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Scott Morrison’s attempt to influence ATAGI advice on AstraZeneca vaccine is wrong

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Scott Morrison this week more or less dismissed Australia’s highest advisory body on immunization, on remarks that were at best misjudged and at worst alarming.

Morrison told a news conference Wednesday that he (or the government) made an “ongoing call” to the Australian Technical Advisory Group on Immunization (ATAGI) to review its advice on AstraZeneca in terms of risk balance.

On Thursday he said on the radio: “I just said the balance of risk is changing, guys, just as this is affecting your advice and it’s time to think about it.”

The “boys” (and girls) at ATAGI are obviously as aware as anyone of changing their risk profile as cases increase.

In fact ATAGI has already changed its advice to AstraZeneca in light of the Sydney explosion.

On July 13 she said where there was an outbreak and Pfizer supply was limited, people under 60 without immediate access to Pfizer should “re-evaluate the benefits for them and their contacts from vaccination with the COVID-19 AstraZeneca vaccine, despite the rare risk of a serious side effect “.

ATAGI, whose members have qualifications in immunization and infectious diseases, is in charge of advising the Minister of Health on immunization issues.

No doubt her advice to AstraZeneca has been very careful.

She threw a key in vaccination affairs when she said Pfizer (of which Australia still does not have enough) was a favorite for those under 50, and then raised the age under 60.

This was based on the very small risk of blood clots, which are more likely to occur in young people. Two other recent deaths that accompanied AZ and clots were announced by the Therapeutic Goods Administration on Thursday that people were in their 40s.

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The Prime Minister says ‘I’m sorry’ about the problems with the distribution of vaccines.

ATAGI is not alone

Whether ATAGI is right or wrong in its care is discussed.

But it is not the only expert source in Australia to take this position.

A paper by Raina MacIntyre of the Kirby Institute and other authorspublished in this month’s issue of the international journal Vaccinereported the “risk-benefit analysis for Australians aged 1859”, comparing the risk of AZ vaccination with the risk of COVID infection.

The authors concluded: “In Australia, the potential risks of the AZD1222 vaccine in younger adults who are at low risk of dying from COVID-19 may outweigh the benefits.”

The article also said: “The recent policy decision to avoid the use of this vaccine in adults <60 years in Australia is fully in line with past vaccine risk benefit policy decisions when rare but serious events were identified. side ".

The authors say their analysis, made after the death of a 48-year-old woman, “was shared with senior health officials in Australia on April 8, 2021”.

It was on the same day that ATAGI advised against AZ for under 50s, with the government announcing this at a hastily called press conference.

It depends on the government whether it accepts whatever ATAGI says as the ATAGI task shows, it only “advises”.

The back of Morrison is against the wall

Of course we know that ATAGI advice (and the debate it sparked) contributed to vaccine reluctance, including those for whom AZ is best suited for the elderly, and this is unfortunate.

It would be legitimate if it was difficult and some would say irresponsible for Morrison at any moment to say that he thought ATAGI was wrong, that other advisers were telling him something else and so the government rejected ATAGI’s advice.

But what he’s a leader with his back to the wall due to the lack of Pfizer and the spread of clutter should not do is try to rely on a group of supposedly independent experts to change his advice.

The Prime Minister’s intention seemed clear. If ATAGI was gentle, he could say, “this is the new health advice that everyone should follow.” He would have the best of all worlds.

Or maybe not. If and when ATAGI changes its advice from now on, even if the Prime Minister’s view has nothing to do with that change, will it have the same credibility? Will not many people, already suspicious and cynical, think that only ATAGI is putting political pressure on them ‘?

If the perception of ATAGI independence is to be undermined, the usefulness of the body whatever is done becomes debatable.

At his press conference Thursday, Morrison tried to regain his pressure on ATAGI.

He fully complied with her advice, he said.

“That’s why we’ve followed ATAGI ‘s advice. It’ s not my job as Prime Minister not just to accept advice critically. Whether he sits in cabinet meetings or in other forums, of course I challenge the advice I get. I do “We were in it. You would expect me to do it. I think Australians will not expect me to just take this advice just ahead.”

Indeed, on numerous occasions, the government has made a virtue of accepting health advice without question.

In the Australian Financial Reviewtwo economists, Ashley Craig and Matthew Lilley, have criticized ATAGI for failing to follow in its recommendations social benefits versus risks.

They write: “Ask yourself if ATAGI made the right call by refusing to properly account for the social benefits on its councils, which encouraged millions of Australians to delay vaccination.”

“It’s not too late to change that message. With millions stuck in blockages, ATAGI can instead highlight how accelerated vaccinations will make society better.”

However, this seems wrong. ATAGI is a close, advisory specialist on vaccination. You will not ask the Treasury to evaluate the effectiveness of Pfizer against AstraZeneca. ATAGI councils are part of a broader picture, which the government has a duty to put together in one framework.

Experts under the spotlight

The ATAGI episode is just the last chapter in the evolving history of the role of health experts in this pandemic.

At first, their status was essentially undisputed. Morrison and other leaders constantly referred to and pushed them.

But then health officials, especially at the state level, became controversial figures, accused of being political.

Although federal bureaucrats have not been targeted in the same way as state officials, there has been a growing perception that their advice is influenced by the political needs of their masters.

This makes it even more important that independent advisory groups like ATAGI are not perceived as having a political nuance.

As Morrison struggled with what he was saying, or not saying, about ATAGI, on Thursday he did what he hates to do, to remove the media from his back on another front.

He had been under pressure for his early refusal to say “sorry” for his spread problems he would resist the word, preferring to say he took responsibility.

But at Thursday’s press conference he said: “I’m sorry we certainly have not been able to reach the points we had hoped for earlier this year. Of course I am.”

He had decided, or was convinced, that the “forgive me” question would not disappear without being addressed. It may be more difficult to pause ATAGI questions.

Michelle Grattan is a professor at the University of Canberra and a senior political correspondent at Conversation, where this article first appeared.

Sources

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2/ https://www.abc.net.au/news/2021-07-23/scott-morrison-atagi-vaccine-advice-astrazeneca/100316092

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