From colonial cavalry to mounted police: a short history of the Australian police horse

Originally published on

Aboriginal and Torres Strait Islander readers are advised this article contains names and/or images of deceased people.

Images of mounted police contending with anti-lockdown protesters on the weekend have now gone viral around the world. In fact, mounted police have a long history in Australia.

They have certainly been used as a method of crowd control at countless demonstrations in living memory — from anti-war protests to pro-refugee rallies and everything in between.

But the history of mounted police in Australia goes much deeper.

Read more:
Enforcing assimilation, dismantling Aboriginal families: a history of police violence in Australia

Mounted reconnaissance and messengers

In early colonial Australia, horses were at a premium. In the 1790s, policing of convicts and bushrangers in the confined region of the Sydney basin was conducted on foot by night watchmen, constables and the colonial military.

By 1801, the then Governor King formed a Body Guard of Light Horse for dispatching his messages to the interior and as a useful personal escort.

By 1816, at the height of the Sydney Wars of Aboriginal resistance, the numbers of horses in the colony had grown.

Their importance as mounted reconnaissance and for use by messengers was critical to Governor Macquarie’s infamous campaign, which ended in the Appin Massacre of April 17, 1816.

Along with firearms and disease, the horse was a key element in occupying Aboriginal land and controlling the largely convict workforce on the frontier.

The horse as a key element of occupation

Along with firearms and disease, the horse was a key element in occupying Aboriginal land and controlling the largely convict workforce on the frontier.

In the early 1820s, west of the Blue Mountains, the use of horses in the open terrain of the Bathurst Plains was critical in capturing escaped convicts and bushrangers, as well as defending remote outstations against attacks from Wiradjuri people.

Early intrusions into Wiradjuri land were not so much by British colonists, but by the animals they brought with them. In what is now recognised as “co-colonisation”, cattle and sheep did a lot of the hard yards for the British, often well before they arrived in Aboriginal lands.

In 1817, Surveyor General John Oxley thought he was well beyond the limits of settlement when, as he wrote:

to our great surprise we found the distinct marks of cattle tracks [that] must have strayed from Bathurst, from which place we were now distant in a direct line between eighty and ninety miles.

From a colonial cavalry to mounted police

During the first Wiradjuri War of Resistance between 1822 and 1824, calls were made to the colonial authorities for the formation of a civilian “colonial cavalry” to assist the beleaguered and overstretched military forces. My (Stephen Gapps) forthcoming book, developed in consultation with Wiradjuri community members in central west region of NSW, The Bathurst War, looks in deeper detail at this period.

It was hoped colonial farmers would be their own first line of defence against Aboriginal warrior raids on sheep and cattle stations.

Governor Brisbane wrote to London that in 1824 a mounted force was becoming “daily more essential [for the] vital interests of the of the Colony”.

But by August that year, heavily armed and mounted settlers, overseers and their armed convict workers had decimated Wiradjuri resistance before a formal cavalry militia was established.

After possibly hundreds of Wiradjuri people had been massacred by heavily armed and mounted settlers, a “Horse Patrol” was created in 1825, which soon formally became the Mounted Police.

The Mounted Police were critical during a spree of bushranging soon after — a largely unanticipated side-effect of arming of convict stockworkers to defend themselves against Wiradjuri attacks in 1824.

The Mounted Police were critical during a spree of bushranging.
Dixson Library, State Library of New South Wales

By the 1830s, the force had proved useful as a highly mobile quasi-military unit in combating Aboriginal resistance as well as bushranging.

As the colony continued to expand with an insatiable desire for running cattle and sheep on Aboriginal lands, three regional divisions were based at Bathurst, Goulburn and Maitland.

After conflict between colonists and Gamilaraay warriors on the Liverpool Plains, commander Major Nunn led a Mounted Police detachment on a two-month campaign around the Gwydir and Namoi Rivers, resulting in the Waterloo Creek Massacre on January 26, 1838. Armed colonists soon followed suit, ending in the Myall Creek Massacre in June that year, where colonists killed at least 28 Aboriginal people (possibly more).

The Mounted Police’s military functions came with heavy expenses, which included uniforms, equipment and barracks. During the 1840s, a Border Police force of ex-convicts equipped only with a horse, a gun and rations was created and attached to Commissioners of Crown Lands.

It was funded by a tax on squatters (whose interests they protected) and proved a much cheaper policing option for the frontier.

The Native Mounted Police

By 1850 the “Mounted Police” were disbanded. Another relatively cheap and what proved to be a tragic, if remarkably successful, option had been found — the creation of a “Native Mounted Police” force of Aboriginal men with British officers.

The troopers were provided with uniforms, guns and rations. By the 1860s, particularly in Queensland, the main problem on the frontier was not policing colonists but stopping Aboriginal resistance. So arming Aboriginal fighters was part of a tried and tested British method of exploiting existing hostilities by rewarding those who collaborated and punishing those who resisted.

As Bogaine Spearim, Gamilaraay and Kooma man, activist and creator of the podcast Frontier War Stories has noted, the Queensland Native Mounted Police (NMP) were not only feared by bushrangers such as Ned Kelly, but known for their violence toward the Aboriginal population of Queensland.

The NMP united incredible bush skills with military capability. Their legacy has been the focus of a recent project by Australian researchers Lynley Wallis, Heather Burke and colleagues.

The role of animals in colonisation and policing

From 1850, the colonial police force (and then from 1862, the NSW Police force) incorporated mounted police as mobile units in mostly remote locations.

But they also found them useful in urban areas, especially with growing numbers of strikes, political disturbances, protests and riots in the rapidly industrialising cities in the late 19th century.

The use of horses in crowd control has a long history in policing, which itself has a long history in warfare. Among the other issues this presents, we might also consider horses’ long suffering histories of being placed in the front lines of conflict.

Like the inexorable march of sheep and cattle as part of the invasion of Aboriginal lands, understanding the role of animals in colonisation and policing is crucial to a broader understanding of Australian history.

Read more:
Make no mistake: Cook’s voyages were part of a military mission to conquer and expand

Stephen Gapps is affiliated with the University of Newcastle and is a Senior Curator at the Australian National Maritime Museum. He is the author of The Sydney Wars (NewSouth Books) and of the forthcoming book, Gudyarra – The First Wiradjuri War of Resistance, the Bathurst War 1822-1824, which was developed in consultation with Wiradjuri community members in the central west region of NSW.

Angus Murray does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

The policing of Australian satire: why defamation is still no joke, despite recent law changes

Originally published on


Changes to Australian defamation laws that came into effect this month in several states could provide some respite for political satire as a mode of political communication.

In recent years, the defamation lawsuit risk for Australian comedians has been real.

