In the earlier days of the pandemic, it was hailed as a solution for Australia’s lagging immunisation rate, and the jab that would win over the “vaccine hesitant”.
But of the 51 million Novavax doses purchased by the Commonwealth and 13.3 million delivered, only 218,000 shots have been administered — leaving millions destined for the bin as their expiry date looms.
Executives have attributed the low uptake of their Covid-19 vaccines in Australia to what they say was a “poor policy decision” by the federal government and its panel of immunisation experts.
Novavax claims its protein-based vaccine is not being discussed, featured within Australia’s immunisation strategy or actively offered “through the various channels”.
The company’s chief medical officer Filip Dubovsky and its chief business officer John Trizzino have also been critical of ATAGI’s decision not to recommend their vaccine as a first choice for booster shots.
“I think there’s certainly a direct link from that decision to the use of the vaccine,” Mr Trizzino said.
“There’s very little that we can do as a company to overcome what we believe is a poor policy decision.”
The Australian Technical Advisory Group on Immunisation has recommended Novavax as a booster only for people who can’t or don’t want to have one of Pfizer or Moderna’s mRNA vaccines, which it says are “preferred”.
Novavax has made multiple appeals to ATAGI to reconsider its advice, with Mr Trizzino saying “they certainly have a right to have their opinion” but “the data and the science are in our favour”.
“I think it’s fair to characterise that we were disappointed in (ATAGI’s) first recommendation based upon the data that had been submitted to them,” Mr Trizzino.
“And now we’re eager to make a supplemental presentation in order to reverse the decision.”
Mr Trizzino said Novavax’s issue with ATAGI’s advice — which it is yet to change and may not still — was “water under the bridge”.
Asked if he wanted ATAGI’s decision making process to be made more transparent, Mr Trizzino said: “Different countries approach this in different ways”.
Pressed on what new data Novavax had to present to ATAGI, Dr Dubovsky said there was “growing body of evidence” from the US government, the UK government, academics in Asia and other partners that showed its vaccine was an effective booster for people who had already been inoculated with other vaccine types.
A spokesman for the Health Department confirmed on Friday it was scheduling another meeting between ATAGI and Novavax “to examine the latest available evidence and data”.
Dr Dubovsky and Mr Trizzino spent the week lobbying politicians in Canberra to give Novavax a bigger role in its long term immunisation strategy and met with Health Minister Mark Butler on Wednesday.
Mr Butler declined to comment, redirecting questions put to him to the Health Department.
The Morrison government once considered the acquisition of Novavax vaccines to be a top priority in what would become its drawn-out mission to inoculate Australians against Covid-19.
Novavax was thought to be a good pick for the “vaccine hesitant” who for whatever reasons shied away from Pfizer, Moderna and AstraZeneca shots and said they were “waiting for Novavax”.
But only 120,000 Novavax vaccines have been administered as primary doses, with 98,000 given as third or fourth booster shots.
So what happened?
Novavax’s Covid-19 shots became the first vaccine the company ever successfully brought to market in its then-34-year history.
By mid-2021, the Novavax vaccine was showing encouraging results in clinical trials but it had failed to supply the national medicines regulator with enough information to approve it for use, setting back its entry into Australia.
The Morrison government walked back its commitment to using Novavax as a primary vaccine as it focused on acquiring Pfizer shots, which were in short supply and high demand.
At the time Novavax was yet to be approved anywhere in the world. The company says its vaccine is now being used in more than 40 countries.
By the time the Therapeutic Goods Administration approved Novavax for use as a primary course of vaccination in adults on January 20, 93 per cent of people aged over 16 had already had two doses of a Covid vaccine.
The TGA’s John Skerritt said at the time that even if just two per cent of that seven per cent were interested in taking Novavax it would “continue our journey towards mastering Covid in this country.”
“I don’t know whether it is 50,000 or 100,000 or a million or whatever individuals (who will come forward for vaccination), I don’t think anybody knows but there are some individuals, and this just gives them further choice,” he said.
