across the country.[3][9] The country's vaccination rollout has faced criticism for its slow pace, falling far below initial government targets.[10][11]

Vaccine approval[]

The four vaccines currently approved for administration in Australia are classified as being "provisionally approved", meaning that they have been deemed both safe and effective based on clinical and scientific data and are in the process of non-expiring registration. The authorisation means the vaccine will become part of the Australian Therapeutic Goods Register and will be up for review again in two years based on additional clinical data.[12]

Pfizer–BioNTech vaccine[]

This section is an excerpt from Therapeutic Goods Administration § Pfizer–BioNTech vaccine.[]

On 25 January 2021, the TGA provisionally approved the two-dose Pfizer–BioNTech COVID-19 vaccine, named COMIRNATY, for use within Australia. The provisional approval only recommends the vaccine for patients over the age of 16, pending ongoing submission of clinical data from the vaccine sponsors (the manufacturers, Pfizer and BioNTech).[13] Additionally, every batch of vaccines have their composition and documentation verified by TGA laboratories before being distributed to medical providers.[14]

The Department of Health planned the administration of COVID-19 vaccinations in five phases, organised by the risk of exposure. Border, quarantine, and front-line health and aged care workers were vaccinated first, followed by over 70 year-olds, other health care workers, and essential emergency service members. Following the provisional approval of COMIRNATY, Prime Minister Scott Morrison said that it was planned for the first group to begin vaccinations by February 2021, six weeks earlier than originally planned.[15]

The first public COVID-19 vaccination in Australia actually took place on 21 February 2021 with the Pfizer–BioNTech vaccine at Castle Hill in Sydney. An 84 year-old aged care resident was the first Australian to receive the vaccine. To show confidence in the national immunisation vaccine rollout, Prime Minister Morrison and Chief Medical Officer Professor Paul Kelly also received vaccinations.[16]

On 23 February 2021, Australia's second shipment of the Pfizer vaccine arrived at Sydney airport. Health Minister Hunt confirmed the arrival of 166,000 doses, and 120,000 more doses expected to arrive in the following week.[17]

On 9 April 2021, Prime Minister Morrison announced that Australia had secured another 20 million doses of Pfizer vaccine on top of 20 million already on order, meaning 40 million doses should be available to Australians in 2021. This was amid concerns about the AstraZeneca vaccine, in rare cases, causing blood clots; see section Oxford–AstraZeneca vaccine below. The additional doses of Pfizer were expected to arrive in Australia in the last quarter of 2021.[18][19]

On 23 July 2021, the TGA approved the Pfizer COVID-19 vaccine for teenagers between 12 to 15 years old.[20]

Pfizer–BioNTech vaccine effectiveness[]

This section is an excerpt from Pfizer–BioNTech COVID-19 vaccine § Effectiveness.[]

A case-control study published in May 2021, in The New England Journal of Medicine found that, among vaccine recipients in Qatar, the Pfizer-BioNTech vaccine has an effectiveness of 89.5% against any documented cases of the Alpha variant (lineage B.1.1.7) and 75% effectiveness against the Beta variant (lineage B.1.351). The same study reported that the effectiveness of the vaccine against severe, critical, or fatal disease against any variant of SARS-CoV-2 is 97.4%.[21]

A test-negative[note 1] case-control study published in August 2021 found that two doses of the BNT162b2 (Pfizer) vaccine had 93.7% effectiveness against symptomatic disease caused by the alpha (B.1.1.7) variant and 88.0% effectiveness against symptomatic disease caused by the delta (B.1.617.2) variant.[22] Notably, effectiveness after one dose of the Pfizer vaccine was 48.7% against alpha and 30.7% against delta, similar to effectiveness provided by one dose of the ChAdOx1 nCoV-19 vaccine.[23]

On 27 August, the Centers for Disease Control and Prevention published a study reporting that the effectiveness against infection decreased from 91% (81–96%) to 66% (26–84%) when the Delta variant became predominant in the US, which may be due to unmeasured and residual confounding related to a decline in vaccine effectiveness over time.[24]

Unless indicated otherwise, the following effectiveness ratings are indicative of clinical effectiveness two weeks after the second dose. A vaccine is generally considered effective if the estimate is ≥50% with a >30% lower limit of the 95% confidence interval.[25]

Effectiveness by variant
Doses Severity of illness Alpha Beta Gamma Delta Others circulating previously[A]
1 Asymptomatic 38% (29–45%)[27] 17% (10–23%)[21] Not reported 30% (17–41%)[27] 60% (53–66%)
Symptomatic 27% (13–39%)[27] 43% (22–59%)[28] 33% (15–47%)[27] 66% (57–73%)
Hospitalization 83% (62–93%)[B] 0% (0–19%)[21] 56% (−9 to 82%)[28] 94% (46–99%)[B] 78% (61–91%)
2 Asymptomatic 92% (90–93%)[27] 75% (71–79%)[21] Not reported 79% (75–82%)[27] 92% (88–95%)
Symptomatic 92% (88–94%)[27] 88% (61–96%)[28] 83% (78–87%)[27] 94% (87–98%)
Hospitalization 95% (78–99%)[B] 100% (74–100%)[21] 100%[C][28] 96% (86–99%)[B] 87% (55–100%)
  1. ^ Surveillance study from 20 December 2020 to 1 February 2021 in Israel.[26] During this period, according to Nextstrain, the dominant variant in Israel was lineage B.1.1.50 and the Alpha variant was becoming dominant.
  2. ^ Jump up to: a b c d Preliminary data of effectiveness against hospitalization referenced by Public Health England.[29][30]
  3. ^ A confidence interval was not provided, so it is not possible to know the accuracy of this measurement.

