(Image: Private Media)

As the Delta variant emerged as the dominant strain of COVID-19 around the world in May this year, pandemic deaths once again started to rise. Studies showed Delta doubled the risk of hospitalisation compared with the previous dominant Alpha variant, while other studies found an increase in fatalities. 

Pharmaceutical companies had been scrambling to develop a COVID-19 vaccine, and early in 2021 were successful in getting their candidates approved by governments. The UK became the first Western nation to begin vaccinating against the virus — the Queen was one of the first in line for the Pfizer jab in early December 2020 — with the UK, EU and the US ordering millions of doses of the mRNA jab early on. 

The scramble to get doses in arms was in motion. A problem, however, was that Australia hadn’t yet secured a solid supply. 

“Not a race” remark soon regretted

Australia had hoped on using local resources to vaccinate residents, betting on the University of Queensland’s vaccine candidate — which was scrapped in December 2020 following false-positive HIV readings — and the AstraZeneca vaccine to be manufactured onshore. 

By the end of 2020, we’d ordered just 10 million doses of Pfizer, 53.8 million doses of AstraZeneca (the majority of which were to be made onshore), 10 million doses of Moderna — which only became available this year — and 51 million doses of Novavax, which scored its first emergency authorisation abroad this week. 

With COVID-19 cases largely under control, Prime Minister Scott Morrison declared in March the rollout was “not a race” and “not a competition” as we looked abroad to see the effect of the vaccines. Morrison was happy to let the world be our guinea pig. The only problem? We couldn’t control the Delta variant.

By the time Delta reared its ugly head in early June, just 2% of the Australian population had been fully vaccinated. By doses per 100, we were right down at the bottom of the list of developed nations, trailed only by Japan and New Zealand. The vaccine rollout schedule had been changed five times, before being abandoned altogether in April. 

Despite being paid $155.9 million, private contractors hired by the government to vaccinate aged and disability care residents botched the rollout. Aged care workers didn’t have their first doses recorded; queue jumpers were able to get vaccinated before the vulnerable; an untrained doctor incorrectly administered the vaccine; thousands of vaccines were thrown away after issues with temperature control; and disability care residents were later found to have been deprioritised in the rollout. 

Analysis showed had we ordered vaccines when first approached by Pfizer in June 2020, 2021 lockdowns would have been shorter, with 80% fewer new daily cases and a steep reduction in hospitalisations.

How hesitancy played a role

Manufacturing of AstraZeneca in Australia took off, with plenty of doses available at GPs and mass vaccination hubs. But no mass communication campaigns had been released by the government to encourage uptake.

AstraZeneca had been linked to an incredibly rare blood clot, while in Norway several elderly people died after receiving the Pfizer vaccine (although the deaths haven’t been linked to the vaccine). 

In May, almost one-third of adult Australians said they were unlikely to get the COVID-19 vaccine in the coming months. Uptake of the vaccine was slow, and a blame game began.

Because of the low level of community transmission, the ​​Australian Technical Advisory Group on Immunisation (ATAGI) advised those under 60 not to get the vaccine, changing its advice several times, raising and lowering the minimum age. 

Morrison lashed out at ATAGI, saying their advice had been overly cautious. “[It] ​​had a massive impact on the rollout of the vaccine program, it really did,” he said in July. 

But mixed messaging had come from within his own government. Health Minister Greg Hunt said while he encouraged those eligible to get vaccinated as early as possible, “as supply increases later in the year, there’ll be enough mRNA vaccine for every Australian”.

Queensland’s Chief Health Officer Dr Jeannette Young jumped on the bandwagon, discouraging young people from getting the AstraZeneca jab. 

“We are not in a position that I need to ask young, fit, healthy ­people to put their health on the line (by) getting a vaccine that could potentially significantly harm them,” she said — a message that was soon picked up by anti-vaxxer groups. 

Hesitancy was a huge concern. Although in a strange way, Delta saved us from ourselves. 

Vaccines were late… but they did their job 

Across 2020, Australia had recorded 909 deaths and 28,408 cases of COVID-19. Given the transmissibility and risk of severe disease of Delta, there were grave concerns for Australia’s health system capacity and elderly residents. 

But across this year, fewer deaths — amid significantly more cases — have been recorded. There have been 142,000 cases and 825 deaths.

Cases peaked in NSW on September 10, with 1542 new daily cases recorded. Victoria’s cases peaked a month later than Sydney’s, with 2297 cases recorded on October 14. Across this outbreak, NSW recorded over 500 deaths and Victoria over 200 — a steep drop compared with the 730 deaths recorded in Melbourne’s 2020 winter wave as the virus swept through aged care facilities.

By mid-September, 80% of NSW residents had received their first dose of the COVID-19 vaccine while Victoria hit the 70% mark. Australia is on track to become the most vaccinated country in the world (although uptake is still lagging within some Aboriginal and rural communities).

But that doesn’t mean things were smooth sailing: In September, Victorian Premier Dan Andrews lashed out at the Commonwealth government, accusing them of favouring Sydney for the vaccine rollout.

“I signed up to a national plan to vaccinate our nation; not a national plan to vaccinate Sydney,” he said. “We have seen hundreds of thousands of vaccines that should have come and should now be in the arms of Victorians going into Sydney.”

While nearly 350,000 Pfizer vaccines had been allocated to Sydney’s doctors amid the outbreak, the government said doses would be compensated to other states within the coming weeks. Analysis showed per capita, doses were more or less equally distributed. 

Vaccines arrived too late to prevent an outbreak, but just in time to keep deaths low.