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Vaccine not Australia’s COVID transmission ‘silver bullet’

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Since the COVID-19 pandemic was declared on 11 March, global resources being poured into vaccine efforts have given rise to multiple promising candidates.
 
And, just nine months on, multiple parts of the world sit on the precipice of rolling out an effective vaccine to their citizens.
 
But a vaccine alone is unlikely to hold the key to a return to normality, according to a new report commissioned by the Australian Academy of Health and Medical Sciences (AAHMS).
 
Director of the Marie Bashir Institute for Infectious Diseases and Biosecurity, Professor Tania Sorrell, is Chair of the AHHMS COVID-19 Expert Committee that produced the report. She told newsGP interim results from ongoing vaccine trials, while promising, are showing that they are unlikely to prevent viral transmission. 
 
‘If we were really relying on the vaccine alone, then we would have to have a vaccine that is highly effective, that is relatively long lasting in terms of its protective immunity, that is taken up by a very high proportion of the population – and even then, no vaccine is 100% effective,’ Professor Sorrell said.
 
‘We would need a vaccine that not only reduces the severity of disease, but prevents transmission of infection and the current crop of vaccines do not appear to do the latter.’
 
While Australia has been well prepared in securing supply of COVID-19, investing $3.3 billion on four agreements, Professor Sorrell says the logistics of mass manufacture and distribution, as well as the development of strategies to administer the vaccine in a culturally appropriate way, should not be underestimated.
 
The AAHMS report outlines the steps for Australia to maintain control of the virus into 2021:

• Ongoing implementation of comprehensive public health measures, including high levels of testing combined with contact tracing, isolation, quarantine, social distancing and mask-wearing
• Optimal roll-out of vaccines and other interventions as they become available
• Effective prevention and treatment of long-term health issues arising from the pandemic, including mental health and ‘long’ COVID’
• Support to other countries in the region
• Sustained and enhanced backing for research and innovation to develop the tools required to tackle the pandemic

 
The report notes it is ‘crucial that we regard lockdowns as a measure of last resort’, given their considerable impacts on individuals, communities and the economy.
 
With all active cases in Australia currently reported among returned travellers, continued high levels of testing, rapid turnaround times for results, strong contact tracing, isolation, and quarantine will be crucial.
 
‘As we’ve seen with outbreaks that have occurred even in this country, one can lose control very quickly,’ Professor Sorrell said.
 
‘We know that people coming into the country from overseas are continuing to bring the virus with them, so making sure that our public health measures at the borders are maintained at a high level [is important]. We’ve seen evidence of that being ramped up following the Victorian outbreak, but also in other states as well.
 
‘We need to be sure that if people are sick, or have been in a high-risk environment for COVID-19, that they do get appropriately tested, and GPs, of course, are at the frontline of some of this.’
 
The AAHMS report also notes the need to prevent and treat the long-term health issues that have arisen from the pandemic, including mental health and long COVID, and Professor Sorrell says general practice will again be at the forefront.
 
‘The majority of patients that are becoming ill with COVID are not requiring admission to hospital. At the present time in New South Wales, in particular, about 5% are being admitted to hospital,’ she said.
 
‘[So] the GP’s role in that primary care situation is absolutely critical, and making sure that we understand long COVID in enough detail to alert GPs to the fact that it’s an entity, that it can affect a number of organ systems, not least of which is the brain, mental health and neurological complications, but also potentially cardiac complications, or respiratory complications.’
 
While experts agree Australia is in a fortunate position, looking beyond its borders to the northern hemisphere raises a warning of complacency. Professor Sorrell says that is where continued, tailored public messaging is important.
 
‘There can’t be a single message because our population is made up of a large number of different groups within the population with different cultural backgrounds, with different ethnic backgrounds, with different understandings, or degrees of understanding about COVID-19, and for many English is not their first language,’ she said.  
 
‘So what we need to do is work with communities to tailor the messaging so that they do understand the issues and are then engaged in the behaviours that really have to be sustained for quite a while yet to prevent outbreaks and transmission of infection.’
 
That messaging will be equally important in the lead-up to a vaccine being rolled out, Professor Sorrell says, to address any hesitancy around uptake.
 
‘[T]hat is potentially of some concern, and that’s really why the messaging has to be appropriate to the different backgrounds and beliefs of Australians,’ she said.
 
‘There will always be some people who are reluctant to be vaccinated. But, in general, the majority of the population, if they understand the issues, would be prepared to do that.
 
‘It was the reason that the health experts recommended to the Australian Government not to proceed with the UQ vaccine – because of those false positives for HIV.
 
‘It wasn’t the efficacy of the vaccine or any side effects of it, it was the fact that there was concern that the public would feel anxious and not wish to take it up.
 
‘So bringing the public on board is incredibly important.’
 
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