Oxford–AstraZeneca vaccine[]

This section is an excerpt from Therapeutic Goods Administration § Oxford–AstraZeneca vaccine.[]
Oxford AstraZeneca COVID-19 vaccine (2021)

On 16 February 2021, the Oxford–AstraZeneca vaccine was approved by the TGA for use in Australia. The administration of this vaccine is scheduled to start in March.[31] Two weeks later, on 28 February, the first shipment of the vaccine, around 300,000 doses, arrived at Sydney for rollout from 8 March.[32] On 5 March 2021, Italy stopped the export of AstraZeneca vaccine to Australia due to their slower rollout of that vaccine in the EU.[33] On 23 March, TGA approved the first batch of locally manufactured AstraZeneca vaccine by CSL-Seqirus in Melbourne, and 832,200 doses were ready for rollout in the following weeks.[34]

On 17 June 2021, Federal Health minister Greg Hunt announced a rise in the age limit for administration of the AstraZeneca vaccine. After new advice from the Australian Technical Advisory Group on Immunisation (ATAGI), the vaccine was no longer recommended for people aged under 60 years. This advice came after new cases of blood clotting, thrombosis with thrombocytopenia syndrome (TTS), in those under 60 after AstraZeneca vaccinations.[19]

On 23 June 2021, the Federal government released vaccine allocation projections and forecast that the Oxford-AstraZeneca vaccine would be in "little need" past October 2021 when all Australians over 60 years were expected to be fully vaccinated.[35]

Oxford–AstraZeneca vaccine effectiveness[]

This section is an excerpt from Oxford–AstraZeneca COVID-19 vaccine § Effectiveness.[]

Preliminary data from a real-world study in Botucatu in Brazil, where the Gamma variant predominates, found a 71% reduction in symptomatic cases after 81% of the population received the first dose.[36]

Preliminary data from a study in Brazil with 61 million individuals from 18 January to 30 June 2021 indicate that the effectiveness against infection, hospitalization and death is similar between most age groups, but protection against all these outcomes is significantly reduced in those aged 90 or older, attributable to immunosenescence.[37]

A vaccine is generally considered effective if the estimate is ≥50% with a >30% lower limit of the 95% confidence interval.[38]

Effectiveness by variant
Doses Severity of illness Alpha Beta Gamma Delta
1 Asymptomatic 37% (32–42%)[39] Not reported 33% (32–34%)[37] 18% (9–25%)[39]
Symptomatic 39% (32–45%)[39] Not reported 33% (26–40%)[40] 33% (23–41%)[39]
Hospitalization 76% (61–85%)[A] Not reported 52% (50–53%)[37] 71% (51–83%)[A]
2 Asymptomatic 73% (66–78%)[39] Not reported 70% (69–71%)[37] 60% (53–66%)[39]
Symptomatic 81% (72–87%)[39] 10% (−77 to 55%)[B] 78% (69–84%)[40] 61% (51–70%)[39]
Hospitalization 86% (53–96%)[A] Not reported 87% (85–88%)[37] 92% (75–97%)[A]
  1. ^ Jump up to: a b c d Preliminary data of effectiveness against hospitalization referenced by Public Health England.[41][42]
  2. ^ Efficacy from a study with 2026 participants.[43]

Moderna vaccine[]

Vials containing the Moderna COVID-19 vaccine sit on a table in preparation for vaccination
Vials of the Moderna COVID-19 vaccine

On 24 June 2021, the Moderna COVID-19 vaccine, Elasomeran, was issued a provisional determination by the TGA making it eligible to apply for provisional registration in Australia. It is targeted for use in individuals aged 18 years of age and older pending approval.[44] The Moderna vaccine has been approved to use in Australia for 18 years or older by TGA on 9 August 2021. It is also under evaluation for adolescents aged between 12 and 17.[7][45]

Moderna vaccine effectiveness[]

This section is an excerpt from Moderna COVID-19 vaccine § Effectiveness.[]

A vaccine is generally considered effective if the estimate is ≥50% with a >30% lower limit of the 95% confidence interval.[46]

Preliminary data from a study in Minnesota suggest that the vaccine remains effective against hospitalization and asymptomatic infection by the Delta variant. From January to July 2021, the dominant variant in Minnesota shifted from Alpha in January, with a prevalence of 85%, to Delta in July, with a prevalence of 70%. Effectiveness against hospitalization by any variant fell slightly, from 92% (95% CI, 81–97%) over the entire period to 81% (33–96%) in July. Effectiveness against asymptomatic infection by any variant also fell only slightly, from 86% (81–91%) over the entire period to 76% (58–87%) in July. By comparison, effectiveness against asymptomatic infection by any variant fell further for the Pfizer–BioNTech vaccine, from 76% (69–81%) over the entire period to 42% (13–62%) in July.[47]

On 27 August, the Centers for Disease Control and Prevention published a study reporting that the effectiveness against infection decreased from 91% (81–96%) to 66% (26–84%) when the Delta variant became predominant in the US, which may be due to unmeasured and residual confounding related to a decline in vaccine effectiveness over time.[48]

Effectiveness by variant
Doses Severity of illness Alpha[c] Beta[c] Gamma[c] Delta Others circulating previously[c]
1 Symptomatic 61% (56–66%) 43% (22–59%) Not reported 61% (53–67%)
Hospitalization 59% (39–73%) 56% (−9 to 82%) Not reported 76% (46–90%)
2 Symptomatic 90% (85–94%) 88% (61–96%) Not reported 93% (87–96%)
Hospitalization 94% (59–99%) 100%[d] Not reported 90% (80–100%)
  1. ^ Jump up to: a b For percentage, only the population aged 16 years and older is considered.
  2. ^ Front-line workers is limited to staff at border and quarantine facilities, health care staff in emergency and COVID-19 wards in hospitals, and other direct-contact workers.
  3. ^ Jump up to: a b c d 14 December 2020 to 19 April 2021 in Ontario, Canada.[49]
  4. ^ A confidence interval was not provided, so it is not possible to know the accuracy of this measurement.