University of Sydney vaccine expert Julie Leask says people who are hesitant to get vaccinated could be further deterred by the fact it isn’t easy to access Novavax and one might “really need to shop around” to get it.
But Professor Leask backed ATAGI’s advice, saying its recommendations were carefully thought out and “based on evidence and pragmatism”.
“If ATAGI doesn’t have sufficient evidence that the heterologous (mixing different vaccine types) boosting using the Novavax vaccine is effective, they will hold back to some degree,” she said.
Professor Leask said some people had incorrectly interpreted ATAGI’s advice to think it meant they needed a doctor’s letter in order to have Novavax.
“If the advice is interpreted in these varying ways then that’s up to governments to ensure that the brokering between the advice and the implementation is done as clearly as possible,” she said.
Novavax’s Australian sponsor, Biocelect, estimates only about one in four providers are administering Novavax, partly because of concerns about wastage and confusion over ATAGI’s advice.
The Sydney-based small pharmaceuticals commercialisation firm supplies the vaccine to the Commonwealth which it then distributes it to state-run clinics, GPs and pharmacies.
“We feel it’s probably easier for ATAGI to issue new advice than for us to provide information to every provider,” said Biocelect’s co-founder Jennifer Herz.
“Novavax has indicated they have some new data. We would hope to have that reviewed as soon as possible.”
Australian Medical Association vice president Danielle McMullen said it wasn’t unexpected Novavax had been less involved in the country’s vaccine rollout, given it was much later to market that AstraZeneca and Pfizer.
“It’s a valuable option for people, particularly if people did have an adverse reaction to other vaccines, but it’s not at all surprising that it’s much smaller numbers being used,” Dr McMullen said.
University of Sydney virologist and vaccine expert Tony Cunningham said it was hard for him to comment on what ATAGI was saying.
“I think there are published studies that show the mRNA vaccines are better than Novavax at boosting, but I’ve seen data recently that suggests Novavax is pretty good, and I don’t think that data is yet published,” he said.
Doherty Institute immunologist Dale Godfrey said he thought Novavax was as good a contender for a booster as any of the other shots, but conceded there was less information available on how well it worked.
“There’s some data I’ve seen that suggests Novavax looks pretty impressive as a booster,” he said.
“I certainly don’t think people are avoiding it because it’s inferior. I think there’s a bit of vaccine fatigue.”
Paul Griffin, director of infectious diseases at the Mater Hospital in Brisbane, said he personally didn’t agree with ATAGI’s advice on Novavax particularly as booster uptake was “well behind where it should be”.
Dr Griffin acknowledged he was “very involved” with the development of the Novavax vaccine as the principal investigator for its early clinical trials in Australia.
He said he appreciated ATAGI had had a challenging time during the pandemic but thought it would be beneficial if there was greater transparency about the rationale for its decisions.
A Health Department spokesman said ATAGI’s recommendations were based on thorough consideration and review of all available local and international evidence.
“Their deliberations take into account data provided through the provisional approval process of the TGA together with all available local and international data,” he said.
“Novavax will continue to play an important role in protecting the Australian community against severe illness or death associated with Covid-19 infection.”
While the Commonwealth government says it invested more than $8bn in the Covid-19 vaccine rollout, the amount it has spent on each vaccine is enclosed in a confidential purchasing agreement with the manufacturers.
Health Minister Mark Butler on June 30 announced a “snap” inquiry into the Morrison government’s Covid-19 vaccine supply deals.
Former Health Department secretary Jane Halton was asked to lead the review, examining why Australia’s supply fell short at the height of the pandemic and how its purchasing processes compared internationally.
“There’s no hard deadline for this review to be completed, but it’s obviously something we want conducted in weeks, not many months,” Mr Butler said at the time.
It’s understood the Albanese government is awaiting the inquiry’s final report.