New COVID-19 vaccines on the way for Australia

Australians could have access to a COVID-19 vaccine as soon as March 2021, but how would -75°C cold chain work?

The Australian Government has secured two more vaccines, including the Pfizer/BioNTech vaccine that was widely heralded this week, with Pfizer reporting that interim analysis showed more than 90% effectiveness in preventing COVID-19 in trial participants without evidence of prior SARS-CoV-2 infection.

No serious safety concerns were raised, although Phase 3 data is still being collected before submission for scientific peer-reviewed publication. 

The government’s agreement with Pfizer includes full cold chain logistics distribution, federal Minister for Health Greg Hunt said today.

As an mRNA vaccine, it is expected to require a cold chain of -75°C. 

‘We have secured that cold chain for Australia,’ Minister Hunt said.

‘This includes the ability to provide and distribute …  to hospitals, respiratory clinics and general practices.

‘It is well ahead of expectations … We are on track to deliver a vaccine to Australians, commencing in March 2021.’

Head of the Therapeutic Goods Administration (TGA) Professor John Skerritt said Pfizer had done some ‘really clever work’ on the distribution of the vaccine.

‘They’re working on what Australians could call “eskies”,’ he said.

‘They’re very sophisticated eskies, which require dry ice. They last for 14 days and can be refilled twice.

‘Without the need to connect to electricity, the eskies, with the two refills, give you a month-and-a-half of cold chain protection. Even in a country the size of Australia you can get anywhere a lot quicker than that.’

Although there are limitations on the amount of dry ice that can be transported per flight, Professor Skerritt said the relaxing of border restrictions, and the corresponding increase in domestic flights, would help authorities distribute the vaccine.

He said he suspected there would need to be a number of vaccines to cover different patients.

‘We don’t know what population [the vaccines] are suitable for yet,’ Professor Skerritt said. 

‘That information will come through in the months and years after the vaccines are approved.’

The Pfizer/BioNTech agreement, in addition to a new deal with Novavax, will provide 50 million coronavirus vaccine doses. This is on top of existing commitments to purchase vaccines from the University of Oxford/AstraZeneca and the University of Queensland/CSL partnerships, which were announced in September.

Access to the four vaccines and a total of 134 million doses is on track, however these arrangements depend on whether the vaccines are found to be safe and effective in clinical trials, which are still ongoing and subject to approval by the TGA for use in Australia.

There are five separate agreements for the supply of COVID-19 vaccines in Australia, including one with the COVAX Facility, a global effort to support rapid, fair and equitable access to vaccines. 

The facility invests in potential vaccines with support from the World Health Organization, UNICEF and the Coalition for Epidemic Preparedness Innovations. Participation allows Australia to purchase vaccine doses as they become available.

Variability in vaccine types strengthens Australia’s position to access safe and effective vaccines as soon as they are available.

Priority groups first in line to access a vaccine are those at increased risk of exposure such as health and aged care workers, including pharmacists, and the elderly and vulnerable. 

Consultations are underway with state and territory governments, medical experts and industry peak bodies before the roll-out of the COVID-19 vaccination program in early 2021. Locations will initially include general practices, respiratory clinics, state and territory vaccination sites and workplaces, such as aged care facilities.

COVID-19 vaccinations will not be mandatory but will be available free for those who opt in.

Pharmacist involvement

Jarrod McMaugh MPS, a locum pharmacist in Melbourne and PSA Senior Pharmacist – Consulting, told Australian Pharmacist that an offer to prioritise COVID-19 vaccination for community pharmacists would be a ‘positive thing’, with some caution regarding safety.

‘It makes sense for community pharmacists and their staff to have early access,’ he said. 

In Mr McMaugh’s experience, unwell people present to their pharmacy for an opinion before consulting their doctor, leaving pharmacy staff vulnerable if any patients are infected by the virus before a diagnosis is made.

Although he hasn’t knowingly had direct contact with a COVID-19–infected person, the experience of virus spread and subsequent lockdown in Melbourne had resulted in concern among Melbourne health professionals about contracting the illness. 

According to the Victorian Department of Health and Human Services’ latest figures, 63 Victorian pharmacists were infected by COVID-19.

Chris Campbell MPS, PSA General Manager Policy and Engagement, echoed Mr McMaugh’s comments, saying pharmacists are frontline healthcare providers who are in regular contact with vulnerable populations within hospitals, community pharmacy and aged care.

‘It is critical pharmacists are provided the COVID-19 immunisation as part of the mass vaccination program,’ he told AP.

In addition, pharmacists have been called upon to provide COVID-19 vaccinations to the community when the vaccination program expands to the broader population. 

‘It will be a team effort by all immunisation providers and I’m truly proud of the role pharmacist immunisers look to play,’ Mr Campbell said.

‘It will be critical to ensure all immunisation providers are immunised early against COVID-19 to protect themselves and, just as importantly, the population they are providing care for.’