Janssen (J&J) vaccine[]

On 25 June 2021, provisional approval was given by the TGA to the Janssen COVID-19 vaccine, the third vaccine for potential use in Australia. Strict conditions were imposed on Janssen which includes further investigation documents related to the efficacy, long term effects and safety concerns that must be provided regularly to TGA.[8] As of 3 August 2021 following the release of the 'Op COVID SHIELD National COVID Vaccine Campaign Plan', it is not included in the vaccination programme.[50]

Janssen vaccine effectiveness[]

This section is an excerpt from Janssen COVID-19 vaccine § Efficacy.[]

A vaccine is generally considered effective if the estimate is ≥50% with a >30% lower limit of the 95% confidence interval.[51]

Efficacy by variant
Severity of illness Alpha Beta Gamma Delta Lineage B.1[a]
Moderate[b] to severe[c] Not reported 64% (41–79%) Not reported Not reported 72% (58–82%)
Severe to critical[c] Not reported 82% (46–95%) Not reported 71%[d][e] 86% (−9 to 100%)

Novavax vaccine[]

On 20 January 2021, the Novavax vaccine was issued a provisional determination by the TGA making it eligible to apply for provisional registration in the Australian Register of Therapeutic Goods (ARTG).[54] As of 14 June 2021, Novavax had entered the final stage of trials.[55] As of 8 July 2021, the Novavax COVID-19 vaccine is under evaluation by the TGA (not yet approved) for use in Australia.[45]

ATAGI recommendation on vaccine use[]

After the TGA approves vaccines, the Australian Technical Advisory Group on Immunisation (ATAGI) provides recommendations and clinical guidance on vaccine use. The recommendation as of 29 July 2021 is that the AstraZeneca COVID-19 vaccine is the preferred vaccine for people aged 60 years and older. The Pfizer COVID-19 vaccine is the preferred COVID-19 vaccine in people aged under 60 years of age; and is additionally recommended in people with a history of cerebral venous sinus thrombosis (CVST), heparin-induced thrombocytopenia (HIT), or antiphospholipid syndrome with thrombosis. These recommendations are based on the risk of TTS appearing to be higher in younger adults than in older adults, and younger adults having a lower likelihood of having severe outcomes from COVID-19 compared to older adults, and theoretical concerns that a history of the rare conditions listed above may increase the risk of TTS.[56] The AstraZeneca vaccine is also recommended to most people aged 18 years after consultation with their GP who are resident in declared hotspot areas.[57]

In June 2021, the Federal government projected that the Oxford-AstraZeneca vaccine would see "little need" after October 2021 when all over 60 year-old Australians were expected to be immunised.[58]

Vaccine rollout and distribution[]

"We're not safe until we're all safe", a print ad promoting vaccination and providing information about how to book an appointment

The federal government has stated it will provide free COVID-19 vaccinations to everyone living in Australia, largely regardless of immigration status. Like most vaccines, Australians will not need a prescription to receive them.[59]

COVID-19 vaccine national rollout phases[]

National Vaccine Rollout Strategy[60]
Order Priority group Number of eligible (estimated) [61] Number of doses targeted [f] Progress [g]
Phase 1a
1 Quarantine, border & front-line health care workers 678,000 up to 1.4 million In progress
2 Front-line health care worker sub-groups for prioritisation
3 Aged care and disability care staff
4 Aged care and disability care residents
Phase 1b
5 Elderly adults aged 80 years and over 6,139,000 up to 14.8 million In progress Registration open
6 Elderly adults aged 70–79 years
7 Other health care workers
8 Aboriginal and Torres Strait Islander people aged 55 and over
9 Adults with an underlying medical condition, including those with a disability
10 Critical and high-risk workers, including defence, emergency services and meat processing
Phase 2a
11 Elderly adults aged 60–69 years 6,570,000 up to 15.8 million In progress
12 Adults aged 40–59 years
13 Aboriginal and Torres Strait Islander people aged 18–54
14 Other critical and high-risk workers
Phase 2b
15 Australian aged 16-39 years 6,643,000 up to 16 million In progress
16 Any unvaccinated Australians from previous phases
Phase 3
17 Australians aged 12-15 years 1,536,821 up to 2.4 million 13 September 2021

On 21 February 2021, a day before the previously announced programme start date, Prime Minister Scott Morrison, Chief Medical Officer Paul Kelly, Chief Nurse Alison McMillan, and "a small group" of aged care staff and residents became the first Australians to receive the Pfizer–BioNTech vaccine. The early vaccination was heavily televised with the hopes of reassuring Australians about the quality, efficacy, and safety of COVID-19 vaccines.[62]

On 22 March, Health Minister Greg Hunt announced the start of the phase-1b vaccination roll-out. In this phase, more than 6 million Australians are targeted for inoculation, and approximate 1,000 GP clinics are participating in vaccination all over the nation to ramp up the speed of vaccination.[63]

The Federal Government of Australia has decided to prioritise people 50 years or older for vaccination. They will be eligible for vaccination from 3  May 2021 at General Practice Respiratory Clinics and state or territory vaccination clinics. From 17 May, people over 50 can also get their vaccination at selected participating GP clinics. The Australian Technical Advisory Group on Immunisation advised the government to reserve the Pfizer vaccine for those under 50 years of age, and the AstraZeneca vaccine will be administered for phase 2a.[60] On 19 August 2021, an announcement has been made by Prime Minister Morrison regarding the aged group 16-39 years old residents will be eligible for Pfizer vaccine from 30 August 2021.[64]

Vaccination progress[]

Cumulative vaccinations in Australia

As of 30 August 2021

Daily vaccinations chart of Australia

Cumulative vaccinations in states/territory

As of 30 August 2021

Vaccination timeline criticisms[]

