Associate Professor Nathan Bartlett writes: It is madness to keep changing the rules based on perceived current risk - a calculation that is subject to change daily

In avoiding nation-wide COVID-19 illness and death, the national conversation has been focused on vaccine safety. And there are only two vaccines we can discuss, and only one vaccine we can make and supply locally. So, our options are limited.

The TGA has approved the AstraZeneca vaccine - therefore we know it is safe and effective. Yet we find ourselves fixated on reporting largely meaningless numbers to the general public.

We have been focused on risk-ratio calculations in an effort to try to allay the public concerns of very rare vaccine-induced adverse events.

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Risk calculations, numbers, more numbers - these really are not helpful to the general public who, as a result of being bombarded with stats, percentages, risk calculations - coupled with constant changes to the rules - have become more afraid of the small risks associated with the AstraZeneca vaccine than the risks of the virus.

How did it come to this, despite the catastrophic scenes in India, South America, and South East Asia?

We are in the midst of a pandemic that has killed more than four million people, that continues to destroy lives and livelihoods, separate families and causing immeasurable death and misery.

Yet we remain an unvaccinated, confused country - with many afraid or unable to get a vaccination as we look down the barrel of a significant national outbreak.

With the now infamous Australian COVID-risk equation constantly changing, there will no doubt be more vaccine advice over the coming weeks causing more confusion, anxiety, and even hesitancy.

The thing is - we have a good supply of the AstraZeneca vaccine. But it has not been administered to the population as promised.

Given the most recent changes in recommendations - lifting the age to 60 then the Prime Minister announcing, contrary to this medical advice, that all adults can have it if they want it - the vast majority of Australian adults are now even more confused about what they should do.

This is still the same vaccine that was approved for use by the TGA - destined to vaccinate most of the country and ensure we were not in this exact precarious situation - a situation where we rely on lockdowns, restrictions, and contract tracing to contain a hyper-transmissible virus that is now eyeing off a largely unvaccinated population.

This could go either way.

It is madness to keep changing the rules based on perceived current risk - a calculation that is subject to change daily. We need clear, consistent messaging to support the vaccine rollout and get the public on board.

The AstraZeneca vaccine is an approved medication. Those in charge must stop destroying public trust by continually changing the rules around access to the only vaccine we can supply en masse.

But is it already too late for AstraZeneca to play a significant role in the current outbreak?

The guidelines recommend a 12-week gap between the first and second AstraZeneca vaccine jabs. Assuming you need about two weeks post-second jab to reach full protection, that is three-plus months to reach full protection.

Even if AstraZeneca was made available to everyone - and who knows, next week it might be - it is not going to impact national protection for some time.

By limiting access to the AstraZeneca vaccine and effectively stifling the vaccine rollout, it could be too late for that vaccine to play a role this winter. It is getting to the point where those under 60 might as well wait for Pfizer, with which they will be fully protected by five weeks.

Unfortunately, we do not have enough Pfizer doses in the country to open up vaccination to all Australian adults. So lock downs, quarantine, border closures, restrictions - more social and economic hardship - is what we will have to rely on to get through this winter.

I understand the need for transparency for vaccine safety. Absolutely the public has a right to know about vaccine adverse events and understand these rare but no less tragic events. But the government must control this narrative to ensure the messaging is balanced, accessible and consistent.

It needs to be supported by effective communication on the critical importance of vaccination and the devastating reality of COVID-19 - a reality I hope we can somehow manage to avoid, but we may very well face in coming weeks.

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