Australia considers six-week gap between Pfizer doses
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22/07/2021 Australia considers six-week gap between Pfizer doses
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Policy Health And Education Coronavirus pandemic
Australia considers six-week gap between
Pfizer doses
Jill
Jill
JillMargo
Margo
Margo Health editor
Jul 15, 2021 – 5.54pm
A proposal to lengthen the gap between Pfizer’s jabs from three to six weeks is now
under consideration by vaccine experts in Australia.
This proposal does not include areas where there are outbreaks nor people at high
risk, such as unvaccinated frontline workers.
Given the Pfizer shortage and the contagiousness of the delta variant, a longer gap
means more people under 60 would be able to have at least some protection until
more doses arrive.
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22/07/2021 Australia considers six-week gap between Pfizer doses
With winter and more outbreaks predicted, lengthening the time between Pfizer jabs would increase the
proportion of people with good, although not perfect protection. Wolter Peeters
The Australian Technical Advisory Group on Immunisation, ATAGI, is believed to
have modelled this proposal and found it favourable.
But it’s a difficult message to convey as it directly contrasts with
with
withrecent
recent
recentmedical
medical
medical
advice
advice
adviceto
to
toshorten
shorten
shortenthe
the
thegap
gap
gap for AstraZeneca doses from 12 to around six weeks in
areas of outbreak, so people have more protection faster.
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It’s a risk-supply equation. Where there is very high risk, as in Sydney’s outbreak,
and plenty of vaccine, as with AstraZeneca, people can be rushed to the second
dose.
Where there is different but significant risk and a shortage of vaccines, as with
Pfizer, people can afford to wait so others can get a dose too.
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22/07/2021 Australia considers six-week gap between Pfizer doses
Manipulating time gaps between jabs is now considered a new lever for controlling
the pandemic in Australia.
Leading vaccine expert Professor Terry Nolan of the Doherty Institute at
Melbourne University, who previously served as chairman of ATAGI for nine years,
says this lever has been used effectively in the UK and Canada.
With winter and with more outbreaks predicted, he says the Pfizer proposal would
increase the proportion of people with good, although not perfect protection.
“Having people closer together in winter and delta more transmissible, creates a
situation of more immediate risk. It’s better to deal with it now rather than assume
we can defer and fix it all later.”
He sees three problems with much of the data linking protection to time intervals.
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Much of the data on dosing intervals predates the delta variant, says Professor Nolan of the Doherty
Institute.
First, the data is general and refers to any symptoms of COVID-19, from a sore
throat to severe disease. Second, the data usually predates delta. Third, the early
single study that found AstraZeneca was most effective with a 12-week gap was
very small, without enough information to be precise about fine-grained
distinctions between four, six and eight weeks, as there were not enough severe
cases.
It estimated 55 per cent effectiveness with a six-week gap, 60 per cent at six to
eight weeks, 64 per cent at nine to 11 weeks and 81 per cent at 12 weeks.
This made people concerned ifififthey
they
theysquashed
squashed
squashedtheir
their
theirtwo
two
twodoses,
doses,
doses, they would lose out
in the long term. In an outbreak, the advice is that it’s better to bring forward short-
term protection.
Professor Nolan says there’s some level of useful data but it boils down to expert
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judgment.
“The reduction in the inter-dose interval for AstraZeneca’s vaccine makes sense
because you are trading off a fairly modest decrease in protection with the
immediacy of being challenged by an outbreak.”
He finds it more useful to look at severe disease resulting in hospitalisation with
the delta variant.
RELATED
How
How
Howto
to
tovaccinate
vaccinate
vaccinatethe
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world
worldmore
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quickly
quickly
A recent analysis from Public Health England estimated one dose of AstraZeneca
was 76 per cent effective in preventing hospitalisation and two doses took this to 92
per cent.
With Pfizer, one dose reached 94 and two reached 96 per cent.
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Jill
Jill
JillMargo
Margo
Margo is the health editor. She writes about medicine and health from the Sydney office.
Jill has won multiple prizes, including two Walkley Awards and is an adjunct associate
professor of the University of NSW, Sydney. Connect with Jill on Twitter
Twitter.
Twitter Email Jill at
jmargo@afr.com
jmargo@afr.com
jmargo@afr.com
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