On 11 March 2021, the Australian Medical Association (AMA) attested that it was implausible that the government's target of offering vaccination to every Australian by October 2021 would be achieved, and suggested that mid-December 2021 would be a more realistic date. The government had aimed to administer 60,000 doses by the end of February but administered only 31,000 doses.[65] The vaccination programme was also 83.25% behind its target figure by the end of March: 4 million doses were targeted by the Health Department before the rollout, but only 670,000 had been delivered.[66]

The vaccination rollout had a further setback when pharmacists postponed joining the vaccination programme until June.[67] The federal government said that the European Union (EU) blocking the shipment of more than 3 million doses of vaccine to Australia was a major reason for the delayed vaccine rollout, although the EU only officially confirmed blocking the export of 250,000 doses in early March.[68][69]

Medical advice discouraging the use of the AstraZeneca vaccine on people under the age of 50 due to incidents of vaccine-related blood clotting was a further major setback in the vaccination rollout, given the AstraZeneca vaccine was originally slated as the cornerstone of the entire program. Prime Minister Scott Morrison stated at the time that a definitive timeline for vaccine rollout could no longer be provided, and there is a need to re-evaluate and recalibrate the program.[70]

On 11 April 2021, Prime Minister Morrison conceded the earlier target to vaccinate all Australians by the end of 2021 was difficult to achieve, also saying there was no set target for the vaccination timeline due to the many uncertainties involved.[11] Morrison suggested two meetings of the National Cabinet be held per week until all issues delaying the vaccine rollout were fixed.[71]

More than two million COVID-19 vaccinations had been administered by 28 April 2021, but this was three million short of original plans.[10]

On 16 August 2021, more than 10 million Australians have received their first dose of COVID-19 vaccines across the nation.[72]

Vaccination rollout by state and territory[]

State or territory Eligible Population [73] Total Doses Administered[h] First Dose Administered Second Dose Administered Population received first dose(16+) Population received both doses(16+) Population (70+) received first doses Population (70+) received both doses AEFI reporting rate per 1000 Ref.
Australian Capital Territory 344,013 454,575 222,267 142,253 65% 41% >95.0% 76.1% 2.2 [9][74]
New South Wales 6,566,161 6,869,640 4,475,444 2,433,592 68% 37% 89.8% 64.0% 2.0 [75][9][74]
Northern Territory 190,705 209,927 104,839 71,871 55% 38% 77.0% 58.3% 2.7 [9][74]
Queensland 4,112,639 3,444,758 2,079,463 1,303,918 51% 32% 85.7% 62.4% 2.9 [76][9][74]
South Australia 1,440,565 1,250,903 758,560 492,748 53% 34% 84.3% 57.8% 3.0 [77][9][74]
Tasmania 440,196 448,160 262,868 185,145 59% 42% 88.5% 67.3% 5.1 [78][9][74]
Victoria 5,407,615 4,934,476 3,031,660 1,873,762 56% 35% 85.4% 61.9% 4.5 [79][9][74]
Western Australia 2,115,458 1,750,227 1,066,553 667,121 50% 32% 82.9% 60.4% 2.8 [80][9][74]
 Australia 20,621,217 19,362,666 12,106,618 7,222,529 59% 35% 87.4% 63.0% 3.1 [81]

Vaccination doses by jurisdiction and delivery channel[]

State or territory Vaccination hub Aged care GP clinics
Australian Capital Territory 196,013 8,848 217,680
New South Wales 2,184,175 322,393 3,654,290
Northern Territory 118,783 5,102 74,308
Queensland 1,223,019 109,050 1,871,839
South Australia 512,096 46,991 608,447
Tasmania 221,586 15,099 182,353
Victoria 2,182,290 145,690 2,234,263
Western Australia 750,200 51,922 811,350
 Australia 7,388,162 705,095 9,654,530
As of 25 August 2021 12:00 PM AEST[82]

Australian Capital Territory[]

On 22 February 2021, the first Canberran received a COVID-19 vaccination. She was a 22-year-old registered nurse, and a member of a COVID-19 testing team.[83]

In the ACT, by 11 June 2021, one mass vaccination clinic centre in Garran, one vaccination clinic in Calvary Public Hospital and some selected GP clinics were delivering vaccinations.[84]

60% of the population of ACT have received their first dose on 24 August 2021.[9]

A COVID-19 vaccination clinic in Canberra

New South Wales[]

On 8 April 2021, the Australian Technical Advisory Group on Immunisation (ATAGI) recommended that the Pfizer vaccine (Comirnaty) be preferred over the AstraZeneca vaccine in people under the age of 50.[85] This led to the NSW government to temporarily suspend inoculation with the AstraZeneca vaccine in the state for one day.[86]

On 10 May 2021, a mass vaccination hub opened at Sydney Olympic Park. The same day, registrations began for NSW residents aged 40 to 49 to receive the Pfizer vaccine.[87]

From 16 June 2021, NSW residents who were aged over 50 could get an AstraZeneca vaccination from selected pharmacies. The NSW health department approved 1,250 pharmacies to administer the vaccine under strict regulations.[88]

On 12 July, the state government opened up the AstraZeneca vaccine to over-40s, with vaccination hubs opening in the Fairfield, Canterbury-Bankstown and Liverpool regions, amid a growing outbreak in those areas of the Delta variant of COVID-19.[89][90]

On 24 July, ATAGI released a statement in response to the NSW outbreak, which stated that all individuals aged 18 years and over in greater Sydney, including adults under 60 years of age, should strongly consider getting vaccinated with any available vaccine, including the AstraZeneca COVID-19 Vaccine. This was on the basis of an increasing risk of COVID-19 infection and ongoing constraints in supplies of the Pfizer vaccine.[91]