The treatment of YouTube personality Jordan Shanks and his producer Kristo Langker is a case in point. FriendlyJordies, Shanks’ popular YouTube channel, had mockingly depicted NSW Deputy Premier John Barilaro as Mario, the fictional video game character who wins races by cheating. Shanks’ satirical stunts and commentary included content about alleged incompetence and corruption.

In response, Langker was arrested by no less than the Fixated Persons Investigations Unit of the NSW police, which is normally concerned with rooting out extremists and terrorists, and subjecting them to psychological assessment. Furthermore, Shanks is now being sued by Barilaro for defamation.

Read more:
NSW deputy premier threatens to sue FriendlyJordies, reminding us that parody hits in a way traditional media can’t

How will new defamation laws protect satirists?

The reformed defamation laws came into effect on July 1 in New South Wales, Queensland, Victoria and South Australia. They will become nationally uniform by the end of this year.

The reformed laws now include a public interest defence and a serious harm provision, both of which promise room for manoeuvre for political satirists.

The changes mean more protection for satire highlighting matters of interest to the public. The only exception is that representations can’t make accusations without factual basis. And the new serious harm provision means that satirical insult does not automatically equate to reputational damage.

Read more:
Why defamation suits in Australia are so ubiquitous — and difficult to defend for media organisations

How this will be tested in law remains to be seen, particularly as it relates to the implied right to freedom of political expression. These legal reforms may be welcome relief, reducing some risk to satirists.

But in terms of power relations, the defamation issue may still come down to who has the money to mount a defence. For grassroots and citizen satirists without the funds to access legal advice, this is still problematic.

Limits to the modern court jester

Whether or not one approves of Shanks’ potentially racist depiction of Barilaro, the actions against him and his producer do seem to be disproportionate and a far cry from the past.

For example, back in 2004, in a stunt that resonated with the satirical series The Chaser’s War on Everything, a man named Patrick Coleman distributed pamphlets in Townsville with the words “Get to know your local corrupt type coppers”. He was arrested and convicted under vagrancy laws for use of insulting language in a public place (among other charges).

Read more:
Friday essay: why is Australian satire so rarely risky?

However, the High Court overturned the charge of insulting police, saying the police should be expected to resist the sting of insults directed at them.

Indeed, tolerance for even more risqué political satire stretches a long way back, from the no-holds-barred comedy of The Big Gig and The Comedy Company, to the rogue and surreal inversion of Australian politics and culture in the series DAAS Kapital.

In the past, many politicians have even supported or engaged in satire themselves, such as former Victorian Premier Joan Kirner’s self-mocking performance on The Late Show in 1993.

Joan Kirner singing Joan Jett’s ‘I Love Rock n’ Roll’ on the Late Show.

There have also been notable instances of resistance, too. In the late 1990s, Pauline Hanson mounted legal challenges against the work of satirist Simon Hunt, aka Pauline Pantsdown. ABC’s The Glasshouse was also cancelled in 2006 — some say at the request of John Howard — arguably because the political commentary got too pointed for the prime minister’s office.

Attempts to criminalise impersonations before

In recent years, the concerns of increasingly sensitive politicians seem to have found greater weight in law.

In 2017, Attorney-General George Brandis fired a serious warning shot at those who may dare to satirise government officials.

The government’s proposed legislation would have replicated existing laws that already made proper impersonation illegal and was an extremely broad-brush approach to defining impersonation. In his submission to the parliamentary inquiry reviewing the changes to the law, Melbourne Law School professor Jeremy Gans warned about legislative overreach.

He pointed out the draft legislation could have led to the criminalisation of satirical conduct as political expression,

and to say otherwise is silly, confusing and (perhaps) ambiguous as to which party will bear the evidential burden on this issue.

While those reforms didn’t get up, they may be reflective of a broader desire on the part of government to sanitise public political comment.

Comedian Max Gillies impersonating former Prime Minister Bob Hawke.

Continued risks to satirists, despite the changes

Attempts such as this to regulate satire are concerning in multiple ways. First, they enhance the powers of already powerful governmental officials relative to more vulnerable actors.

Even with the new changes to defamation laws, many up-and-coming satirists without the legal backing and expertise of media or production companies will still face challenges to safely practice their craft.

And satirists will almost certainly continue to experience heightened pressure to self-censor due to the risk of lawsuits. This undermines a key medium for articulating legitimate political critique and protest.

Comedian, writer and broadcaster Wendy Harmer once observed that what we see on TV and in other media “tells you where your society is at”.

If media artists are too afraid to express what our communities feel through satire for fear of government or legal reprisal, then surely we come to know less about who we are.

The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

Samoa’s first female leader has made history — now she faces a challenging future at home and abroad

Originally published on

After nearly four months of being taken to the brink of dictatorship, Samoa’s constitutional crisis ended on July 26 when the prime minister for the past 23 years, Tuilaepa Sa’ilele Malielegaoi, conceded defeat.

With the April 9 election loss, the 40-year dominance of Samoan politics by Tuilaepa’s Human Rights Protection Party (HRPP) ended too.

Samoa’s new leader, Fiame Naomi Mata’afa, might be the country’s first female prime minister, but she is a veteran politician. As she attempts to bring her nation out of its greatest test in the 59 years since independence, she will need all the deep experience she brings to the role.

A political dynasty

Fiame was born in 1957 into one of Samoa’s leading chiefly and political families. Her parents were both trailblazers, too. Her father, Mataʻafa Faumuina Mulinuʻu II, served as Samoa’s first prime minister over two terms (1959-1970 and 1973-1975).

When he died in office in 1975, Fiame’s mother, La’ulu Fetauimalemau Mata’afa, represented his constituency of Lotofagu. She was just the second woman to be elected to Samoa’s parliament.

Read more:
Samoa’s stunning election result: on the verge of a new ruling party for the first time in 40 years

After serving in parliament, La’ulu was appointed Samoa’s consul general to New Zealand in 1989 and then served as Samoa’s high commissioner to New Zealand from 1993 to 1997.

Fiame also has strong ties to New Zealand. From age 11, she attended Marsden College in Wellington before studying political science at Victoria University, graduating in 1979.

A veteran and trailblazer

Fiame’s own political career began in 1985 when she won her parents’ former parliamentary seat of Lotofagu. Since then, Fiame’s career has ridden the wave of the HRPP’s popularity.

Under former prime minister Tofilau, she became the country’s first female cabinet minister, holding the education portfolio for 15 years. Fiame has also overseen the Ministry of Women, Community and Social Development, and the Ministry of Justice and Courts Administration, as well as other government appointments.

