COVID Deaths + Vaccine Passport Q&A - Dept Health Aust. - June 1 2021

Senator RENNICK: We haven’t had any COVID deaths this year in Australia, have we, from people who have contracted it here?

Dr Murphy : Not from people who contracted it here.

CHAIR: Senator Roberts, what are your questions? I want to clarify yours as well.

Senator ROBERTS: They are continuing on the vaccine.

Senator ROBERTS: I will finish off on one I touched on briefly. The intergenerational effects of the vaccine are unknown. The effect of the vaccine on transmission is unknown. GPs are not even allowed to see which vaccine they have available. Australians have a right to know. The foundation of informed consent is accurate and full information. How is it possible to achieve real informed consent in this information vacuum?

Dr Murphy : The GPs are certainly able to say which vaccines they have available. They provide informed consent—

Senator ROBERTS: I will interrupt there. I attended a presentation by you and Professor Kelly saying that the vaccine injections would not be disclosing which vaccine was given at that time where people go to get their injection.

Dr Skerritt : They are not given a choice.

Senator Colbeck: I think you’re talking about two different things. Clearly, at this stage of the rollout, the GPs are distributing AstraZeneca. The issue would have been the choice. Perhaps there might have been some other issues.

Senator ROBERTS: Nonetheless, Minister, with so many effects unknown, how can there be informed consent?

Senator Colbeck: I’m not going to try to give you health advice. I will defer.

Dr Murphy : Professor Kelly might be able to address that. I will be very clear. People undergoing the informed consent process are very clear about which vaccine they are getting. We’re not disguising the vaccine. Professor Kelly can go through the informed consent process.

Prof. Kelly : Informed consent is a very important component of any medical procedure or treatment. Doctors do that with their patients every day every time they see them, pretty much. They are talking through the pros and cons of various, in this case, vaccines. As the secretary has said, it’s pretty clear if you turn up to a GP at the moment. With a couple of exceptions, almost all GPs are only using one vaccine. For those over the age of 50, it is AstraZeneca. The benefits of it in the particular circumstances of the person in front of them would be discussed in great detail. We’ve provided a lot of very detailed information, based on the ATAGI advice, on that risk and benefit equation for GPs and other medical practitioners and nurses to use.

Senator ROBERTS: Thank you. My first question goes to the question of mandatory vaccination. Is the government considering mandatory vaccination?

Dr Murphy : The government has repeatedly said that it is not considering mandatory vaccination for COVID vaccines or any other vaccines.

Senator ROBERTS: Is a vaccine passport still under consideration?

Dr Murphy : The only situation, as we referred to earlier today, is where a state or territory, for example, may refuse entry to a residential aged care facility. That is the position that AHPPC is considering. That is not mandating vaccination. It is basically saying that it may be not possible to participate in a certain activity unless you’ve been vaccinated. But it has not been a position so far. AHPPC is reconsidering it.

Ms Edwards : Obviously the issue with medical advice is the extent to which, and whether and when, you might want to limit access to aged care facilities, which the secretary is talking about. The broader issue of whether there is a vaccine passport to identify you’ve had a vaccine and what impact that might have internationally or otherwise is a matter for the Department of Home Affairs.

Dr Murphy : We are providing citizens with evidence of vaccination. They can get a vaccination certificate. They can use that in whatever way they choose.

Senator ROBERTS: That is essentially a vaccine passport, isn’t it, Ms Edwards?

Ms Edwards : It would be a certificate. The Australian Immunisation Register has been around for quite a long time. It got expanded a few years ago to cover all vaccinations. It will have the evidence of your vaccination for COVID-19. You can access it in a printed form or electronically. It has evidence that you have had the vaccine. There is no activity at the moment that you are either permitted or prevented from doing by virtue of vaccine status. Obviously, it is medical information for you.

Senator ROBERTS: So that vaccine register should be confidential, shouldn’t it?