On 9 August, Qudos Bank Arena at Sydney Olympic Park was opened as a Pfizer vaccination hub for Higher School Certificate (HSC) students. The hub was fully booked with almost 3,000 appointments on its first day.[92]

On 24 August, NSW completed the milestone of 60% completion of 1st dose of the eligible population.[93]

A COVID-19 vaccination centre in Sydney

Northern Territory[]

On 22 February 2021, the first COVID-19 vaccinations (phase 1A) in the Northern Territory (NT) were administered to "at-risk frontline workers" using the Pfizer–BioNTech COVID-19 vaccine.[94] As of 13 June 2021, 25 general practices and 3 respiratory clinics were delivering vaccinations across the territory.[95]

Queensland[]

By 13 June 2021, the Queensland Health Department was delivering vaccines under phase 1a, 1b & 2a (people aged over 40) in the state. Age 40+ vaccination centres including hospitals, event centres and GP clinics. Eligible residents can register their interest in vaccinations online or make an appointment at the nearest centre. Queensland Premier Annastacia Palaszczuk said that preparation is underway to establish a mass vaccination centre by the end of 2021.[96]

The state's first mass vaccination hub opened at the Brisbane Convention & Exhibition Centre on 11 August.[97][98]

South Australia[]

On 5 May 2021 the first Oxford-AstraZeneca vaccination was administered at Murray Bridge, South Australia. The recipient was a doctor in regional SA.[99]

On 19 March 2021, South Australia faced a setback due to a misdirected shipment of vaccine. The Pfizer vaccine was supposed to go to Adelaide but was wrongly delivered to Perth, Western Australia. Premier of South Australia Steven Marshall denied knowledge of any delivery and said it was a federal government responsibility to deliver the vaccine. Federal officials confirmed the misdirected delivery.[100]

On 30 April 2021, South Australia's first COVID-19 mass vaccination hub opened at Adelaide Showground.[101]

Tasmania[]

By 11 June 2021, the Tasmanian Health Department was conducting vaccinations according to the national vaccine roll-out plan in a phased manner. Those eligible can book an appointment online or over the hotline number. Hospitals, clinics, community health centres and GP clinics (for ages 50+) are participating in the vaccination programme.[102]

Victoria[]

COVID-19 vaccination centre in Broadmeadows, Victoria

On 21 April 2021, Victoria's first three mass vaccination centres were opened at the Melbourne Convention Centre, the Royal Exhibition Building in Carlton and in Geelong. Those eligible for vaccination can make an appointment over the phone or walk in at any centre.[103] One more mass vaccination centre for central Victoria is due to be opened in Bendigo by the end of May.[104]

On 28 May, the state expanded its vaccine rollout to adults aged 40 and over, ahead of the federal rollout timeline.[105][106]

On 9 August, the AstraZeneca vaccine became available to adults aged 18–39 at state-run vaccination hubs. The Pfizer vaccine was also made available for immuno-compromised children between the age of 12 and 15 at the same mass vaccination centres.[107][108] On the same day, Australia's first drive-through mass vaccination hub opened at the site of a former Bunnings store in Melton. It is initially offering Pfizer doses for those aged 40 and above, with AstraZeneca doses expected a week later.[109]

Anyone who is 16 years old and over will be eligible to get the Pfizer vaccine from 25 August 2021. As per the announcement made by the state government, 16 and 17 years old are only allowed the Pfizer vaccine, and 18 to 59 years old can choose between the AstraZeneca or Pfizer vaccines. [110]

Western Australia[]

As of 10 June 2021, people aged 30 years and over, as well as the below groups aged 16 years and over, are eligible for COVID-19 vaccination.[111][112] However, Pfizer-BioNTech bookings for 30–39 year-olds that are not in one of the below groups are now unavailable until later in 2021 when further vaccine supplies are expected.[111]

  1. People with a specified underlying medical condition.
  2. Carers of people with specified underlying medical conditions and disabilities.
  3. Essential outbound travellers with a travel exemption.
  4. Critical and high-risk workers.
  5. Health care, aged care, disability care workers and volunteers.
  6. Quarantine and Border workers including household contacts.
  7. Aboriginal and Torres Strait Islander people.
  8. Pregnant women are aged 16 and over.

Metropolitan community clinics, GP respiratory clinics, GP clinics, Aboriginal Medical Services and regional community clinics are participating in the vaccination rollout.[113]

Children (that is, aged below 18 years) are offered Pfizer-BioNTech, adults aged between 18 and 59 years are offered Pfizer-BioNTech and AstraZeneca, and adults aged 60 and over are offered AstraZeneca.[112][113]

On 16 August, Western Australia expanded eligibility for the Pfizer vaccine to anyone aged 16-29.[114]

Vaccine supply[]

This section is an excerpt from COVID-19 pandemic in Australia § Vaccine supply.[]

The Australian government entered into agreements with Pfizer/BioNTech, University of Oxford/AstraZeneca, Novavax, the University of Queensland and COVAX for the supply of vaccines.[115] The University of Queensland vaccine was abandoned in December 2020 after trials revealed that, while it was safe, it triggered false positives on HIV tests.[116][117] The Therapeutic Goods Administration (TGA) provisionally approved the Pfizer vaccine in January 2021.[118] The Australian government ordered 10 million doses, with the first 80,000 to be delivered in February 2021, but production problems and the imposition of export controls by the European Union (EU) onto deliveries to countries outside Europe made meeting the delivery schedule problematic.[119]