In 2016, she again broke new ground when she was appointed Tuilaepa’s deputy prime minister. She held this position until her resignation in September 2020 in protest at Tuilaepa’s controversial “three bills” (which gave the Lands and Titles Court additional powers over the bestowal of lands and titles within families and villages and undermined judicial independence and the rule of law).

Read more:
Samoan democracy hangs in the balance as a constitutional arm wrestle plays out — with the world watching

The bills and their rushed passage into law ignited widespread protests and the formation of the Fa’atuatua i le Atua Samoa ua Tasi (FAST Party), which Fiame joined as leader in March 2021. Ultimately they led to Tuilaepa’s political demise.

The bitter election campaign and its protracted aftermath, when Tuilaepa went to extraordinary lengths to retain power, has tested Fiame’s mettle as a national leader.

Throughout, she has embodied the same faith that justice would prevail that she asked of Samoa’s people as they witnessed the alarming twists and turns of Tuilaepa’s power play.

The challenge of power

Her impressive track record and admirably steady temperament will continue to be called upon as she faces multiple challenges as leader.

Firstly, Fiame will have to contend with something Tuilaepa never had to during his long term — a viable opposition, whose leader just happens to be Tuilaepa. True to form, he has already questioned the legitimacy of Fiame’s FAST government.

How much power Tuilaepa can wield in parliament is yet be to determined. Seven by-elections have been triggered so far due to petitions stemming from the general election. FAST currently holds 26 seats and the HRPP 17, with one independent.

Read more:
Has the door finally opened for Samoa’s first female prime minister, after weeks of constitutional crisis?

There will also be a by-election for the 52nd parliamentary seat created since the April 9 election — the seat designated for a woman candidate to meet a constitutionally mandated 10% quota of female parliamentarians. It was by creating this seat and “weaponisinggender politics that Tuilaepa hoped to keep Fiame out of power.

Fiame must also contend with Tuilaepa’s residual powers beyond parliament. His son, Leasiosio Oscar Malielegaoi, was appointed CEO of the Ministry of Finance in 2018, as well as various other positions, by his father.

The bureaucracy is staffed by other Tuilaepa loyalists. Reinvigorating national power structures will be a delicate operation for Fiame. But she is aided in her nation-building by the grassroots, village-level support for her government that has seen a succession of leaders calling on Tuilaepa to concede over the past weeks.

This support will be critical, not only for the pending by-elections but also to ward off the threat of COVID-19, now tragically playing out in neighbouring Fiji.

Samoa’s place in the world

While no deaths have been attributed to COVID-19 in Samoa, vaccinations are vital to keep it that way. Currently, only 18.6% of the population are fully vaccinated and vaccine hesitancy persists.

Ameliorating the devastating impact of the pandemic on Samoa’s tourist economy is another major challenge. And Fiame will also need to negotiate China’s considerable economic influence, encouraged by Tuilaepa but which Fiame has signalled she will not emulate.

Read more:
With five countries set to quit, is it curtains for the Pacific Islands Forum?

Regionally, Fiame has an opportunity to be a constructive presence at a time when the pandemic has exacerbated frayed relations between Pacific democracies and China, and within the Pacific Islands Forum, which has recently seen a third of its member nations quit.

None of which detracts from the historical significance of Fiame’s election. She joins an exclusive group of women political leaders and can encourage other women in the region aspiring to political office.

As US Vice President Kamala Harris said of her own election, “I may be the first woman to hold this office. But I won’t be the last.” For Fiame, perhaps, that is the ultimate challenge.

Patricia A. O’Brien received funding from the Australian Research Council and New Zealand’s JD Stout Trust.

Confused about which English subject to choose in year 11 and 12? Here’s what you need to know

Originally published on


This article is part of a series providing school students with evidence-based advice for choosing subjects in their senior years.

English (or an equivalent literacy requirement) is a compulsory subject for all secondary students in Australia. In years 11 and 12 there are several types of English subjects to choose from.

There are different versions of “English” in different states, with various titles and levels of difficulty.

There’s English, English studies, general English, foundation English, English standard, English advanced, English language, English and literature extension and literature. It is important to choose the right version of English to reach your desired destination.

Different types of English

The Australian Curriculum is the base for the development of state and territory senior secondary courses. It breaks English down into four broad categories: English, literature, EALD (English as an Additional Language or Dialect) and essential English.

Literature is known as the most challenging of the four and focuses on literary texts such as poetry, prose and drama. Literature explores the creative use of language through in-depth study of culturally important literary works.

In a literature course, you could be asked to explore representations of race in Joseph Conrad’s Heart of Darkness.
Drümmkopf/Flickr, CC BY

For example, students may explore colonial representations of race in Joseph Conrad’s novella Heart of Darkness, the beauty and unsettling nature of Shakespeare’s sonnets, or Australian cultural identity in Jack Davis’ play No Sugar.

Literature is more like philosophy or history than what we think of as English from NAPLAN (grammar and comprehension).

Literature used to be a popular subject in some states, but its popularity has been falling. Recent figures from Victoria show while literature was the 15th most commonly studied subject in 2015 in the senior years, it tumbled to 19th in 2019. In 2020, it fell off the top 20 list entirely.

In Western Australia, some schools have dropped literature because of low enrolments. A report in 2018 noted the percentage of year 12s studying literature fell from 26% in 1998 to 11% in 2017.

Theories about this fall include the fact literature is seen as an elitist subject, that you have to be someone who reads all the time to take it, and you have to love great 19th and 20th century literature.

These things aren’t true. Anyone interested but willing to challenge themselves should and can take literature. And some examples of recent texts include Breath (Tim Winton), The Handmaid’s Tale (Margaret Atwood) and The Book Thief (Marcus Zusak). There are many “fun” texts students can study and while literature is challenging it can also be enriching, and can cultivate a love of reading.

Read more:
5 Australian books that can help young people understand their place in the world

Also, my research showed some students found studying literary texts to be an empowering experience. One year 12 student said:

I’m the black sheep in my household. I identified with Rose (a character from Tim Winton’s Cloudstreet) quite a bit as the strong girl who was being resilient and was trying to break out of where she was. I do performing and everyone else does engineering or chemistry.

English develops analytical and creative skills through studying a range of literary and non-literary texts (including oral, multimedia and digital “texts” such as documentaries, graphic novels and feature articles).

If you’re not in love with reading or writing but want to study subjects such as commerce or engineering at university, this may be the course for you.

In English, you can study a range of texts, such as magazine feature articles.

Although it’s seen as easier than literature, not everyone finds it that way. One Victorian student who had taken both literature and English wrote actually found the latter harder. This is because she felt she had more freedom in literature while English “wasn’t really compatible with tangents”. She found it harder to be more concise in her expression.

