Scott Morrison’s try and affect ATAGI recommendation on AstraZeneca vaccine is misguided

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Scott Morrison this week kind of trashed Australia’s prime advisory physique on immunisation, in remarks that have been at finest ill-judged and at worst alarming.

On Wednesday Morrison instructed a information convention he (or the federal government) made a “constant appeal” to the Australian Technical Advisory Group on Immunisation (ATAGI) to evaluation its recommendation on AstraZeneca based on the stability of danger.

On Thursday he mentioned on radio: “I’ve just simply said balance of risk is changing, guys, so how is that impacting on your advice, and it’s time to think about that.”

The “guys” (and ladies) on ATAGI are clearly as conscious as anybody of the altering danger profile as instances enhance.

Certainly ATAGI has already altered its recommendation on AstraZeneca in gentle of the Sydney outbreak.

On July 13 it mentioned the place there was an outbreak and the Pfizer provide was constrained, individuals beneath 60 with out fast entry to Pfizer ought to “reassess the benefits to them and their contacts from being vaccinated with COVID-19 vaccine AstraZeneca, versus the rare risk of a serious side effect”.

ATAGI, whose members have {qualifications} in immunisation and infectious ailments, is charged with advising the well being minister on immunisation points.

There is no doubt its recommendation on AstraZeneca has been very cautious.

It threw a spanner within the vaccination works when it mentioned that Pfizer (of which Australia does not but have sufficient) was most popular for these beneath 50, after which raised the age to beneath 60.

This was primarily based on the very small danger of blood clots, which usually tend to happen in youthful individuals. Two newer deaths associating AZ and clots have been introduced by the Therapeutic Items Administration on Thursday — the individuals have been of their 40s.

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Play Video. Duration: 2 minutes 15 seconds

The Prime Minister says ‘sorry’ for issues with vaccine rollout.

ATAGI is not alone

Whether or not ATAGI is true or unsuitable in its warning is disputed.

However it isn’t the one professional supply in Australia taking this place.

A paper by the Kirby Institute’s Raina MacIntyre and different authors published in this month’s issue of the international journal Vaccine reported their “risk-benefit analysis for Australians aged 18–59”, evaluating the chance of AZ vaccination with the chance of COVID an infection.

The authors concluded: “In Australia, the potential risks of the AZD1222 vaccine in younger adults, who are at low risk of dying from COVID-19, may outweigh the benefits.”

The article additionally mentioned: “The latest policy decision to avoid use of this vaccine in adults < 60 years in Australia is entirely consistent with past vaccine risk–benefit policy decisions when rare but serious adverse events were identified.”

The authors say their evaluation, performed after the demise of a 48-year-old girl, was “shared with senior health officials in Australia on April 8, 2021”.

That was the identical day ATAGI suggested in opposition to AZ for beneath 50s, with the federal government saying this at a rapidly known as evening information convention.

It is as much as the federal government whether or not it accepts no matter ATAGI says — as ATAGI’s remit signifies, it solely “advises”.

Morrison’s again is in opposition to the wall

Actually we all know ATAGI’s recommendation (and the controversy it prompted) contributed to vaccine hesitancy together with amongst these for whom AZ is most acceptable — older individuals — and that is very unlucky.

It might be official — if tough and a few would say irresponsible — for Morrison at any level to say he thought ATAGI unsuitable, that different advisers have been telling him one thing else, and so the federal government rejected ATAGI’s recommendation.

However what he — a pacesetter together with his again in opposition to the wall due to the Pfizer scarcity and the rollout shambles — mustn’t do is attempt to lean on a supposedly unbiased professional group to alter its recommendation.

The PM’s goal appeared apparent. If ATAGI was pliable, he might say, “this is the new health advice — everyone should follow it”. He would have the very best of all worlds.

Or maybe not. If and when ATAGI modifications its recommendation any further — even when the PM’s view has nothing to do with that change — will it have the identical credibility? Will not many individuals, already suspicious and cynical, suppose ‘that is simply ATAGI giving into political strain’?

If the notion of ATAGI’s independence goes to be undermined, the usefulness of the physique — no matter it says — turns into questionable.

At his Thursday information convention, Morrison tried to re-spin his strain on ATAGI.

He utterly revered its recommendation, he mentioned.

“That’s why we’ve followed the advice of ATAGI. It’s my job as Prime Minister not just to simply accept advice uncritically. Whether it’s sitting in cabinet meetings or in other forums, of course I challenge the advice that I receive. I ask questions. I drill into it. You would expect me to do that. I think Australians would not expect me to just take this advice simply on the face of it.”

Really, on quite a few events, the federal government has made a advantage of simply accepting well being recommendation with out query.

In the Australian Financial Review two economists, Ashley Craig and Matthew Lilley, have criticised ATAGI for not constructing into its suggestions social advantages versus dangers.

They write: “Ask yourself whether ATAGI made the right call by refusing to properly account for social benefits in its advice, which encouraged millions of Australians to delay vaccination.”

“It is not too late to change this message. With millions stuck in lockdowns, ATAGI could instead be emphasising how accelerating vaccinations will make society better off.”

This, nevertheless, appears wrong-headed. ATAGI is a slim, specialist vaccination advisory physique. You would not ask Treasury to evaluate the effectiveness of Pfizer in opposition to AstraZeneca. ATAGI’s recommendation is a part of a wider image, which authorities has the job of bringing collectively into one body.

Specialists beneath the highlight

The ATAGI episode is simply the most recent chapter within the evolving story of the function of well being specialists on this pandemic.

Early on, their standing was considerably unquestioned. Morrison and different leaders consistently referred and deferred to them.

However then well being officers, particularly at state degree, turned controversial figures, accused of being political.

Though the federal bureaucrats haven’t been targets in the identical means as state officers, there was a rising notion their recommendation is influenced by the political wants of their masters.

This makes it all of the extra essential that unbiased advisory teams like ATAGI should not perceived as having a political tinge.

As Morrison struggled with what he was saying, or not saying, about ATAGI, on Thursday he did what he hates doing, to get the media off his again on one other entrance.

He had been beneath strain for earlier refusing to say “sorry” for the rollout issues — he’d resisted the phrase, preferring to say he took accountability.

However at Thursday’s information convention he mentioned: “I’m certainly sorry that we haven’t been able to achieve the marks that we had hoped for at the beginning of this year. Of course I am.”

He had determined, or been persuaded, that the “sorry” query would not go away with out being handled. It may be tougher to place the ATAGI inquiries to relaxation.

Michelle Grattan is a professorial fellow on the College of Canberra and chief political correspondent at The Conversation, the place this text first appeared.


This web page was created programmatically, to learn the article in its authentic location you may go to the hyperlink bellow:
https://www.abc.net.au/news/2021-07-23/scott-morrison-atagi-vaccine-advice-astrazeneca/100316092
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Michelle Grattan

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