Delivery issues also affected deliveries of the Oxford–AstraZeneca COVID-19 vaccine, which was provisionally approved by the TGA in February,[120] and received final approval in March.[121] Orders were reduced from 3.8 million to 1.2 million doses of this vaccine, which was manufactured in Belgium,[119][122] and arrival was pushed back to March 2021.[123] CSL Limited began manufacturing 50 million doses of the AstraZeneca vaccine in Melbourne in November 2020. Deliveries were expected to commence in March.[124] The AstraZeneca vaccine could be stored at normal refrigeration temperatures of 2 to 8 °C (36 to 46 °F), whereas the Pfizer vaccine required storage at −70 °C (−94 °F).[123] However, concerns were raised about the efficacy of the AstraZeneca vaccine.[125][126] The Australian and New Zealand Society for Immunology called for a pause in its rollout, as the efficacy of the vaccine reported by trials was insufficient to achieve the desired herd immunity effect.[127] CSL management declined an invitation to appear before an Australian Senate inquiry.[128]

Although the Prime Minister of Australia, Scott Morrison, said that Australia would be "at the front of the queue",[129] and the Minister for Health and Aged Care, Greg Hunt, claimed that Australia would be among the first countries to receive COVID-19 vaccines, 61 other countries had already commenced vaccinating their citizens by the end of January 2021, while the Australian vaccination rollout was not scheduled to commence for another month.[128]

On 15 February 2021, 142,000 doses of the Pfizer–BioNTech COVID-19 vaccine arrived in Australia. The first doses were due to be administered on 22 February.[130] The world-wide distribution of the vaccine has been described as "... the largest logistics effort in the world since World War" by Dr Roberto Perez-Franco of the Deakin University's Centre for Supply Chain and Logistics.[131] This was followed, on 28 February, by 300,000 doses of the Oxford–AstraZeneca vaccine, which arrived at Sydney airport. It was planned that most Australians would be vaccinated with this vaccine, the majority manufactured in Australia by CSL Limited.[132] On 5 March, Italy and the European Union blocked a shipment of 250,000 doses of the Oxford−AstraZeneca vaccine from Italy to Australia, citing low COVID-19 case numbers in Australia and the limited availability of vaccines in the EU.[133]

Local manufacturing began in November 2020.[134][135] On 16 February, the first vials of COVID-19 vaccine produced in Australia came off the production line at the CSL Behring plant in Broadmeadows, Melbourne.[136] This is the active raw vaccine material. The vaccine vials are filled and packaged into doses by Seqirus, a CSL subsidiary in Parkville, Melbourne.[137] Production of the AstraZeneca vaccine in Australia received its final approval from the TGA on 21 March.[121] Some front line health care workers were reported to have preferred the Pfizer vaccine over the AstraZeneca one.[138]

The Australian government had also signed a deal with Novavax for 51 million doses of its vaccine, with supply originally slated for "mid-2021".[139] As of April 2021, it had yet to be approved by the TGA. It is not manufactured in Australia, so like the other imported vaccines, its availability was uncertain. In trials it was reported to be 95.6 per cent effective against COVID-19, and an 86.3 per cent effective against the variant identified in the UK.[139] Australia's first human trials of a candidate COVID-19 vaccine was Novavax's NVX-CoV2373 which began in Melbourne by 26 May 2020.[140]

In a February 2021 pre-budget submission, the Australian Academy of Science renewed its call for the government to develop the capability to produce mRNA vaccine technology in Australia. The ability to mass-produce such vaccines onshore would insulate Australia against supply shocks, and cater for future pandemics and potential biosecurity situations. The mRNA coronavirus vaccines made by Moderna and Pfizer showed strong results in clinical trials and are expected to be easier to reconfigure to cater for new virus variants than more conventional vaccines.[141][142]

The US Moderna company entered an agreement with the Australian Federal government, announced on 13 May 2021, to provide 25 million doses of its COVID-19 vaccine 'mRNA-1273', subject to TGA approval.[143]
Vaccine name Status Quantity Vaccine approved Began administering Ref
Pfizer–BioNTech Green check.svg In use 125 million Green check.svg 25 January 2021 Green check.svg 22 February 2021 [144][145][146]
Oxford–AstraZeneca Green check.svg In use 53.8 million Green check.svg 16 February 2021(Restricted)[i] Green check.svg 5 March 2021 [147][148]
Janssen Green check.svg Approved None Green check.svg 21 June 2021 Dark Red x.svg Not yet [8]
Moderna Green check.svg Approved 25 million Green check.svg 9 August 2021 Dark Red x.svg Not yet [149][7][150]
Novavax Phase III clinical trials 51 million Dark Red x.svg Not yet Dark Red x.svg Not yet [151]

Vaccine candidates in clinical trials[]

As of 5 August 2021, there are 9 vaccines candidates registered to conduct in clinical trials in Australia, however not all have begun enrollment of trial participants.[152]

Vaccine Country of origin Type (technology) Progress Ref
RBD SARS-CoV-2 HBsAg VLP
SpyBiotech 		United Kingdom Virus-like particle Phase I–II (280)
Randomized, placebo-controlled, multi-center.
Aug 2020 – 2021, Australia 		[153]
COVAX-19
Vaxine Pty Ltd 		Australia Subunit (recombinant protein) Phase III (16,876)
Randomized, Two-armed, Double-blind, Placebo controlled
Aug – Sep 2021, Iran 		[154]
COVIGEN
University of Sydney 		Australia DNA Phase I (150)
Double-blind, dose-ranging, randomised, placebo-controlled.
Feb 2021 – Jun 2022, Sydney 		[155]
bacTRL-Spike
Symvivo 		Canada DNA Phase I (24)
Randomized, observer-blind, placebo-controlled.
Nov 2020  – Feb 2022, Australia 		[156]
SC-Ad6-1

Tetherex Pharmaceuticals

United States Viral vector Phase I (40)
First-In-Human, Open-label, Single Ascending Dose and Multidose.
Jun  – Dec 2021, Australia 		[157]
IVX-411

Icosavax, Seqirus Inc.

