(AP Photo/Ted S. Warren)

Yesterday, a triumphant Scott Morrison announced that Australians could be among the first in the world to get a long-awaited COVID-19 vaccine. The vaccine would be free. And it would come soon.

Good news — except there were many caveats. The federal government has signed a letter of intent with AstraZeneca, the Anglo-Swedish company which is working with researchers at Oxford University to produce what is, so far, a front-runner in the international vaccine race. 

But AstraZeneca immediately poured cold water on Morrison’s moment. A company spokesperson said the government’s deal was simply a letter of intent — the critical fine print, like costs and manufacturing capacity, is still yet to be determined. While biotechnology company CSL is expected to produce the vaccine locally under a licensing deal, this is yet to be nutted out.

And crucially, while the vaccine candidate looks very promising, we don’t yet know if it will work. Even if it does, the road to normal remains long and bumpy.

A question of when

In contrast with the early days of the pandemic, the mood around the possibility of a vaccine is increasingly positive. National Centre for Immunisation Research and Surveillance chair Kristine Macartney chalks this down to the incredible progress made by the scientific community, which has accomplished in six months what might normally take six years.

“I’m confident we will have one or more vaccines, and I think it will be more than one,” Macartney told Crikey.

Yesterday, Morrison hinted that if all went well, a vaccine could be available to Australians early next year. But University of Sydney global health security associate professor Adam Kamradt-Scott said we should temper that excitement a little.

“I have to emphasise that this vaccine hasn’t been proven to be 100% effective yet, so we’re making huge assumptions,” he said.

If it passes phase three clinical trials, there are big logistical challenges ahead. To inoculate the world, we would need to produce between 12 and 15 billion doses, twice our current vaccine manufacturing capacity. We also face global shortages of syringes and glass vials.

Locally, the Therapeutic Goods Administration could ask for more data before approving a prospective vaccine. There’s also plenty we still won’t know about a vaccine until we start rolling it out. We don’t know how long immunity will last, or how much of the population needs to be vaccinated before we start seeing results.

Behind the curve

Last week, Labor’s health spokesman Chris Bowen hit out at the government for being slow off the mark at getting a vaccine deal. He pointed out that the United Kingdom signed an advance purchase agreement with AstraZeneca in May. The United States has six such deals.

“[It] would be just unthinkable [to] think a vaccine breaks through and we just can’t get access for it in Australia because of these failings,” Bowen told the ABC’s Fran Kelly.

The Morrison government’s approach so far has been to avoid putting all its eggs in one basket, although the letter of intent represents a calculated bet on the Oxford vaccine’s success.

Kamradt-Scott said despite the criticism, there were advantages to this tactic. It means we’ve avoided getting locked into too many expensive agreements over vaccines that might not work. And if the Oxford vaccine does, a local manufacturer will be licensed to produce it onshore, meaning we won’t have to wait in line behind say, the European Union, which already has a deal with AstraZeneca.

On the other hand, there are over 160 candidate vaccines, 10 of which are at phase three or beyond. If another one is successful first, Australia may have to wait, pending an agreement with the manufacturer.

An information war?

As COVID-19 spread around the world, so too did disinformation and conspiracy theories. Anti-vaxxer Facebook groups saw their numbers swell, their cause aided by a carousel of C-list celebrities.

In the United States, where a third of people say they won’t take a vaccine, there are fears of a coming “vaccine information war”. Morrison seemed to nod at this hesitancy, when he yesterday toyed with the idea of making a COVID-19 vaccine mandatory.

But University of Sydney professor Julie Leask said in spite of worries about anti-vaxxers, most Australians would be eager to get vaccinated.

“The vaccine is framed as a ticket back to normal life. I think that is enough incentive for many people to get it.”

Macartney emphasised that Australia generally had a high rate of vaccine uptake.

“There’s a lot of support for vaccination, and we know that disinformation isn’t listened to by the majority of the Australian people,” she said.

Who goes first?

For Leask, who works on vaccine uptake, dealing with the vaccine hesitant is just half the challenge. The other part is ensuring safe and equitable access, and overcoming structural barriers to health. While there’s some consensus that health workers and people with vulnerabilities should get priority access to a vaccine, the question of who gets jabbed first needed to be transparently set out, with public consultation, Leask said. That’s not just an issue for Australia, but for the entire world.

“I think that’s really important to remember that we’re global citizens here, and not just worry about ourselves,” Leask said.

There’s an impulse for countries, Australia included, to look after themselves in securing vaccine supply. That’s great for wealthy countries like Australia, but as the World Health Organization has warned, such vaccine nationalism only delays our return to a “normal” pre-COVID life, if such a thing is really possible.

Macartney said it would be years until the whole world was vaccinated — some lifesaving vaccines have taken decades to roll out. It’s why Kamradt-Scott said the government should be clearer about how it’s going to ensure access for the rest of our region. Regular trips overseas just won’t be a thing until those countries also have the vaccine.

“There’s this assumption that once you’re vaccinated, you can go to Bali on holiday again. But then you’re conceivably interacting with people who’ve been unvaccinated,” Kamradt-Scott said.

Getting a jab won’t be the end. Until everyone has it, until we know more about how well it works, masks, quarantine, rolling lockdowns and more, an atomised life could be here to stay.