Ms Edwards : It is.

Dr Murphy : It is. But each citizen can print their own certificate and they can use it as they choose fit.

Ms Edwards : We use it for aggregated data. So a lot of the data we’re getting about how many people have been vaccinated, not just for the COVID-19 vaccine but for the range of vaccines that we know, is drawn out of the Australian Immunisation Register in a de-identified, aggregated form.

Senator ROBERTS: So a vaccine passport, though, could be established for restricting the movement of people or entry of people to a specific venue?

Ms Edwards : Well, it is a hypothetical question, not one within the remit of the health department. All we’re talking about is having evidence that you have had the vaccine, which is really important, apart from anything else, so that people know what your risk is if you come into contact with COVID-19. It is also used in vaccination clinics to check that it is your second dose. If you turn up for your second dose, they’ll check the register that you’ve had one dose of AstraZeneca and it is time for the second one. It is used for those safety reasons for an individual. It is evidence of the medical treatment that you’ve had. But any further use of it is not in contemplation that I am aware of. We are certainly not involved in that. The question about how it might be used internationally and so on is a matter for Home Affairs.

Senator ROBERTS: Where would Home Affairs get their advice from? It would be from you, wouldn’t it?

Ms Edwards : They would seek health advice from us and advice about how the immunisation register works and so on together with Services Australia. They would be engaging with other agencies as well.

Senator ROBERTS: As I see it, threatening Australians with the loss of privileges, free movement, a job or even a livelihood without a vaccine passport is really creating a digital prison.

Ms Edwards : I am not aware of any proposal to do any of those things.

Senator ROBERTS: Are not aware of any? Is the government enforcing vaccination through coercion if that were to occur?

Senator Colbeck: That is a hypothetical question and it is an opinion. I don’t think it is appropriate to ask the officials that question.

Senator ROBERTS: People expect the vaccine to do more than prevent deaths, more than not cause deaths. People expect the vaccine to bring back life as we knew it, with the removal of all restrictions and the resumption of international travel. Clearly, while acknowledging the many unknowns that you commendably and openly acknowledged this morning, what percentage of vaccination unlocks the gate and removes the restrictions and when?

Dr Murphy : I think Professor Kelly can address the fact that that is still an unknown parameter. Our knowledge is evolving. Professor Kelly has been asked this question on many occasions.

Prof. Kelly : I have since answered it. Thank you, Secretary.

Senator ROBERTS: We’re still asking it.

Prof. Kelly : I will get to your question. On my phone through my Medicare app, I have proof of my vaccination. It arrived within 24 hours of that vaccination happening. It just shows that this is already happening. Anyone who has had a vaccination will be able to access it. If it is needed to be shown, it is there.

Senator ROBERTS: We are not worried about that. My constituents are very worried about it becoming a condition of entry to a venue or to travel or something like that.

Prof. Kelly : Well, as the associate secretary has mentioned, that is a matter for other parts of government to consider. We will provide medical advice about how that information can be verified in terms of a vaccine that we trust and know works. As to your question about the target, this has come up on multiple occasions. I guess my answer is that these are non-binary states. So every single extra person who is vaccinated in Australia is part of our path to the post COVID future you’re describing. There’s no magical figure that says when we get to that, we’ve reached herd immunity and everything will be fine. Rather it is a process of getting towards that. We do need quite high coverage, though, to be able to get to the situation where, for most of the time, a seeding event, such as what we are experiencing in Victoria right now, will not lead to a large outbreak. So that is modelling that is being done at the moment by colleagues at the Doherty in Melbourne and others. It is part of the work that AHPPC has been asked to do to provide information into Mr Gaetjens’s committee, which is in turn providing information and advice to national cabinet.

