From Oxford to Melbourne: The story behind Australia’s vaccine choice

It has long been held aloft as a way out of the coronavirus abyss.

A COVID-19 vaccine — the thing that will bring back some semblance of normality to Australian lives.

And yesterday — according to the Federal Government, at least — it got that little bit closer.

The announcement that the Australian Government was at the “front of the queue” with UK-based drug company AstraZeneca to secure Oxford University’s potential COVID-19 vaccine sent a wave of collective relief across the nation.

And according to those in the know, that’s exactly what it was supposed to do.

“The decision makes sense,” Tony Cunningham, a vaccine expert from Sydney’s Westmead Institute, told the ABC.

“But there is a long way to go.”

Writing on the wall

Over the past few months, one by one, Australia’s international allies and political foes have been falling behind their candidates, securing vaccine supply.

In the US, the Trump Administration picked its potential winner back in May.

This month, Russia claimed it had already won, while China is spreading its wings far and wide, with three of six vaccine candidates in phase three trials.

A vaccine vial and a syringe.
Despite the sell, experts say there are still many unknows with Australia’s “letter of intent”.(ABC News: Emma Machan)

The UK, predictably, backed in its candidate from one of its oldest and grandest institutions, Oxford University, whilst at the same time committing billions to deals with a French company and global pharma giant Pfizer.

Political pressure was building in Australia, with some industry insiders and vaccine experts questioning the Government’s lack of action on the issue.

Last month, it gave its first real indication it was leaning towards the Oxford-AstraZeneca candidate, with Mr Morrison and Health Minister Greg Hunt revealing they were in talks with the UK Government.

Yesterday’s deal with AstraZeneca confirmed that.

But, like any major deal, the devil is in the details.

And in this case, the detail has gaping holes and a multitude of unknows.

What’s in the detail?

The deal itself is only a “letter of intent” with as-yet-unconfirmed “final formal agreement” to include vaccine distribution, timing and price — a price which is estimated to be in the billions if it comes off.

Unlike other countries, which have locked-in agreements, insiders say the “letter of intent” is flimsy and summed up by the “deal” — also announced this week — with US medical technology company Becton Dickinson for 100 million needles and syringes for a vaccine that doesn’t yet exist.

Further, CSL, Australia’s biosecurity partner and the only company in the country with the capability to mass-produce vaccines, currently does not have the technical capabilities to produce it.

Department of Health secretary Professor Brendan Murphy has indicated CSL had given him advice that, with prior warning, it could move quickly to produce the Oxford-AstraZeneca vaccine if required.

The message was backed up by the Prime Minister.

But CSL has maintained firm.

It confirmed on Wednesday it was “in discussions” with Oxford-AstraZeneca on “whether it is possible to provide local manufacturing support” at its Melbourne facility.

“We are assessing the viability of options ranging from the fill and finish of bulk product imported to Australia through to manufacture of the vaccine candidate under licence,” it said in a statement.

The Oxford-AstraZeneca vaccine is an “adenovirus” vaccine — a type which has never been produced in Australia before.

However, according to experts, it can be made in “mammalian cells” — the kind CSL produces for its influenza vaccine.

The ABC understands that with a substantial cash injection, CSL could realign its technology to produce the adenovirus version and the Federal Government is pushing for the company to lock in a formal agreement with AstraZeneca.

However, mRNA vaccines, such as the Trump Administration’s Moderna candidate, are more complicated for CSL and would require a significant modification of its technology.

Insiders suggest that would have been a factor to why the Federal Government’s leant towards Oxford-AstraZeneca, with CSL effectively ruling out a move to locally produce an mRNA vaccine.

Publicly, CSL said its priority remained the University of Queensland’s vaccine candidate, which is in the middle of human trials.

So why was Oxford-AstraZeneca picked?

According to Professor Tony Cunningham, the vaccine itself, which is in stage three trials, had shown positive early signs.

Tony Cunningham from Sydney's Westmead Institute
Tony Cunningham says the public needs to be prepared for a low bar of vaccine effectiveness.(ABC News: Chris Taylor)

Labelled “AZD1222” in scientific terms, the Oxford-AstraZeneca candidate is a “chimpanzee adenovirus vaccine vector” that has been genetically changed so it is impossible to grow in humans.

According to Oxford University, it is a “very well-studied vaccine type” that makes it safer to give to children, the elderly and anyone with a pre-existing condition such as diabetes.

“When the vaccine enters cells inside the body, it uses this genetic code to produce the surface spike protein of the coronavirus,” it said.

“This induces an immune response, priming the immune system to attack the coronavirus if it later infects the body.”

It said it could deliver the first vaccines by the end of 2020.

But Professor Cunningham said any vaccine required ongoing study, which came through the phase three trials of 30,000 people or more.

He said the global community needed to be prepared for a “reasonably low bar” for any vaccine because of the unprecedented pressure to speed up the development process.

“And we might have a vaccine where, after a year, you would need to have a follow-up.”

So what’s next?

On Wednesday, the Prime Minister revealed a vaccine advisory group led by Department of Health secretary Brendan Murphy.

The group, described as a collection of science and research mega-minds, also includes acting Chief Medical Officer Paul Kelly, chief scientist Alan Finkel and CSIRO chief Larry Marshall.

It met for the first time this week and will advise on implementing Australia’s COVID-19 vaccine and treatment strategy.

“[The group] will be identifying the others of the 160 [vaccines] that are out there and the positions we’ll take on others as well,” the Prime Minister said.

“We’re certainly not putting all our eggs in one basket here.

“It’s part of a more diversified approach.”

This is backed up by the Australian Academy of Science’s independent advice to the Federal Government, which is headed by Professor Cunningham.

Its latest advice suggests it is still too early to pick a winner.

Professor Cunningham said it was “smart” not to put “all our eggs in one basket”.

“We won’t know definitely [the results] until next year,” he said.

“There’s obviously quite a lot of urgency driving people to move quickly on this.

“But, as I said, there is a long way to go.”