English as an additional language is designed for students with English is their second language. This is an ATAR subject in some states such as Western Australia and Victoria.

Essential English develops students’ use of language, but it is not an ATAR subject. Essential English and general English are tailored to students who would like to graduate from high school but don’t want to go to university.

How do I decide which to take?

The first question you can ask is: “Do I want to go to university?”. If the answer is “yes”, you are likely to choose an English subject that will go towards your ATAR.

It’s worth noting you can still get into university without an ATAR, or without a very high one, but it does give your more options.

Read more:
Don’t stress, your ATAR isn’t the final call. There are many ways to get into university

ATAR subjects are traditionally seen as more difficult than non-ATAR ones, although for anyone who has ever studied non-ATAR subjects, this is debatable.

So, let’s take an example student, Mia. She is tossing up between medicine, mechanics or music teaching.

If Mia wants to become a mechanic, she does not need an ATAR to get a school-based apprenticeship. She may be better off studying general English, which focuses on the skills students need to become competent communicators in everyday life, or at work.

If Mia wants to become a mechanic, she doesn’t need to do an English subject that contributes to an ATAR.

But if Mia wants to be a music teacher or doctor, she is better off choosing an English subject that contributes to an ATAR. If she would like to be a teacher, she could choose something like English standard or English advanced and will need an ATAR score over 70 (but more than likely around 85).
If she would like to study medicine, she will need an ATAR closer to 99.

What about scaling?

Some English subjects are scaled higher, while others lower.

Scaling uses an algorithm to make subject scores more or less comparable to each other. This also makes sure if a student takes a difficult subject, they aren’t disadvantaged. It’s easier to get an A in an easier subject than a harder subject, so scaling generally adds more points to students doing harder subjects.

ATAR literature, a traditionally more difficult course, is usually scaled up. In Western Australia in 2020, for instance, English was scaled down about two points and literature was scaled up by nearly seven.

Read more:
Choosing your senior school subjects doesn’t have to be scary. Here are 6 things to keep in mind

But students shouldn’t just take a subject like literature because it’s scaled up. Because it’s harder, they may get a lower mark and the scaling won’t make much difference. You should do what interests you, and what you think will contribute best to your future while ensuring a good senior school experience.

What could I do with English?

English is compulsory because you need it for everything in life, from social communication to employment.

Studying literature, which isn’t compulsory, can be useful for occupations that require an advanced command of language such as journalism, research, law, public relations, philosophy and politics.

Read the other articles in our series on choosing senior subjects, here.

Kirsten Lambert does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Growing evidence suggests Russia’s Sputnik V COVID vaccine is safe and very effective. But questions about the data remain

Originally published on

Antonio Calanni/AP/AAP

Russia was the first country to register a COVID vaccine, with its health ministry giving emergency approval to the Sputnik V vaccine in August 2020.

This decision was met with scepticism from the international scientific community because it came a month before results of phase 1 and 2 trials were published.

Growing data from clinical trials and real world rollouts suggests the vaccine is safe and very effective. But there are several outstanding questions around the vaccine, such as whether it’s associated with the very rare blood clotting condition seen with AstraZeneca’s vaccine, and how well it performs against variants of the coronavirus.

So what kind of vaccine is Sputnik V, how does it work, and what data are we missing?

How does Sputnik V work?

Sputnik V was designed by The Gamaleya National Research Center for Epidemiology and Microbiology. It has its very own Twitter account advertising its status as the “world’s first registered COVID-19 vaccine” and approval in 69 countries including Russia, South Korea, Argentina and the UAE.

Like the Oxford-AstraZeneca vaccine, the basis for the vaccine is a harmless form of adenovirus, one of several viruses that can cause the common cold.

The adenovirus acts as a packaging system for DNA to deliver instructions to our cells. This DNA instructs cells to make the spike protein from SARS-CoV-2. The immune system is then trained to generate an immune response to the spike protein, which provides protection against the real SARS-CoV-2 virus.

Unlike the other adenovirus-based vaccines, Sputnik V uses two different adenoviruses for the first and second dose. This is done as people can develop an immune response against the adenovirus vector used in the first shot of the vaccine, which could possibly reduce the overall effectiveness.

The two doses are separated by three weeks, rather than the 8-12 weeks usually recommended for the Oxford-AstraZeneca vaccine.

Sputnik V doesn’t require the ultra-cold temperatures like the mRNA-based vaccines, which makes it an attractive candidate for many countries desperate for vaccines. Gamaleya has been open to sharing its manufacturing platform, unlike some other vaccines.

How well does Sputnik V work against COVID-19?

Data from the phase 1 and 2 clinical trial was published in September in the highly reputed medical journal The Lancet. The data showed no major adverse reactions, and side effects that were common to the other COVID-19 vaccines. These were primarily fever, headaches and pain at the injection site.

Most impressively were the results of the larger phase 3 trial published in The Lancet in February this year, which reported 91.6% efficacy against symptomatic infection. This places Sputnik on par with the mRNA vaccines by Pfizer and Moderna, for which the original efficacies were 95% and 94.1% respectively.

The results from the phase 3 trial also suggested a single dose was protective, with an efficacy of 79.4%. This led to the approval of “Sputnik Light” in some countries, a single dose regimen that overcomes some of the issues manufacturing the second dose of Sputnik V. The two different adenoviruses used in the first and second dose of Sputnik V need to be produced using separate cell cultures. Only having to produce a single type of adenovirus streamlines the production.

Outside of these trials, a press release from Gamaleya says real world analysis of the vaccine given to nearly 3.8 million Russians reported an efficacy of 97.6% against infection. This led Gamaleya to claim Sputnik V is “the world’s most effective vaccine”.

Despite the encouraging efficacy results, there are still some concerns. Both the phase 1 and 2 safety trials, and the phase 3 efficacy trials, have been criticised for not sharing their raw data or the full details of their study design, as well as inconsistencies in the published data.

Sputnik V isn’t yet approved by the European Medicines Agency (EMA) or the World Health Organization, meaning it cannot be used by COVAX, the COVID vaccine global access initiative. Gamaleya has yet to provide the EMA with all the necessary manufacturing and clinical data necessary to gain this approval.

What are the unanswered questions about Sputnik V?

There are a number of outstanding issues with the vaccine.

Of particular importance is the question of whether it’s associated with the very rare blood clotting condition that’s been linked to the AstraZeneca and Johnson and Johnson vaccines, which also use adenovirus vectors.

Gamaleya claims there have been no reports of this occurring in individuals given Sputnik V. Analysis following the administration of 2.8 million doses of Sputnik V in Argentina supports this. The results, announced via a press release by the Argentine health ministry, reported no deaths associated with vaccination and showed mostly mild adverse events.

