(Image: AAP/Luis Ascui)

In Both Sides Now, author and ethicist Leslie Cannold presents two sides of an argument. Then it’s over to you: what do you think is true, and what do you think Cannold really believes?

Today: should Australians over the age of 50 arrange to have their AstraZeneca jab from Monday?

Yes: It’s not ideal but it’s the best chance we’ve got for safely removing the barriers to opening up our borders, and the risks to health for the over-50s are very low. No: Australians over-50s should not accept this inferior vaccine when coronavirus numbers are so low that the risks outweigh the benefits.


If you’re over 50, your chance to get your COVID-19 vaccination starts from next week. From Monday, people over 50 can get their AstraZeneca jab at general practice respiratory clinics as well as state and territory vaccination clinics. They can also book in for a jab at their participating general practice, which will start offering appointments from May 17.

Hopefully, older Australians will show up. A new Essential poll suggests that just over half of older Australians (53%) are vaccinated or intend to get the jab as soon as they’re eligible.

A big part of the hesitation is about the AstraZeneca shot. In the wake of worldwide publicity about an extremely rare but serious side effect of this and other viral vector vaccines, the poll showed only 40% of Australians newly eligible for the shot — seniors aged 50 to 69 — were willing to get either the Pfizer or AstraZeneca vaccine. Nearly a third of this age group — 29% — said they would accept Pfizer only.

But there’s not enough Pfizer to go around, and won’t be even by the end of the year when the additional 20 million doses the Australian government has belatedly ordered arrive on shore. These are intended to cover the under-50s for whom Pfizer is now the recommended shot.

This is a problem. Australia needs 70-85% vaccine coverage — or even 90% according to health broadcaster Norman Swan — to safely remove barriers on our borders. If by year’s end only about half of Australia’s seniors have been vaccinated, how can we open up?

The short answer is we can’t. In fact, according to University of Melbourne epidemiologist Tony Blakely, seniors refusing to get an AstraZeneca shot could delay Australia’s opening up by at least six months.

We all wish Australian governments had not been so late to the party when it came to Pfizer and Moderna, the two mRNA vaccines that experts agree have been the standout in the vaccine race so far.

But that ship has sailed. The decision now facing Victorians aged 50 to 69 is a take-it-or-leave-it one. Take the AstraZeneca vaccine now or miss out on vaccination until at least the second quarter of next year.

Waiting that long would be foolish. The AstraZeneca shot is 100% effective at reducing severe disease, hospitalisation and death, even against the South African variant. New trial results show it reduces transmission by 76% if the second dose is given 12 weeks after the first.

Saying “no” to the AstraZeneca jab is selfish, too. Public health crises challenge us to think as individuals but also as community members. While we must accept the risk of harm that comes from refusing medical care as individuals, in the case of vaccination, those harms aren’t confined to us.

My mind keeps turning back to all the sacrifices made by young people, especially here in Victoria, during last winter’s lockdown. They complied with one of the harshest lockdowns on earth, wearing the terrible consequences for their education, job prospects, relationships, and mental health with few complaints. They didn’t do this for themselves, because then, like now, the risk of younger Australians getting seriously ill from COVID-19 is low. They did it for us, their parents and grandparents.

Now is our chance to pay them back — by getting vaccinated as soon as we can with whatever we’re offered so that when the Pfizer shots that they need are in hand later this year, we seniors are done and dusted.


For Australians over 50, trying to decide whether to take the AstraZeneca jab is tricky. Risks must be weighed against benefits, as is the case for all medical interventions.

But while serious short-term side effects are rare, the benefits of getting vaccinated right now in Australia are unclear. Because we have almost no community spread.

So, how to make the choice? The experts are no help. While they admit Pfizer is the far better jab — offering comparable protection from serious disease and greater reductions in transmission — they insist older Australians should stick their arms out for the AstraZeneca jab anyway. Says Professor Anthony Kelleher, director of the Kirby Institute: “Although it would be ideal to have something that was even better than the AstraZeneca candidate, we’re not in an ideal situation.”

Professor Dale Godfrey, immunology theme leader at the Doherty Institute, agrees: “I certainly wouldn’t be writing off the AstraZeneca vaccine yet, especially since we don’t have an option of saying we want the Pfizer, or any other vaccines instead … and ‘just waiting’ could leave us very vulnerable, especially if we get another major wave.”

But how likely is another wave? As recent escapes from hotel quarantine have shown, our contact tracing systems, in combination with high rates of vaccination coverage of frontline health and border workers with Pfizer, have protected us well. The other risk — opening up — can’t happen until the whole adult population has been offered vaccination anyway which, given the expected arrival time of the Pfizer doses we need for this to happen, won’t be until early next year.

By then, the drumbeat to open up will be deafening, leaving older Australians protected only by the AstraZeneca vaccine in the lurch: both contributing to the government’s “fully vaccinated” figures that will trigger the floodgates to open, yet the most at risk and least protected from the variants of concern that will come pouring into the country.

It doesn’t make sense. The only thing that does is for every Australian to be given the vaccine that is safest for them and the most effective at preventing serious disease and transmission. Which means mRNA vaccines all around.

What side are you on? And where do you think Cannold sits? Send your thoughts to letters@crikey.com.au with Both Sides Now in the subject line.