United States Virus-like particle Phase I–II (168)
Randomized, observer-blinded, placebo-controlled.
Jun 2021–?, Australia 		[158]

Vaccine passport[]

See also: Immunity passport

The federal government revealed they plan to introduce a Digital Vaccine Passport in the future as proof of vaccination. All vaccinated Australians will be able to access their digital vaccine certificates through the Express Plus Medicare app or myGov account. Governments that have stated their intention to have a similar system are Canada, the European Union, and the UK. Fully vaccinated persons can also add their digital certificate in their Apple Wallet or Google Pay.[159][160]

Screenshot of the Digital COVID-19 Vaccination Certificate from the Express Medicare App (provided by Service Australia)

Vaccination and Australia's reopening[]

On 30 July 2021, the federal government released a revised four-phase plan to transition Australia's National COVID-19 Response from its current pre-vaccination settings, focussing on continued suppression of community transmission, to post vaccination settings focussed on prevention of serious illness, hospitalisation and fatality, and the public health management of other infectious diseases reopen Australia with a vaccination programme. The phases transitions are triggered in a jurisdiction when the average vaccination rates across the nation have reached the threshold and that rate is achieved in a jurisdiction expressed as a percentage of the eligible population (16+), based on the scientific modelling conducted for the COVID-19 Risk Analysis and Response Task Force. As of 17 August 2021, Australia is in phase one, which is “vaccinate, prepare, and pilot.[161][162]

In a statement by the Prime Minister on 30 July 2021, it was announced that the federal governments and all states and territories had agreed in-principle to the updated plan.[163]

There has been no date set for each phase. The percentage fully vaccinated eligible population to transition into the second phase, Phase B, is 70%, and 80% into the third phase, Phase C.[164][161]

On 30 August 2021, the percentage of eligible population aged 16 and older fully vaccinated reached 35%.[165]

National Plan to transition Australia's COVID-19 response[164][161][162]
Measures may include Estimated completion date Target percentage of fully vaccinated eligible population (16+) [j] Status
Phase One - Vaccinate, prepare and pilot
  • Implement the national vaccination plan to offer every Australian an opportunity to be vaccinated as soon as possible
  • International arrival cap temporarily reduced by 50% (announced with the first version of the plan)
  • Trial of returned vaccinated travellers with home quarantine system and a pilot program of international students
  • International Freight Assistance Mechanism extended
  • Preparation for vaccination booster plan & establishment of digital vaccination passport at Airport
  • Undertake a further review of the national hotel quarantine network
 1 July 2021-present Vaccination drive is underway Live
Phase Two - Vaccination Transition Phase
  • Lockdowns less likely but possible
  • Ease in domestic restrictions for vaccinated residents
  • International border caps and low-level international arrivals with safe and proportionate quarantine
  • Restore international arrival cap for unvaccinated travellers and larger cap for vaccinated return travellers
  • Capped entry of International students and economic visa holders
  • Prepare/implement vaccine booster programme (depending on timing)
 28 Oct 2021 [9] Target Flat Icon.svg 70% Fully vaccinated

50% (57 days remaining)

   

Phase Three - Vaccination Consolidation Phase
  • Highly targeted lockdowns only
  • Exempt vaccinated residents from all domestic restrictions
  • No cap on return of vaccinated travellers
  • Increased capped entry of student,economic, and humanitarian visa holders
  • Lift all restrictions on outbound travel for vaccinated Australians
  • Extend travel bubble for unrestricted travel to new candidate countries (Singapore, Pacific)
 14 Nov 2021 Target Flat Icon.svg 80% Fully vaccinated

43.8% (74 days remaining)

   

[9]
Phase Four - Post-Vaccination Phase (Back to Normal)
  • Live with COVID-19: management consistent with other infectious diseases
  • Open international borders, quarantine for high-risk inbound travel
  • Uncapped entry for all inbound vaccinated persons, without quarantine
  • Uncapped entry of non-vaccinated travellers subject to pre-flight and on arrival testing
  • Vaccine boosters as necessary
 TBA TBA TBA

On 3 August 2021, the Australian Government publicly released the 'Operation COVID SHIELD National COVID Vaccine Campaign Plan'[50] and the ' Modelling Report to advise on the National Plan to transition Australia's National COVID Response'.[166]

Adverse Events Following Immunization (AEFI)[]

Further information: Anti-vaccination activists and other people are known to spread COVID-19 misinformation, including a variety of unfounded conspiracy theories, rumors, and overblown claims about vaccine side effects

Approved COVID-19 vaccinations are considered safe. There are strict protections in place to help ensure the safety of all COVID-19 vaccines, including clinical trials to meet the benchmark of safety nationally and internationally. COVID-19 vaccines can cause mild, short term side effects, such as a low-grade fever or pain or redness at the injection site much like other vaccines and injected medications. Most reactions to vaccines are mild and go away within a few days on their own. More serious or long-lasting side effects to vaccines are possible but extremely rare. Vaccines are continually monitored for as long as they are in use, to detect rare adverse events and implement approaches to limit their occurrence.[167]

Possible side effects due to vaccination[]

Further information: Embolic and thrombotic events after COVID-19 vaccination
  • Common side effects can include headache, muscle pain, fever, chills, muscle pain, lethargy, injection site reactions and fatigue
  • Very Rare side effects can include Thrombosis with thrombocytopenia syndrome (TTS), Myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the membrane around the heart)
Total adverse event reports (AEFI) to 22 August 2021[74]
AEFI reporting rate per 1000 doses 3.1
Total AEFI reports received 52,849
Total Doses administered 17,150,654
Total reports for AstraZeneca vaccine 32,818
Total reports for Comirnaty (Pfizer) 19,706
Total reports for TTS 67 confirmed & 49 suspected
Total death reports due to TTS 6 (out of 8.8 million doses)
Total reports for Guillain-Barre Syndrome (GBS) 89 suspected
Total reports for Myocarditis or pericarditis 235 suspected case[k]
Total reports for Immune thrombocytopenia (ITP) 56 suspected case[k]