And there was no indication of an association between Sputnik V and this condition in the clinical trials.

However, there hasn’t been enough published real world data to be completely confident researchers would be able to pick up on the condition if it did emerge.

It’s also unclear how well Sputnik performs against the rapidly spreading variants of concern, such as Delta. Some of these variants are partially able to escape from the immune response generated by COVID vaccines.

Read more:
Why is Delta such a worry? It’s more infectious, probably causes more severe disease, and challenges our vaccines

Research published in July examined antibodies in the blood of people vaccinated with Sputnik V to see how it performed against the Alpha, Beta, Gamma and Delta variants. It found there was a reduction in the ability of their antibodies to block infection. It’s unclear how this reduction would impact the vaccine’s effectiveness against hospitalisation and death, as we’re still waiting to see published real world data on this.

We need further studies which directly compare blood samples from people vaccinated with the different vaccines before Sputnik’s claims of being highly effective against variants can be confirmed. We’ll also need to see real world analysis of its effectiveness against variants, such as that performed with Pfizer and AstraZeneca.

Megan Steain receives funding from the Medical Research Future Fund (MRFF).

Jamie Triccas receives funding from Medical Research Future Fund (MRFF) and The National Health and Medical Research Council (NHMRC)

Whipping cream canisters have many uses beyond ‘nangs’. Banning them isn’t necessary

Originally published on


Australia’s Therapeutic Goods Administration (TGA) has been considering whether whipping cream canisters containing nitrous oxide should be placed in Schedule 10 of the Poisons Standard.

Schedule 10 is the most restrictive category within the Poisons Standard, reserved for “substances of such danger to health as to warrant prohibition of sale, supply and use”.

The canisters contain nitrous oxide, which, when mixed with cream in a whipping cream dispenser, creates high-quality whipped cream. This method is used by bakers and chefs worldwide.

There’s no evidence whipping cream canisters pose any risk to people who use them for their intended purpose.

So why has an application been made to the TGA to prohibit whipping cream canisters?

While the applicant hasn’t been named, the proposal is based on increasing concern about people using the canisters to get high.

Read more:
Explainer: what is nitrous oxide (or nangs) and how dangerous is it?

Is nitrous oxide harmful?

Nitrous oxide has been used in medicine and dentistry as an analgesic (a drug which relieves pain) and anaesthetic since it was first found to assist with the extraction of a tooth in 1844.

Commonly referred to as “laughing gas”, nitrous oxide continues to be used in clinical environments in Australia as a Schedule 4 Medicine.

However, no drug is risk-free. There are some harms associated with the recreational use of nitrous oxide (sometimes called “nangs”).

For example, there’s evidence regular heavy use of nitrous oxide can lead to a deficiency in vitamin B12 resulting in peripheral neuropathy. Peripheral neuropathy can be caused by a range of toxins and nutritional deficiencies. Symptoms include unexplained pain, burning and numbness.

In unpublished data submitted to the TGA, 6% of almost 1,900 young Australians who reported nitrous oxide use (surveyed in 2018-2019) reported persistent numbness or tingling, consistent with peripheral neuropathy.

A large global study of people who reported nitrous oxide use found persistent numbness/tingling in the hands or feet was rare (3%) and heavily dependent on dose.

There have also been reports of misadventure resulting in death following its use.

Nitrous oxide is often used in medical settings.

Some numbers

The 2019 National Drug Strategy Household Survey found roughly 1.7% of Australians had used inhalants in the previous 12 months. But this survey doesn’t specify which inhalants are used, so this number is likely to include many different inhalants, not just nitrous oxide.

The National Drug and Alcohol Research Centre has interviewed people who regularly use MDMA and psychostimulants annually for nearly 20 years to understand more about the drug use habits of this group.

Around one-quarter reported nitrous oxide use from 2003 to 2015. But this proportion doubled to 50% by 2018, and has remained at a similar level in 2020 (54%).

It’s important to note people who use nitrous oxide do so infrequently (on average less than once per month).

As use of nitrous oxide has increased among certain groups, we’ve also seen indications of increased rates of harm. For example, in New South Wales, emergency department presentations associated with nitrous nitrous oxide increased from ten cases per year in 2016 to 60 cases in 2018.

Read more:
Weekly Dose: from laughing parties to whipped cream, nitrous oxide’s on the rise as a recreational drug

A proportional response?

If the TGA was to make whipping cream canisters Schedule 10 under the Poisons Standard, these products would become prohibited in Australia.

Australian bakers and chefs could be forced to use carbon dioxide canisters, which are sold for Soda Stream machines. But use of carbon dioxide canisters has been reported to result in whipped cream that tastes acidic. It also creates large bubbles in the cream due to the different properties of the two chemicals.

We believe it’s unlikely the TGA will classify whipping cream canisters as being of such danger to health that their sale, supply and use becomes prohibited.

However, the TGA could make whipping cream canisters a Schedule 7 Dangerous Poison. This would mean culinary aficionados could be required to obtain a license to access whipping cream canisters from a limited number of suppliers licensed to sell them. We believe this would also be a disproportionate response.

There’s some evidence that when a drug becomes harder to access, people will substitute that drug with a more harmful drug. Making whipping cream canisters Schedule 7 or Schedule 10 could lead young people to use volatile substances more harmful than nitrous oxide instead (for example, spray paint, deodorant or petrol) since these are likely to be more accessible.

Nitrous oxide is used to make whipped cream.

We’ve made submissions to the TGA arguing classifying whipping cream canisters as Schedule 10 in the Poisons Standard would be a disproportionate response to the harms associated with their use as a recreational drug.

Given they’re widely used by Australian bakers and chefs, we suggested the most pragmatic solution would be for the TGA to place the products in Schedule 5 or 6 of the Poisons Standard.

If the TGA was to list these products in Schedule 5, they would be required to contain warnings on the labelling. If they were placed in Schedule 6, similar restrictions to spray paint would apply, where retailers are required to limit access to the products to minors.

Next steps

The TGA is set to announce its interim decision on this proposal any day now.

The evidence indicates a minority of people, predominantly those who use nitrous oxide at very high doses, are at risk of developing serious neurological problems.

We should be raising community awareness of this risk as we carefully consider the consequences of tighter restrictions on the availability of a product which is generally safe, if used as directed.

Stephen Bright is a Director of the not-for-profit company Psychedelic Science In Medicine & Research (PRISM) and a Director of the not-for-profit organisation Students for Sensible Drug Policy.

