If you are 18 years of age or older, and in an area where there is an outbreak of COVID-19, the best vaccine for you is the one you can get now. This probably means you should get the AstraZeneca vaccine, as Pfizer is still in short supply. This updated advice was given by the government’s specialist vaccine advisory body ATAGI (Australian Technical Advisory Group on Immunity) on 24 July. After months of prioritizing Pfizer for young people, why would it change to recommend AstraZeneca or Pfizer? More young people are being hospitalized, in ICUs and dying during this current outbreak in Australia, where the Delta strain dominates.
Whether this is a function of the delta strain being more dangerous to younger people, or because older people (as a group) are more likely to be already protected by vaccination, remains a matter of debate. However, there is no argument that the Delta strain is more contagious, which is why we want to vaccinate our population as soon as possible.
So if you are 18 years of age or older and have not yet been vaccinated, you may be asking whether getting the AstraZeneca vaccine right now is the right thing for you to do. To answer this we need to consider the benefits and risks of the AstraZeneca vaccination. What do vaccines achieve? When thinking about what any COVID-19 vaccine should achieve, there is an order of priority.
First, it must stop people who catch COVID-19 from dying. Second, it should reduce the risk of serious illness (symptoms are bad enough to require ICU treatment).
Third, hospitalization should be low. If a vaccine is doing more than these three things, it’s a bonus.
We are very lucky that the AstraZeneca and Pfizer vaccines not only achieve all three, they also reduce the number of people suffering from any type of illness (including mild symptoms), and possibly reduce transmission (COVID-19). making people less likely to infect -19). Do vaccines work against the delta variant? As Delta has become the dominant strain of COVID-19 around the world, researchers are working hard to see how well current vaccines perform against it.
So far, the news is good. Let’s look at the proof. In the United Kingdom, where the Delta strain is currently the cause of most infections, there were 229,218 Covid-19 infections between February and July. Of these, 12.5% were in fully vaccinated people. These are known as breakthrough infections (because they broke through the vaccine’s protection).
Of those successful transitions, 3.8% required a visit to the ED. Only 2.9% required hospitalization, and less than 1% died. This means that even though vaccines did not completely protect people from disease, they did achieve their primary purpose: to save lives and keep people out of hospital.
Another study in the UK that narrowed down hospitalization with the Delta strain concluded that AstraZeneca is 92% effective against hospitalization after two doses. Other studies have shown a 60% to 67% reduction in symptomatic prognosis.
Although AstraZeneca works to reduce the infectivity of the Delta strain, people who are vaccinated can still pass it on to others. That’s why it’s so important for vaccinated people to still follow all other evidence-based ways to reduce the spread, including wearing masks, social distancing and lockdown restrictions, until we have enough people in the community to be vaccinated. Don’t be
But what are the downsides? Of course there are potential risks from the AstraZeneca vaccine: injection site pain, fatigue, headache, muscle aches, fever, and chills are the most commonly reported side effects. Most of these are mild and temporary, getting better in one to two days.
There are also rare but serious side effects: anaphylaxis (two to five per million people), and thrombocytopenia (TTS) with thrombosis colloquially known as clots. The only risk factor that has been shown to predict how likely you are to get TTS is after the age of the AstraZeneca vaccine. TTS clots are very different from other blood clots you may have heard of. Just as removing basal cell cancer from your skin doesn’t put you at higher risk of getting a brain tumor, having a blood clot in your medical history (or family history) doesn’t put you at higher risk of TTS.
In addition, we now have effective treatments for TTS, so the mortality rate is low. To put this into perspective, your risk of getting a blood clot from TTS is still much lower than your risk of dying in a car accident next year, and most people still don’t think twice about getting in a car.
Obviously, if there is no COVID-19 in the community, the risk from the vaccine will be greater than the risk from the disease, with even a small risk greater than zero. ATAGI changed its advice to recommend the AstraZeneca vaccine for younger age groups in areas of outbreaks, as the risk of serious illness and death skyrockets as COVID-19 begins to spread in the community. Which makes the vaccine suddenly a very sensible option in Sydney and other high-risk areas.
How can you get it? If and when you decide to get the AstraZeneca vaccine and you live in NSW, you can book a bus from any location that offers it in your area. This could be a GP or a state vaccination clinic. You don’t need to see a GP before, but of course you should only book once you have answered your questions and are ready to move forward with it.
In addition to contacting local providers directly, you can register for vaccinations through the eligibility checker here (you fill out your details after completing the checker). Pharmacies will not administer the AstraZeneca vaccine to people younger than 40 years old at this stage.
Finally, I have expressed frustration at many young people in my practice being unable to receive a vaccine before now, as they see this as an important step forward for our community and the world. His life has often been extremely disrupted by COVID-19 and he believes the risk of any vaccine is better than continuing with the status quo.
As one patient told me: I am young, I lead a risky life. Getting this vaccine is the safest thing I’ve done all week.
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