Health officials and experts are assessing what to do with the tens of millions of COVID-19 vaccines Australia has purchased but does not need, with concerns some may simply go to waste.
Of the roughly 255 million vaccine doses the federal government has purchased, less than a quarter — roughly 60 million — have been administered around the country.
A further roughly 40 million doses have been donated around the Indo-Pacific region.
Some vaccine supplies, particularly Novavax, have hardly been touched.
Even with the increased uptake of fourth doses, Australia will be left with an enormous number of vaccines purchased but not required, particularly as variant-specific vaccines are procured and rolled out.
Health Minister Mark Butler has ordered a review of Australia's vaccine agreements, to be led by former Health Department secretary Jane Halton, which will look at what to do with excess vaccine supplies.
"If it does turn out that we have a surplus, then I'd want to have a range of options in front of us as to what to do with any surplus vaccines we were contractually required to take," he told a press conference announcing the review.
The federal government bought a range of vaccine options to provide cover should one or more fail to work, and built into that plan was the likelihood that if most worked, there would be plenty of doses left over.
Some experts argue while the early months of the pandemic were undoubtedly filled with uncertainty, it is clear Australia and other rich nations ordered far too many vaccines.
They argue the over-ordering of vaccines starved poorer countries of early access to doses, and those countries are still very slowly catching up.
And with a glut of vaccines across the globe, they now might not have anywhere to go.
A lot of Novavax, and not many available arms
One of Australia's largest vaccine deals was with Novavax, securing 51 million doses of the protein-based vaccine.
But Australian Immunisation Register figures show that supply has barely been touched.
Vaccine brand |
Doses bought |
Doses used (to nearest thousand) |
Usage rate (per cent) |
|---|---|---|---|
AstraZeneca |
53,800,000 |
13,807,000 |
25.66 |
Pfizer |
126,000,000 |
41,699,000 |
33.1 |
Moderna |
25,000,000 |
4,612,000 |
18.45 |
Novavax |
51,000,000 |
162,000 |
0.32 |
Note: Australia has donated more than 40 million doses within the Indo-Pacific, either from its own stockpile or procured through UNICEF.
As of late June, just 161,000 of the 51 million doses had been administered.
That is 0.3 per cent.
It is largely because by the time Novavax was approved for use and available to be rolled out, more than 95 per cent of Australians aged 16 and over were fully vaccinated.
And while the shot is now approved for use as a booster, it is not recommended, with the nation's immunisation expert panel preferring that mRNA vaccines like Pfizer and Moderna be rolled out instead.
It means the government could be left hunting for a home for more than 50 million Novavax doses.
Did Australia buy too many vaccines?
Australia was hardly alone in looking to lock in a range of different vaccine deals during 2020, and ordering more than enough to cover the population a few times over.
It was always made clear that there had to be contingencies in place in case certain vaccines did not work out.
But Deborah Gleeson, from La Trobe University, argued even after accounting for the uncertainty of 2020, it was clear the government ordered too many.
"Australia really participated in a bigger trend that we've seen worldwide of wealthy countries buying up far more doses of COVID-19 vaccines than they needed early on in the pandemic," she said.
Others are more generous about the government's approach.
Australian Global Health Alliance chair Brendan Crabb said in the early months of the pandemic the government needed a range of vaccines.
"I'm easy on the government, in this respect," he said.
"In the emergency of a pandemic, it makes sense to have given ourselves a lot of options.
"But we do need to review that very closely and decide how we can do better next time, because there's nothing more tragic than to literally throw out life-saving vials of vaccine."
Many tens of millions of vaccines ordered are yet to be delivered, and there are suggestions the government could look to review contracts with an eye to securing newer boosters, rather than standard vaccine doses.
The cost of the vaccine rush
Both agree rich countries broadly failed poorer countries early in the pandemic, and the consequences are clear to see.
According to Oxford University's Our World in Data project, just 16 per cent of people living in low-income countries are fully vaccinated.
Professor Crabb said while wealthy countries talked about vaccinating the globe, and made some significant efforts, the results speak for themselves.
"That's a failure on behalf of all of the rich countries," he said.
"It's not like Australia didn't do a lot. We did do a lot.
While international vaccination efforts were hampered early by vaccine shortages, the situation has changed fast.
Across the globe, countries with more vaccines than they need are looking to give them away.
The United States has pledged to donate 1.1 billion vaccine doses by the end of the year, and it is already more than halfway there.
Most are being administered through the COVAX initiative, a global collaborative program to acquire and provide vaccines equitably worldwide.
Those involved in the global vaccination effort say problems like strained health systems in developing countries and vaccine hesitancy are bigger problems than supply.
Dr Gleeson said when vaccines were sent abroad, they needed to be a long way from their expiry date, they should be a mix of brands, and they should come with support to administer them.
"We really need to think about the distribution of vaccines around the world in a much more systematic way, rather than just exporting excess doses to countries that will have difficulty using them at short notice," she said.
Fears nations will repeat mistakes with new vaccines
The Australian government has already begun talks with companies like Pfizer and Moderna about acquiring variant-modified boosters to roll out in future.
But there are already fears among some public health officials that wealthy countries will take the same approach to buying variant boosters as they did to the original COVID-19 vaccines.
Dr Gleeson said rich countries again seemed positioned to "hoard" vaccines, which would lead to the same outcomes seen the first time around.
"As we see more second and third-generation vaccines becoming available that perhaps are better at preventing transmission of COVID-19, we'll see the same sorts of bottlenecks in production and the same sorts of inequitable sharing happening with those vaccines unless wealthy countries are prepared to really think about what they've been doing and start doing things differently," she said.
Professor Crabb said the best way to avoid that situation was to use the COVAX mechanism, which was designed from the outset to provide equitable access, rather than leaving rich countries to bid against each other.
"The best way to procure and deliver those [doses] to the wider world is to do that together, as a partnership," he said.
"Pooling our resources and doing things in partnership with others is the best way to efficiently procure and deliver vaccines to the wider world."
