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AstraZeneca now only recommended for Australians aged 60 and over in blow to Covid vaccine rollout

<span>Photograph: Mick Tsikas/AAP</span>
Photograph: Mick Tsikas/AAP

The Morrison government insists the country’s vaccine rollout remains on track to deliver first doses to all Australians by the end of the year, after fresh health advice forced another change to the trouble-plagued program.

More than two million people aged 50-59 who were previously advised to take AstraZeneca vaccine are now being told to take the Pfizer jab, a decision that experts warn will further strain supplies and could lead to a spike in vaccine hesitancy.

On Thursday, the health minister, Greg Hunt, announced the government had made the decision based on advice from the Australian Technical Advisory Group, which said only over-60s should now take AstraZeneca because of 12 new cases of a rare, but sometimes serious, blood condition.

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Another 815,000 people over the age of 50 who have had only the first of two AstraZeneca doses are also caught up in the confusion, with the chief medical officer urging them to go ahead with the second dose despite the changed advice.

The chief medical officer, Paul Kelly, said that while the “risk benefit equation” had now changed for the over 50s because of the reported incidence of the blood clotting condition known as thrombosis with thrombocytopenia syndrome (TTS), those over the age of 60 should continue to take up the AstraZeneca on offer.

“The benefit of AstraZeneca in the over 60s remains much higher than the risk of this particularly rare but sometimes serious syndrome,” Kelly said.

“People over 60 should still be rolling out to their GP or wherever they are getting their AstraZeneca vaccine and getting that first dose.”

He said that for the people aged 50-59 who had received just one dose of AstraZeneca, they should feel comfortable going ahead with the final shot.

“Anyone who has had a first dose of AstraZeneca without a problem should feel very confident to have their second dose and should keep that booking,” Kelly said, citing UK data which showed the incidence after the second dose was one in 1.5 million.

Professor Julie Leask, a social scientist with the Susan Wakil School of Nursing and Midwifery at the University of Sydney, said ATAGI had made the right decision but “The implication of this recommendation is that it will increase demand on the Pfizer vaccine,” she said.

“It is inevitable that some more people will feel more cautious about this vaccine, particularly those already hesitant. This is likely to be a minority.”

Professor Adrian Esterman, Chair of Biostatistics at the University of South Australia, warned the new advice would “again disrupt the vaccine rollout” given the limited supply situation.

“Unfortunately, the Federal Government put most of their eggs in the AstraZeneca basket, and this is now becoming a major problem,” Esterman said.

Hunt said that despite the latest change, which comes just eight weeks after the government ordered a major overhaul of the program to limit AstraZeneca to the over-50s, the government was confident it had enough Pfizer, saying it had secured “whole of population coverage” and would receive 2.8m doses in July.

“It is a difficult, challenging global situation. We have 40 million doses that are secured, which we believe are reliable and which will be delivered,” Hunt said.

“It’s a challenge. Every day during Covid the world has challenges. Australia’s challenges thankfully and mercifully have been different to the rest of the world.

“Are we on track to offer every Australian a vaccine who is eligible during the course of 2021? The answer remains and the advice we have is yes.”

The head of the commonwealth’s vaccine taskforce, Lieutenant-General John Frewen, said it would be a “minor adjustment” to accommodate the new age group, given the ramp-up in Pfizer doses being delivered.

“From a logistics perspective, this is a relatively minor adjustment … There will be a few weeks of adjustment to get the cohort organised, and perhaps switch over to Pfizer, but we can accommodate this adjustment.”

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The Therapeutic Goods Administration (TGA) reported on Thursday there were a further 12 reports of blood clots and low blood platelets assessed to be confirmed or probable cases of TTS linked to the AstraZeneca vaccine in the past week.

The new cases include three confirmed in 55 and 65-year-old women from Victoria, and a 53-year-old woman from NSW. The nine new probable cases include: a 54-year-old man from the Northern Territory, a 65-year-old woman from Tasmania, 50 and 56-year old men and a 69-year-old woman from Victoria, a 58-year-old woman from South Australia, 59 and 80-year-old men from Queensland, and a 67-year-old woman from NSW.

It takes the total of Australian reports of TTS following the AstraZeneca vaccine to 37 confirmed and 23 probable.

The estimated risk of TTS following the first dose is 3.1 per 100,000 for people under 50, 2.7 for people between 50 and 59, 1.4 for people between 60 and 69, 1.8 for people 70 to 79, and 1.9 for people over 80 years of age.

A total of 25.5% of the eligible population have had their first vaccination, including 64% of over 70s.

Australia has a much greater supply of the AstraZeneca vaccine than Pfizer, largely through onshore production of the former. Opening up the Pfizer vaccine to 2.1m more people will add pressure to the Pfizer supply.

Victoria this week halted bookings for Pfizer vaccinations amid concern about a lack of supply from the federal government for second doses.

Frewen said the government would fast-track the use of GPs to deliver the Pfizer vaccines, and 1,300 GPs will be able to administer the vaccine by the end of July. Currently, 21 commonwealth vaccination clinics can administer the vaccine, ramping up to 70 by the start of July, and 136 capable by the end of July.

He said the taskforce was also working with states and territories to administer the Pfizer vaccine through the state clinics.

Ali Telford, the vaccine communications manager for AstraZeneca in Australia and New Zealand, said the company respected the decision taken by the government, in the “context of low community transmission rates in Australia”.

“AstraZeneca remains committed to supporting the rollout of the vaccination strategy in Australia and is confident that our vaccine has an important role in protecting Australians from the virus,” Telford said.

In Question Time, Labor leader Anthony Albanese targeted the government over the latest setback, asking the acting prime minister Michael McCormack to acknowledge that the failure to secure diverse vaccine supply deals had led to a heavy reliance on AstraZeneca.

“Which has been subject to changing health advice, contributed to vaccine hesitancy, slowed Australia’s vaccine rollout and put our economic recovery at risk.”

McCormack said the government had “at all points during this global pandemic, made sure that we followed the best possible medical advice and did what a responsible government would do as far as the vaccination rollout is concerned.”