Exclusive: Vaccine recommendations must also consider Covid's long-standing effects on health systems and workforce, says Dr Michelle Ananda-Rajah
Labor MP and infectious disease specialist Dr Michelle Ananda-Rajah has criticized Australian immunization expert for maintaining "too strict" rules on access to coronavirus vaccines, urging the government to expand eligibility for children and young people in the fight against prolonged Covid .
The Melbourne doctor asked the Australian Technical Advisory Group on Immunization (Atagi) to be more transparent in its decision not to recommend the fourth shot for people under 30 and not allow toddlers to receive the Covid vaccine. He said many parents were "desperate" for their children to be vaccinated.
"We don't have many weapons against Long Covid except vaccinations... not much else," Ananda-Rajah told Guardian Australia.
"I'm frustrated, frankly, that we have too strict and complicated criteria around vaccine eligibility."
Ananda-Rajah was a doctor at the Alfred hospital and a prominent critic of the previous Coalition government's pandemic response before winning the Higgins seat in the May election. He has been criticized for questioning the efficacy of the AstraZeneca vaccine in 2021, and co-founded the Australian Health Care Workers group, which advocates for better Covid protection for medical staff.
Along with several other trained doctors, he is a member of a parliamentary inquiry into "long Covid," or chronic symptoms that persist months after the initial infection. Following an audience with medical staff, Ananda-Rajah tweeted this week that doctors wanted more booster injections, but "the brakes remain locked thanks to Atagi's too strict criteria."
Atagi's current recommendation means people aged 30 and over are eligible for a second Covid booster, or fourth shot; those aged 16 and over can get a booster, or third injection; children aged five to 15 years are eligible for two shots, and can only get a booster if they have a serious health problem; whereas infants under five are only entitled to get vaccinated if they have serious health problems.
Ananda-Rajah said the current rules had disappointed those who were not eligible for additional vaccinations, noting countries such as the United States were offering primary doses for children as young as six months and boosters for all over five.
"I echo and convey the frustration I hear from my constituents asking for vaccines for their children, and colleagues in the health professions who urgently need booster shots," he said.
“My constituents are confused by this, parents are eager to vaccinate their children… I can't answer the question why we don't offer vaccines for children here.”
Long Covid 'hits people in the prime of their lives'
Ananda-Rajah admitted that he was worried about the long impact of Covid in the future. In filing for the inquiry, Prof Raina Macintyre from the Kirby Institute estimates that nearly all Australians will experience at least one Covid infection by August 2023, and that 1 million people could develop prolonged Covid symptoms by October 2023.
His submission warned Australia "faces a growing chronic disease burden" from long Covid, recommended the government consider vaccinating children from zero to four years of age, and expanding booster access.
Dr Zinta Harrington, head of Liverpool Hospital's respiratory department, told a lengthy Covid investigation last week in response to a question from Ananda-Rajah that expanding boosters for younger medical staff would be "very helpful". Dr Tuan-Anh Nguyen, head of the rehabilitation medicine department of Campbelltown Hospital, also supports expanding eligibility.
Ananda-Rajah said that Atagi's vaccine recommendation must take into account the old Covid, and its potential impact on society.
“Long Covid hits people in the prime of their lives, snatching them out of their lives and taking them out of the workforce,” he said.
He said the suitability of the vaccine had been established with the intention of reducing death and disease, but "one they haven't accounted for is the increase in productivity that comes from vaccination".
Ananda-Rajah said Australia should offer booster shots to all children aged five and over, and expand the primary dose to those under five.
He also said Atagi's consideration of the suitability of the vaccine should be published, citing the example of the US Immunization Practices Advisory Committee.
“This is not rocket science. We know vaccines reduce risk. I want to align vaccine recommendations at a minimum with the US," he said. “We must act. We can't sit back and say we need more data and research, it's not good enough, while it affects millions of people, to wait for that research. I want more pragmatism to enter our policy-making."
In a statement, health secretary Mark Butler endorsed Atagi's recommendations, which he said were based on international and local evidence, but flagged potential changes early in the new year.
"The Australian government has received advice from the Australian Technical Advisory Group on Immunization (Atagi) that currently there is no need for additional doses of the Covid-19 vaccine beyond those already recommended," he said.
“Atagi have said that they anticipate recommending a new booster in early 2023 as a winter preparation, which will obviously be an important part of our preparation strategy.”
Butler added that "having all of the vaccines recommended for your condition remains one of the best ways to protect yourself from severe illness or death from it." This article was written by EDUKASI CAMPUS.