Reported events[]

See also: Vaccine adverse event

One of the earliest reported serious adverse events in Australia was a 44-year-old man admitted to Melbourne's Box Hill Hospital on 2 April 2021 when he developed serious thrombosis and thrombocytopenia syndrome (TTS) [low platelet count] after receiving the AstraZeneca vaccine on 22 March. Similar cases had been reported overseas among those who received the AstraZeneca vaccine. The event prompted the TGA to warn anyone who experienced persistent headaches or other worrying symptoms 4 to 20 days after receiving the vaccine to seek medical advice.[168][169]

In April, a 48-year-old woman died in John Hunter Hospital on 15 April after developing TTS four days after vaccination. This was the first death in Australia likely linked to COVID-19 vaccination. It was also confirmed that the woman had diabetes and had other underlying medical conditions.[170] Since then further cases of serious adverse events have been occasionally reported in the media,[171][172][173][174] and two more deaths following COVID-19 vaccination identified in June. A 52-year-old woman whom died on 10 June due to a blood clot in her brain (cerebral venous sinus thrombosis). The TGA stated it was "likely" the death was linked to a rare vaccination side-effect. This was the second death in Australia linked to the Oxford-AstraZeneca vaccine.[175] On 17 June, this partly led to a federal government decision to only recommend the AstraZeneca vaccine for those over 60 years-of-age on advice from ATAGI.[176] In late June, a 61-year-old woman died in Royal Perth Hospital from immune thrombocytopenic purpura (ITP), which the TGA stated was likely linked to her AstraZeneca vaccination.[177][178]

In July 2021, three deaths linked by the TGA following AstraZeneca vaccination were reported. A 72-year-old woman vaccinated on 24 June was admitted to Royal Adelaide Hospital on 5 July and died 6 days later.[179] Another 2 deaths were later identified of people in the 40s.[180]

Ongoing updates on reviews by ATAGI into confirmed and suspected adverse events are publicly available. As of the 4 August 2021 update, ATAGI reinforces that the benefits of vaccination with COVID-19 Vaccine AstraZeneca strongly outweigh the risks of adverse effects in all Australians aged 60 years or older.[181]

Changes to AstraZeneca vaccine recommendations[]

After findings and advice on the AstraZeneca vaccine from the UK and EU were released following several months of data on their vaccine rollout, the Australian Technical Advisory Group on Immunisation (ATAGI) and TGA met on 8 April 2021 to review and advise the government as a part of the periodic review process. Australia's Chief Medical Officer, Paul Kelly, reassured the safety of the vaccine and noted it was being continually reviewed, and that other vaccine options like Pfizer Comirnaty vaccine, and potentially later, Novavax, existed for the nation.[182]

Everyone aged over 50-years were encouraged to get the AstraZeneca vaccine,[183] until 17 June when ATAGI's recommendation was revised to people over 60.[176] Internationally there is no consensus on the age limit.[184][185] The Department of Health information sheet on the AstraZeneca vaccine published 30 July, states "in outbreak settings, adults under 60 years of age should strongly consider AstraZeneca Vaccine if they are unable to access Comirnaty (Pfizer vaccine)".[186]

See also[]

  • COVID-19 vaccine
  • COVID-19 pandemic
  • COVID-19 pandemic in Australia
  • COVID-19 pandemic in Australia (timeline)

Notes[]

  1. ^ Wuhan-H1 variant D614G.[52] Corresponds to 96% of the strains the United States during the study.
  2. ^ Generally includes mild symptoms such as olfactory or taste disorders and moderate symptoms such as pneumonia.
  3. ^ Jump up to: a b Generally understood as requiring some form of hospitalization (from supplemental oxygen therapy to ICU admission). The same statistical variable includes cases of death.
  4. ^ A confidence interval was not provided, so it is not possible to know the accuracy of this measurement.
  5. ^ Effectiveness against hospitalization from a preliminary study with 477,000 healthcare workers.[53]
  6. ^ Both doses
  7. ^ Figure shows eligible got at least one dose of the approved vaccine
  8. ^ Australians who have received at least one dose of an approved COVID-19 vaccine.
  9. ^ Recommended for over 60s, and over 18s in greater Sydney.[91]
  10. ^ Phase progression depends upon the achievement of the threshold of certain vaccination percentage, scientific modelling of vaccination threshold is completed at Doherty Institute
  11. ^ Jump up to: a b Under TGA scrutiny
  1. ^ This is a type of study where researchers recruit two groups: people who test positive for the disease (cases) and those who test negative (controls) (Vandenbroucke 2019). They then survey these individuals for factors which may have affected whether or not they developed the disease (in this case, vaccination status) (Patel 2020). In the case of Lopez Bernal et al, they also assessed which variant each "case" contracted (e.g. alpha [B.1.1.7] or delta [B.1.617.2]) using both RT-PCR testing and whole genome sequencing. To evaluate efficacy, the researchers determined how much less likely a person was to contract each variant based on their vaccination status. In this case, a person who received two doses of the Pfizer vaccine was 93.7% less likely to contract the alpha variant and 88.0% less likely to contract the delta variant, when compared to an unvaccinated person.
    • Vandenbroucke JP, Pearce N (November 2019). "Test-Negative Designs: Differences and Commonalities with Other Case-Control Studies with "Other Patient" Controls" (PDF). Epidemiology. 30 (6): 838–844. doi:10.1097/EDE.0000000000001088. PMID 31430265. S2CID 201117050.
    • Patel MM, Jackson ML, Ferdinands J (November 2020). "Postlicensure Evaluation of COVID-19 Vaccines". JAMA. 324 (19): 1939–1940. doi:10.1001/jama.2020.19328. PMID 33064144. S2CID 222819843. Retrieved 12 August 2021.

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