Australians who skip second AstraZeneca vaccine are ‘almost wasting’ first dose, AMA warns

Australians who choose not to get the second dose of the AstraZeneca vaccine in response to updated federal health advice are “almost wasting the first dose”, the vice president of the Australian Medical Association has said.

Dr Chris Moy said it was too early to get accurate data on how many Australians aged 50 and over have cancelled their first or second appointment for an AstraZeneca shot since the official health advice changed on Thursday to recommend the vaccine not be administered to under 60s.

But he said the phone in the general practice clinic he works at in Adelaide has been running hot, and “we’ve probably had about a quarter of people cancelling essentially immediately, or just not turning up”.

“There’s a lot of anxiety, a lot of phone calls, and our poor reception staff have been inundated,” he said.

Federal, state and territory leaders will meet on Monday to discuss the vaccine rollout, disrupted for the second time in three months by the updated medical advice.

The federal government issued advice on Thursday lifting the recommended age for AstraZeneca from 50 to 60, rendering 2.1m people in the 50-59 age bracket eligible for Pfizer but contributing to greater hesitancy to take AstraZeneca in all ages.

Health authorities concede the rollout will suffer a “temporary reduction” in daily vaccinations caused by people rescheduling bookings to get Pfizer, limits on its supply and the fact GPs will be unable to supply Pfizer until late July.

Australia is due to receive 1.7m Pfizer doses in June, increasing to 2.8m in July. The Sydney cluster has already sparked calls from the New South Wales premier, Gladys Berejiklian, for extra vaccine supply.

The chief nurse, Alison McMillan, told reporters on Sunday the federal government would work with jurisdictions to “provide them [with] as much supply as we possibly can”, noting that supplies had been boosted to Victoria during its latest outbreak.

Moy urged anyone who had received their first shot of the vaccine, regardless of their age, to get the second dose in order to ensure they are fully protected.

“I am 54,” he said. “I have had my first dose, I am going to have my second.

“The bottom line is the risk of getting a clot from the second dose is one-tenth an already tiny risk on the first one. And you need [the second shot] for long-term protection and to protect yourself from the variants.

“You’re kind of almost wasting the first dose if you don’t have the second. It’s a no-brainer – for God’s sake have it.”

Last week the Australian Technical Advisory Group (Atagi) changed its advice on AstraZeneca after concluding there was a “higher risk and observed severity” of thrombosis with thrombocytopenia syndrome (an extremely rare blot clot syndrome) in 50 to 59-year-olds in Australia than was reported internationally or initially estimated in Australia.

It said the risk of clots in the 50-59 age group based on new information had risen to 2.7 per 100,000 – almost double the risk of those aged 60-69, which is 1.4 per 100,000 doses.

Atagi said the risk is much lower for the second shot of AstraZeneca, regardless of age, and Atagi has recommended that anyone who received their first dose without incident be given their second dose.

Moy said the announcement about blood clotting risks was handled better this time than it was in April, when prime minister Scott Morrison and health minister Greg Hunt called an emergency late-night press conference.

“But every time this happens it’s anxiety-provoking news that automatically feeds into peoples own fears about the vaccine,” he said.

Atagi has taken an extremely cautious approach to coronavirus vaccines based on the risks posed by the low-Covid environment in Australia.

But Moy said if Australia were to see a significant surge in infections similar to that seen in Europe over winter, the precautionary approach taken to vaccines now could backfire.

“This decision was made for a non-Covid environment,” he said. “If it switches to a Covid environment that advice has got to change fast. But if it does those 50 to 59-year-olds who have not had the vaccine because of the changing advice now will be exposed.”

Despite concerns first doses without repeats are wasted, Hunt has signalled those who refuse to get a second AstraZeneca shot will not be penalised by going to the back of the queue for Pfizer.

“Our goal is not to be punitive, to be supportive of Australians, and to say that we want everybody to be vaccinated,” Hunt told reporters on Friday.

Berejiklian has also urged people who have received their first shot of AstraZeneca to book in for their second dose, saying on Sunday: “I am 50 and had the AstraZeneca.”

She said the updated federal health advice “excludes a range of people from having access to the vaccine in as timely a way as we anticipated.”

“That NSW government can’t control that, unfortunately,” she said. “We depend on the commonwealth for the vaccine supply and advice they provide around those vaccines. We are urging based on health advice if you’ve had your first shot of AstraZeneca, please have your second of AstraZeneca.”

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