Mon Jan 10

Why has my child's vaccination been cancelled? We're reliant on overseas supply and a complex logistics network

Written by: Archa Fox, Associate Professor and ARC Future Fellow, The University of Western Australia

Reports of GPs cancelling ^[1] or postponing COVID vaccine appointments for 5-11 year olds are piling up, with desperate parents expressing anger and fear about how their as-yet unvaccinated children will fare as Omicron case numbers explode.

Federal COVID-19 Task Force Commander Lieutenant General John Frewen said ^[2] on Monday:

Supply isn’t the issue; we’ve got enough vaccines. The real challenge now is just getting the distribution to where the demand is greatest.

South Australia’s health deputy chief executive Don Frater, however, has reportedly said ^[3] that state has “more demand than what we have supply”.

The child’s dose comes in different vials to the adult dose, with different packaging ^[4].

The rollout of the Pfizer vaccine for children has come at a difficult time, from a logistics perspective. Many GPs have said “delivery delays” are behind the need to reschedule appointments.

What might be behind the delays?

This is a specialised product, which needs to be stored in special freezers at -80℃^[6], and obviously needs to be transported in a certain way.

There are a lot of steps in the transport process – from the supplier overseas to the shipping service bringing them to Australia, from their landing spot in the country, to specialised storage, to individual GPs.

Each of those steps require staff on the ground to ensure the system works – and many workers in this system are likely being affected by Omicron.

The same staffing issues resulting in empty supermarket shelves ^[7] could be affecting the vaccine distribution network too.

Thousands of drivers, administration staff, packers and logistics planners could be furloughed, off sick or in isolation because a household member is.

The rollout of the 5-11 year old vaccination program, timed in an effort to get kids vaccinated before school starts, also comes hot on the heels of the Christmas and New Year break; even without Omicron, it’s possible staffing numbers across the supply chain and logistics network are still yet to return to pre-Christmas levels.

There have been anecdotal reports ^[8] of some ^[9] people having their booster appointments being cancelled too, so it seems it is not only 5-11 year olds who are affected.

It’s hard to know how widespread the issue is. Frewen told Sunrise on Monday

if you’re having trouble at the moment, maybe with your normal healthcare provider, your GP, then please do try pharmacies, maybe try one of the state and territory clinics as they come online.

He told ^[11] RN Breakfast that:

We will have more than enough vaccines for every kid to have their first dose before the end of the year.

This must be very frustrating for people who have tried to get in early and are keen to have their children vaccinated as soon as possible.

Clearly, something has fallen over somewhere in the distribution. It would be good to have some clarity from government and industry on exactly where the systemic problems are and what’s being planned to address them.

Domestic production of mRNA vaccines

The Therapeutic Goods Administration (TGA) only just provisionally approved the use of Pfizer’s COMINARTY COVID vaccine for people aged 5-11 years on December 3 ^[12].

Moderna’s application for the use of SPIKEVAX COVID vaccine for children under age 12 is still under evaluation ^[13], according to the TGA.

Hopefully, once that is approved, parents of children in the 5-11 year old age bracket will have more choice on where and how they can get their child vaccinated.

Both Pfizer and Moderna’s COVID vaccines are mRNA vaccines, and experts have long called for a boost in domestic mRNA manufacturing capacity so Australia is less reliant on overseas supplies.

Promisingly, Moderna and the Australian government late last year announced ^[14] an in-principle agreement to build a mRNA manufacturing facility in Victoria. The site will hopefully be up and running by 2024, according to media reports ^[15].

That’s something to be celebrated, and domestic manufacturing would hopefully mean a shorter and less complex supply chain with less opportunity for difficulties in future. But it does highlight it would have been good to have something worked out earlier.

It would also be prudent for the government to consider what it might take to lure Pfizer to develop mRNA manufacturing capability in Australia. You could argue, from a market point of view, it could be strategic for Moderna to have a manufacturing competitor here in Australia too.

If we are serious about building our biotechnology sector in Australia, then having monopoly of just one player in the country might not be ideal.