Monica Barratt receives (or has recently received) funding from Australian (National Health and Medical Research Council, the Australian Institute of Criminology, the National Centre for Clinical Research into Emerging Drugs) and international (US National Institutes of Health, NZ Marsden Fund) sources. She has conducted commissioned research for the NSW Coroner’s Office, the WA Mental Health Commission and the Victorian Department of Health. In addition to her role at RMIT, Monica is a visiting fellow at the National Drug and Alcohol Research Centre, UNSW Sydney. She is an editor for two peer-reviewed journals, the International Journal of Drug Policy and Drug and Alcohol Review. She also has leadership roles at two not-for-profit harm-reduction organisations: The Loop Australia and

Why governments will have to consider the costs of long COVID when easing pandemic restrictions

Originally published on

With governments worldwide under pressure to ease pandemic restrictions as vaccination rates rise and impatience with border restrictions grows, new threats become clearer.

One of the costliest, it is now feared, could be a tsunami of “long COVID” cases.

Long COVID is a serious ongoing illness that follows an acute episode of the disease. It is characterised by extreme fatigue, muscle weakness, post-exertional malaise and an inability to concentrate (“brain fog”), among many other symptoms.

The focus, therefore, needs to shift towards protecting quality of life as much as saving lives in the first place.

In the UK it is reported two million people have experienced long COVID. Around 385,000 having suffered symptoms for a year or more.

The nation’s so-called “Freedom Day” on July 19 went ahead despite expert warnings of soaring infections, especially among younger and unvaccinated people. A further 500,000 long COVID cases have been predicted during the current wave of infection.

These numbers far outstrip the already staggering 150,000 deaths attributed to the virus in the UK — and the associated costs will be significant.

Putting a price on long COVID

The social costs of long COVID should not be underestimated. For example, suppose an elderly person contracts COVID-19 and dies, when they might otherwise have lived in full health another five years. A health economist would say their early death has cost society five “quality-adjusted life years” (QALYs).

This is usually expressed as a monetary amount that can then be weighed against the cost of saving that person’s life when deciding on appropriate pandemic protections.

Contrast this with a young person contracting COVID-19 and not dying, but suffering long COVID for 10 years, with their estimated quality of life effectively halved while unwell.

Read more:
Long COVID: with one in three patients back in hospital after three months, where are the treatments?

They too will have lost an estimated five QALYs — the same social cost as the elderly person who died.

This means if we ease pandemic restrictions on the basis that people are no longer dying, we might be facing equally serious social costs from long COVID.

If long COVID is chronic and much more common than death from COVID (as the current data strongly suggest), the costs rise further. If sufferers of long COVID also face shortened lives, having endured years of debilitation and misery, the costs rise again.

Rough first estimates suggest the overall economic cost of long COVID could be almost half the cost of COVID-related deaths in the UK.

For younger people, however, the social costs of long COVID are estimated to far outstrip those of dying, meaning they will carry a disproportionate burden of the pandemic’s long-term costs.

Comparison with chronic fatigue syndrome

Long COVID is often likened to chronic fatigue syndrome (CFS), which is sometimes called ME (for myalgic encephalomyelitis). Both are characterised as a form of “post-viral fatigue syndrome”, with CFS leaving sufferers seriously debilitated and unable to maintain normal lives — often for years, even decades.

While we have no long-term data to gauge how chronic or serious long COVID might be, we should be mindful that it could be as long-lived as CFS.

Furthermore, long COVID is also reported to affect multiple organs in measurable ways, including damage to major organs like the heart and lungs.

Consequently, long COVID could shorten lives, if not end them. This distinguishes it from CFS which – frustratingly, for sufferers wanting to be taken seriously – lacks recognised objective markers.

Read more:
The mystery of ‘long COVID’: up to 1 in 3 people who catch the virus suffer for months. Here’s what we know so far

Protecting quality of life

On a personal note, I suffered CFS for 11 years and recovered in 2004. It emerged after a flu-like illness in 1993, which evolved into a constellation of symptoms that defied explanation or treatment.

Recovery required years off work and, with the care and support of family and friends, patient and determined rebuilding of my ability to lead a normal life.

The condition involved huge personal, social and professional costs. I was unable to maintain a normal life, relationships and work commitments. Constant ill health, with no end in sight, was enormously frustrating and miserable.

Read more:
I went from regular TV commentator on COVID to long COVID sufferer in just a few months

It never helped that medical practitioners were either incredulous or believed I was unwell but had no real solutions to offer.

Like CFS, long COVID is a serious condition that cannot be taken lightly. Even if not fatal, it can still seriously affect the sufferer’s quality of life. Hence, policymakers need to consider the social costs of long COVID when deciding when and how to ease pandemic restrictions.

Our pandemic response will need to be as much about protecting quality of life as it has been about saving lives. We need to take serious steps to keep long COVID at bay.

Richard Meade does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Ancient brains: a look inside the extraordinary preservation of a 310-million-year-old nervous system

Originally published on

Javier Ortega-Hernández, Author provided

Charles Darwin famously discussed the “imperfections” of the geological record in his book On The Origin of Species. He correctly pointed out that unless conditions are just right, it’s unlikely for organisms to be preserved as fossils, even those with bones and shells.

He also said “no organism wholly soft can be preserved”.

Read more:
Guide to the classics: Darwin’s On the Origin of Species

However, after more than a century of fossil hunting since his book was published, we now know the preservation of soft creatures is indeed possible — including some of the most fragile animals, such as jellyfish.

But what about the really delicate anatomy of animals, such as their internal organs? Can they be fossilised too?

Our study, published today in Geology, shows how even the intricate brains of ancient aquatic arthropods (invertebrates with jointed legs) can be preserved in remarkable detail.

The discovery of a 310 million-year-old horseshoe crab in the US, complete with its brain intact, adds to a recent string of fossil finds which have unearthed some of the oldest arthropods with a preserved central nervous system.

The horseshoe crab fossil we document in our study sheds new light on how these fragile organs — typically prone to very rapid decay — can be preserved with such fidelity.

(A) Specimen of the fossil horseshoe crab Euproops danae from Mazon Creek, Illinois, USA, preserved with its brain intact. (B) Close-up of brain, as indicated by box in image (A). (C) Reconstruction of Euproops danae, including the position and anatomy of the brain.
Russell Bicknell

Brain freeze: how to fossilise an arthropod brain

Most of our knowledge of prehistoric arthropod brains has been sourced from two key types of fossil deposit: amber and those of Burgess Shale-type.

Amber is fossilised resin that oozes through tree bark and is known to trap a variety of organisms. The entombed individuals are commonly represented by arthropods such as insects — made famous in the original Jurassic Park movie.

These fossils preserve an incredible amount of anatomical detail, as well as behaviours, mainly because very little decay takes place after the organism is rapidly trapped in the resin.

