Government confirms bivalent vaccine supply

Pharmaceutical multinational Moderna will fulfil a contract to deliver 15 million doses of its new bivalent COVID vaccine before the end of 2022, the Department of Health and Aged Care (DoH) has confirmed.
 
The first deliveries arrived last Monday (12 September), a DoH spokesperson told newsGP, the same day that the Australian Technical Advisory Group on Immunisation (ATAGI) released guidance for the vaccine’s use.
 
According to Dr Lucas de Toca, COVID-19 Primary Care Response First Assistant Secretary at the DoH, the first doses will become publicly available from 10 October.
 
‘We will be contacting sites in the coming days with advice on how they can order it,’ he told last week’s COVID-19 response update for primary care.
 
‘It doesn’t mean that it will be available everywhere at the same time on that date … [and] it’s important that we keep emphasising that people don’t wait, but also that we use existing stocks of vaccine that we have in your fridges and around the country.
 
‘The [original vaccine] remains, especially as a booster, really powerful … against COVID.’
 
ATAGI has said the bivalent vaccine can be used as an alternative for any booster dose in people aged 18 years or older, but it is not recommended for the primary course of vaccination.
 
‘The Moderna bivalent vaccine … contains 50 mcg of mRNA, comprising equal quantities encoding the spike protein from the original SARS-CoV-2 virus and Omicron BA.1 variant,’ the guidance states.
 
‘The Moderna primary course requires 100 mcg doses and therefore the Moderna bivalent vaccine is not considered suitable for primary vaccination.
 
‘There are no data as yet on the immunogenicity of this bivalent vaccine in a primary series.’
 
Only 71.8% of eligible Australians have received a third dose, while even fewer – 30.21% – have taken up the option of a fourth, ‘winter dose’.
 
ATAGI says people with lower levels of pre-existing immunity, such as those who have only received two doses, may particularly benefit from the bivalent booster but stresses that receiving all recommended doses – regardless of the brand or type – is the most important factor for protection.
 
‘The Moderna bivalent vaccine generates a modestly higher level of antibody response against multiple SARS-CoV-2 Omicron subvariants [approximately 1.6–1.9 times] … compared with the Moderna original booster vaccine,’ ATAGI states.
 
Aside from generating higher neutralising antibody titres, the new vaccine may also provide longer lasting protection.
 
‘A previous investigational Moderna bivalent vaccine … continued to show higher neutralisation titres than the Moderna original vaccine against multiple variants, including Omicron, at 180 days after the booster dose,’ ATAGI states.
 
‘It is anticipated that the registered Moderna bivalent original/Omicron BA.1 vaccine may show a similar pattern.’
 
However, practitioners have also been warned to take care when storing and preparing the vaccine.
 
‘To minimise the risk of administration errors, providers should preferably prepare and store doses of the Moderna bivalent vaccine separately from other vaccines due to the use of similar coloured vaccine vial caps [such as the Moderna paediatric vaccine six months to five years formulation],’ the ATAGI advice indicates.
 
‘Doses withdrawn in advance of administration should be clearly labelled.’
 
Moderna’s commitment to fulfil the vaccine contract comes despite other agreements to supply hundreds of millions of doses to various larger markets, including the US, UK, Canada, and Europe.
 
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