Image shows a gloved hand holding a small vial of the AstraZeneca COVID19 vaccine.

Children join vaccine queue; mRNA a marvel; start packing for Bali?

Children join vaccine queue; mRNA a marvel; start packing for Bali?

PHAA and Prof Kathy Eagar, AHSRI

As the national vaccine program continues apace, adults are now able to register their 12-to-15 year-old children or dependants for a Pfizer COVID vaccination.

The vaccine was already available to children aged 12-15 who are Indigenous, on the NDIS, live in remote areas, or have specific underlying health conditions.

Professor Kathy Eagar is Director of the Australian Health Services Research Institute (AHSRI) at the University of Wollongong. She writes an informative and entertaining weekly COVID update in which she encouraged parents to book their teens in early for their vaccination.

Here are Professor Eagar’s most recent observations, commentary, and helpful advice.

Children and COVID19

The evidence on children and the Delta strain of COVID is more positive than we might have hoped. But that does not mean that it is totally safe. COVID is definitely much less dangerous for children than adults. But it can still be risky. This is especially the case with kids with existing health conditions. They are much more at risk.

Australian data from January 1 to August 1 this year show that, of kids who get COVID, 2.5% of under 10-year-olds and 2.9% of 10-to-19-year-olds were sick enough to be hospitalised. The rate jumps to 7.7% for young adults (20-29 years) and then keeps increasing with age.

National plan after the Doherty Report

I’ve been feeling frustrated about the way media and politicians are misrepresenting the Doherty report modelling. Just to be clear, the Doherty report projects that, with 70% of the eligible (i.e. people over 15) population vaccinated, we will have 2,144 cases and 8 deaths a day. With 80% vaccinated, we will have 1,265 cases and 4 deaths a day. Their projection (shown in the table below) is for the first 180 days. They don’t project beyond 180 days as they say that the situation is too fluid to project further than that. We don’t have optimum TTIQ (Trace, Test, Isolate, Quarantine) now, so projections based on partial TTIQ are realistic. Also, they did these projections before the NSW outbreak got out of control.

Table shows modelling used in the Doherty Report into reducing COVID19 lockdown restrictions

I’ve been having a further look at the numbers in the Doherty Report, as well as some excellent work done by the Burnet Institute. I have no problem about planning a way out of lockdown. It is both necessary and desirable. We need to learn to live with COVID (see below). But I am very uncomfortable about ending lockdown on the basis of an arbitrary percentage of the population vaccinated, especially when a single percentage figure does not take into account the heterogeneity of the population. We can achieve 70% by vaccinating everyone in Sydney’s wealthy eastern suburbs, and virtually no one in the poor communities in western NSW.

In my view we should to move out of lockdown:

  • When we meet a minimum percentage vaccinated (70% & 80%) AND
  • When everyone over 12 who wants to be vaccinated gets a chance to do so AND
  • At a rate that allows the health system in each state to cope with increased numbers.

My view is that it would be unethical to open any earlier. By definition, I am saying that we need inevitably to come out of lockdown one state at a time. A big bang approach will inevitably backfire.  Where are the public ethicists when you need them?

A glimmer of good news

The lines in the graph below don’t look like much but they are actually quite exciting. The projection for NSW was that, if nothing changed, NSW would hit 7,000 COVID cases a day in October. The orange line is that projection. The actual case number (the blue line) was following the projection very closely until 6 September. Now it’s turning down a bit. What we are seeing is the first effects of the lockdown in combination with improving vaccination rates. Even though it doesn’t feel like it, there are now a few glimpses of small improvements.

Table shows projected and observed rates of infection in NSW.

The natural reproduction number (Reff) of the Delta virus if left unchecked is between 5 and 6.5. New Zealand has their Reff down to 0.4, ACT has the Reff down to 1.01, NSW has it down to 1.01 and Victoria has it down to 1.38. The only way to get the Reff down is by public health measures (masks, social distancing etc) in combination with vaccination. When the Reff gets below 1.0, cases gradually reduce and eventually disappear.

mRNA vaccination is a game changer

The m in mRNA stands for messenger. It’s a new technology that sends messages to your body telling it how to react in certain situations. In lay terms, all the vaccine contains is a message. It doesn’t contain anything to fight the virus. Instead, it sends your body a message on what your body needs to do to fight the virus. And the really brilliant bit is that, because it’s just sending you a message, it can be modified very fast to work against new variants of the virus.  How clever is that!

Once you know what an mRNA vaccine does, it is easy to understand why some people have been running fear campaigns that a mRNA vaccine is a government tracking device.

There has been a lot of misinformation that the COVID mRNA vaccines were developed too quickly. In fact, mRNA technology has been under development for many years. Now that the technology is in place, it is set to be a game changer that will start to be used in other treatments as well.  Work is underway in diverse areas such as cancer, flu, and malaria.

While there is a long way to go, some are predicting that mRNA will be as revolutionary as antibiotics.

Brilliant work, Bali

Australia could learn a lesson from Bali, Indonesia. 95% of Balinese people have had their first vaccine, and 60% are fully vaccinated. As more people have been vaccinated, case numbers and deaths have both fallen. Incidentally, Bali has used AstraZeneca for everyone, and has waited 12 weeks between doses. It won’t be long until they hit 95% fully vaccinated. The great news is that Bali will be ready when travel starts again and we can all return.

Image shows screenshot of tables and graphs for rates of COVID19 vaccinations in Bali, Indonesia.

How can the rest of us help?

The best things the rest of us can do to help is to get vaccinated, get tested, isolate if even slightly unwell and avoid going to an Emergency Department until absolutely necessary.

I’ve been asked for suggestions on how we can support health workers on the frontline and across the board to let them know we care. One practical thing to do is to organise a treat as a thank you for paramedics, ED, ward and ICU staff, many of whom will be working double shifts.  And don’t forget the massive effort of public health staff who’re working around the clock in a myriad of ways to keep us all safe.

Many workers are wearing full PPE for many hours, so good quality hand and face creams help severely chaffed skin.  Staff are very happy to receive savoury and sweet food – it just needs to be easily separated to individual portions so that the food is not accidentally contaminated – i.e. mini quiches, individual portions of zucchini slice, cut sandwiches, cupcakes etc.

Leave a Reply