A centipede and a neighbouring ant suspended in roughly 23 million-year-old Mexican amber.
Greg Edgecombe

Using sophisticated imaging technology on these amber fossils, palaeontologists can study tiny arthropod brains in 3D at minuscule scales. However, the oldest arthropods in amber only extend back to the Triassic Period (around 230 million years ago).

Burgess Shale-type deposits are much older, being Cambrian in age (typically 500 to 520 million years old). They contain an abundance of exceptionally preserved marine arthropods.

These fossils are very important as they represent what are unmistakably some of the oldest animals, and can therefore inform us on their origins and earliest evolutionary history. Their remains are primarily preserved as carbon films in mudstone.

The Cambrian arthropod Chengjiangocaris kunmingensis from China. See the bead-like ventral nerve cord preserved in the fossil (A) and its central position in the reconstruction (B).
Javier Ortega-Hernández

The fossilisation process starts with storm-induced mudflows that sweep up the delicate animals and bury them in the seafloor in low oxygen conditions. Over time, the mud turns to stone and is compressed, leaving the animals pancaked in the rocks.

Many Burgess Shale-type arthropod specimens preserve internal organs, especially the gut. But fewer show parts of the central nervous system, such as the optic nerves, ventral nerve cord or the brain.

Mind-boggling preservation

Our new fossil demonstrates arthropod brains can be preserved in an entirely different way. The specimen of the horseshoe crab, Euproops danae, comes from the world-famous Mazon Creek deposit of Illinois, in the US. Fossils from this deposit are preserved within concretions made of an iron carbonate mineral called siderite.

Some of the Mazon Creek animals, such as the bizarre “Tully Monster”, are entirely soft-bodied. This suggests special conditions must have been in place to preserve them.

We have shown, for the first time, that the Mazon Creek animals were not only moulded by the rapid formation of siderite that entombed their entire bodies, but also that the siderite quickly encased their internal soft tissues before they could decompose.

Notably, the brain of Euproops is replicated by a white-coloured clay mineral called kaolinite. This mineral cast would have formed later within the void left by the brain, long after it had decayed. Without this conspicuous white mineral, we may have never spotted the brain.

A fossil no-brainer

One of the challenges of interpreting ancient arthropod anatomy is the lack of close modern relatives available for comparison. But luckily for us, Euproops can be compared to the four species of living horseshoe crabs.

Even to the untrained eye, a comparison of the fossil’s nervous system with that of a modern horseshoe crab (below) leaves little question that the same structures are found in both species, despite them being separated by 310 million years.

(A) The fossil and (B and C) interpretive drawings of the Euproops danae brain, and (D) the brain of a modern juvenile horseshoe crab, Limulus polyphemus.
(A-C) Russell Bicknell, (D) Steffen Harzsch

The fossil and living nervous systems match up in their arrangements of nerves to the eyes and appendages, and show the same central opening for the oesophagus to pass through.

Uncovering these exceptional specimens gives palaeontologists a rare glimpse into the deep past, enhancing our understanding of the biology and evolution of long-extinct animals. It seems Charles Darwin need not have been so pessimistic about the fossil record after all.

Read more:
Our 500 million-year-old nervous system fossil shines a light on animal evolution

John Paterson receives funding from the Australian Research Council.

Greg Edgecombe receives funding from the Australian Research Council.

Javier Ortega-Hernández receives funding from the National Science Foundation (NSF), and Harvard University.

Robert Gaines receives funding from the US National Science Foundation, the Gordon and Betty Moore Foundation, and Pomona College.

Russell Dean Christopher Bicknell receives funding from the Australian Research Council and the University of New England.

When will we reach herd immunity? Here are 3 reasons that’s a hard question to answer

Originally published on

As we try to control COVID-19, many people are keen to know what proportion of the population will need to be vaccinated in order to reach “herd immunity”.

It’s a reasonable question. People are asking because they want to know when we’ll see an end to lockdowns; when they’ll be able to reunite with loved ones overseas; when their businesses will have more security; when headlines will no longer be dominated by COVID-19.

Right now expert modellers are plugging in numbers and looking at various scenarios to estimate the scope of protection different levels of vaccination coverage will give us. We’re expecting to see the results of this modelling from the Doherty Institute as early as this week.

But it’s important to acknowledge it’s difficult to pin down a single magic number for herd immunity.

What is herd immunity again?

To understand why experts often avoid pinpointing a single vaccination figure needed to reach herd immunity for COVID-19, let’s first recap the concept.

Herd immunity is when immunity in a population is high enough to block the pathway for the ongoing transmission of the disease.

While vaccination provides each of us with direct protection against disease, with herd immunity, even people who are unvaccinated benefit from that blocked transmission pathway.

Different diseases have different thresholds for herd immunity. For measles, for example, the herd immunity threshold is 92%-94%. Estimates for COVID-19 have varied, with some putting it at 85% or higher.

However, many hesitate to give a single number. Here are three reasons why.

Read more:
What is herd immunity and how many people need to be vaccinated to protect a community?

1. Variations in the vaccines, and the disease itself

A single herd immunity figure is difficult to estimate when the infectiousness of SARS-CoV-2 (the virus that causes COVID-19) remains so variable.

We understand the infectiousness of a disease by looking at the R0, or reproduction number — the average number of people infected by one case where no control measures are in place. The ancestral strains of SARS-CoV-2 have an R0 of 2-3, but Delta is estimated to be twice as infectious, with an R0 around 4-6.

The type of vaccine, doses given (whether one or both), and how well the vaccines cover the different variants all factor in.

Estimates from the United Kingdom show two doses of the Pfizer vaccine are between 85% and 95% effective against symptomatic disease with the Alpha variant, while two doses of AstraZeneca are 70% to 85% effective. Overall vaccine effectiveness appears to drop about ten percentage points with the Delta variant.

The lower the vaccine effectiveness, the higher the level of coverage we’ll need to control COVID well.

2. We cannot cover the entire population yet

The Pfizer vaccine has now been provisionally approved for 12-15-year-olds in Australia. If it becomes routinely recommended for this age group, it will still take time to vaccinate them. Even once that occurs, there will remain a gap in our population protection among younger children.

Children should benefit somewhat from adult vaccination. In England, where overall vaccine uptake is 48.5% for two doses, there was initially a decline in infections for children aged under ten years. This is partly due to indirect protection offered by adults being vaccinated.

Read more:
How well do COVID vaccines work in the real world?

3. Population protection will vary in time and space

There is rarely a neat threshold after which everything changes for good. Vaccine protection in individuals is likely to wane over time. With that and new variants appearing, we will almost certainly need boosters to sustain population protection against COVID-19.