Senator ROBERTS: Thank you. Where is the government’s plan for managing the COVID virus? There are six components the three of us discussed at the last Senate estimates. There is isolation lockdown; testing and tracing; quarantining and restrictions; and treatments, cures and prophylactics. The fifth was vaccines. Then you added, I think, Professor Kelly, personal behaviours as No. 6. Perhaps we could add a seventh, and that is prevention through health and fitness, because we’re seeing now that obesity and comorbidities are a big predictor of people dying from COVID. When will we see action in No. 4, which is treatments, cures and prophylactics, and health and fitness?

Dr Murphy : I can perhaps address treatments. The scientific and technical advisory committee, which is the committee that looks at the vaccines, also has a watching brief on all treatments and has considered whether there are any treatments that we recommend the government purchase. The TGA obviously is also reviewing treatments as they appear. We also have an evidence taskforce that looks at the real-time evidence of treatments. At this stage, there are very limited options for treatment other than vaccines. Professor Skerritt can perhaps give you more information.

Dr Skerritt : Thank you, Secretary. At the moment, in Australia, the clinical evidence taskforce endorses three TGA approved treatments. They depend on how sick you are, whether you need oxygen and so forth. If you’re in hospital requiring oxygen, corticosteroids are recommended for use with COVID patients. I would venture to say that globally they’ve probably been the most successful intervention. A drug called remdesivir is approved for moderate to severely ill patients who don’t require oxygen or ventilation. More recently there is a drug that was originally an arthritis drug known as tocilizumab. I don’t get to name them.

Senator ROBERTS: You barely get to pronounce them.

Dr Skerritt : There’s a trick here. They have unpronounceable names so everyone uses the trade name. That is the trick. Tocilizumab is for people who do require oxygen. What we don’t have yet—I think I may have said this at the last estimates—is an antiviral drug that is up there as effective as the recent antiviral drugs for hepatitis C or HIV. But, trust me, there is a major effort of companies working on that area. The other thing that has been coming through the system and seems to be getting better are these antibody based treatments. We are currently looking at an antibody called sotrovimab. It has some very promising early results. We’re currently assessing that. We have always said that antivirals and other treatments will be important for a range of reasons, one of which is that even with the greatest adherence to, say, the three-week gap Pfizer vaccination or the 12-week gap for AstraZeneca vaccination, neither treatment is 100 per cent effective against catching or transmitting the virus. They seem to be very effective against death or hospitalisation. But we do know that treatments will play an important part in getting on top of this virus.

Senator ROBERTS: I will build on that. You didn’t address item No. 7, health and fitness, which I suggested. The focus on the vaccine is not addressing the end-to-end from prevention to resilience to treatment. Don’t we need the full gamut of comprehensive and complementary approaches? What would that look like? Would it not include Ivermectin, assuming someone sponsors it, and other treatments for those who want alternatives to vaccines, because there are people who want alternatives?

Dr Skerritt : Well, very briefly, on general health, the fact of people going to general practitioners and having the COVID vaccination is always an opportunity for the GP to have a quick discussion that, ‘Hey, smoking doesn’t actually help your respiratory chances with COVID.’ There are some mixed messages out there and some mixed results. For example, a lot of people with asthma were very worried early in the COVID pandemic. One asthma drug called budesonide, an orally inhaled steroid, is actually quite effective in the early stages of COVID. So people with asthma, for example, in general, especially if they are on those drugs, don’t seem to have been affected. But it is true that if you have comorbidities such as diabetes and so forth, your risks of COVID infection are greater. That is why in phase 1b, a number of people who, for example, had drug resistant hypertension or had diabetes and so on were prioritised early for vaccination.

Going back to other therapies, we are always interested in evidence based submissions for any other therapy. Some of the early papers suggested, for example, that hydroxychloroquine had a lot of promise. When objective blinded trials were run, the early promise, very sadly, didn’t hold up.

Senator ROBERTS: Thank you, Chair. I will leave it there.

CHAIR: Thank you. It is now four o’clock. We will now go to a break.

Source Video: (15:44)
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