With influenza vaccination, we rarely even talk about herd immunity, because the duration of protection is so short. By the next flu season, immunity from the current season’s vaccine will be much less effective against the newest viral strain.

Spatially, protection can vary across localities and demographics. Even in a country that has reached a herd immunity threshold for vaccination coverage against measles, you can see small outbreaks in pockets of lower coverage in kids, or where a cohort of teens and adults weren’t adequately vaccinated as children.

The capacity to achieve herd immunity is also affected by population density and how much people in a population mix with a variety of others — what’s called heterogeneity of mixing.

We don’t yet have a COVID vaccine approved for children under 12.

Life will gradually change as more people are vaccinated

Given these factors, it’s understandable experts often avoid giving a single figure for herd immunity.

With the infectiousness of Delta, we will need very high vaccination rates. Then, life will look different, particularly once this happens globally. Australia will be able to relax its border restrictions. We will likely see modified forms of quarantine, such as home quarantine, for those who are fully vaccinated.

COVID outbreaks will happen, but they will be less risky, with fewer people susceptible to serious illness. City or state-wide outbreaks will be replaced by more localised ones.

We will still require good public health measures like rapid contact tracing and isolation. Rapid tests may be used more often. New treatments may be found.

Read more:
The best hope for fairly distributing COVID-19 vaccines globally is at risk of failing. Here’s how to save it

All the while, we need to be as concerned about global vaccine coverage as we are about national coverage. Because all people, regardless of means, have a right to the freedoms and security that come from COVID-19 protection.

And as we’ve heard from global leaders, “None of us will be safe until everyone is safe”.

Julie Leask receives funding from the World Health Organization and UNICEF.

James Wood receives funding from the NHMRC and the Commonwealth Department of Health. He is also a member of ATAGI and an unpaid member of the Moderna COVID-19 Variants Advisory Board.

Yes, there’s confusion about ATAGI’s AstraZeneca advice. But it’s in an extremely difficult position

Originally published on

Daniel Pockett/AAP

One can totally understand the frustration around where the AstraZeneca vaccine fits in our vaccine rollout in Australia.

At a time when we’re grappling with so much uncertainty, we need unambiguous information from the federal government about who should have this vaccine.

Instead, it feels very much like we’re swirling in a murky sea of information that is confusing and, at times, seems to be contradictory.

Read more:
Morrison government orders Pfizer ‘boosters’, while hoping new ATAGI advice will warm people to AstraZeneca

The confusion is compounded by the changing advice from ATAGI. ATAGI, the Australian Technical Advisory Group on Immunisation, is the group of vaccine experts which advises the government.

There is no doubt that for many people, some of its language has been difficult to make sense of, including the use of vague terms like “preferred”. As in, the Pfizer vaccine is the “preferred vaccine” for those under 60 years of age.

How exactly this should be interpreted by someone trying to make the important decision about whether to get the vaccine is unclear, and raises more questions than it answers.

The public commentary from a number of political leaders, including the prime minister, that ATAGI has been too conservative and too risk averse hasn’t helped either, with the implication ATAGI cannot be fully trusted to provide sensible advice.

The reality is, ATAGI is in an extremely difficult position and is grappling with competing concerns, considerable uncertainty, and a constantly changing landscape.

What is ATAGI’s role?

ATAGI can only give general advice to the government for the whole population.

Its task is to think about the whole population as if it were merged into a single person, or in the case of AstraZeneca, a series of people of different age ranges. It then has to formulate advice based on population-based averages of the benefits and risks of getting the AstraZeneca vaccine, which has a number of limitations.

It’s important to understand context plays a key role in formulating this advice to the government. The risk of the blood clotting and bleeding condition, called thrombosis with thrombocytopenia, from the AstraZeneca vaccine is slightly higher for younger people.

This is only part of what’s driven the advice for Pfizer to be the preferred vaccine for those under 60.

In fact, the risk of dying from this condition is incredibly rare whatever your age.

Read more:
Concerned about the latest AstraZeneca news? These 3 graphics help you make sense of the risk

What has been the bigger driver of the advice is the fact you’re less likely to develop severe disease from COVID if you’re younger, which means the corresponding benefits of vaccination are much lower if you take a narrow view of the benefits of the vaccine being solely the prevention of severe disease.

How did ATAGI draw its conclusions on AstraZeneca?

ATAGI initially said Pfizer was the preferred vaccine for under-50s in April, and then changed this to under-60s in June.

There are several assumptions in ATAGI’s advice which need to be understood.

Firstly, it calculated the risks and benefits of AstraZeneca across three scenarios — low, medium and high exposure risk. ATAGI has presented its advice assuming a low amount COVID circulating in the community, which has been the case until Sydney’s latest outbreak.

A low amount of COVID in the community means there’s a low chance of severe COVID, which is even smaller for younger people. This means there’s less of a benefit of being vaccinated for younger people, which is what has driven the advice for the Pfizer vaccine to be preferred for younger people.

However, the problem with this low prevalence assumption is we’re vaccinating to protect us not just right now, but also against the future risk of COVID, and future lockdowns, like the situation we’re seeing in Sydney now.

Once you’re in this situation, even if ATAGI changes its recommendations in response to more COVID circulating, which it did on Saturday, in some sense the horse has already bolted.

Another assumption implicit in ATAGI’s advice that it prefers under-60s get Pfizer, is that Pfizer is available and you have the option to get it now.

However, given the limited supply of Pfizer vaccine, the decision to hold off on the AstraZeneca vaccine is not one to get Pfizer, it is one to hold off on getting vaccinated at all. This leaves you exposed and vulnerable to COVID. This is an important distinction to make, which of course will change as we get more Pfizer vaccine.

Another major limitation in the ATAGI advice is the panel, in dealing with population-level data, takes a very narrow view of the benefits of vaccination: the prevention of severe disease.

It doesn’t take into account other benefits that may be relevant to many people. It doesn’t take into account the prevention of long COVID; the benefits of being vaccinated allowing travel and other freedoms; and, most glaringly, the importance many people place on getting vaccinated to protect their loved ones and the community.

These may weigh heavily on individuals but aren’t taken into account when you look at the risk-benefit calculation from a narrow perspective.

So what’s the bottom line on AstraZeneca?

We must remember the AstraZeneca vaccine is a fantastic vaccine.

It’s safe and effective, and two doses offer almost complete protection against severe disease and death from COVID, including the Delta variant.

It does carry a small risk of the blood clotting and bleeding condition, but this risk is incredibly small. COVID is much more of a threat to your health than the vaccine, as we are seeing in NSW right now.

If you’re under 60 years of age, the decision to have the AstraZeneca vaccine is one only you can make. But if you do make it, you should understand the benefits go beyond just preventing severe disease.

Hassan Vally does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.