Informed Consent and Vaccine Passports – Department of Health Part 2

After failing to get some of the answers we were seeking on vaccines, I went back to the Department of Health and Dr Murphy to ask some more questions about informed consent and vaccination by coercion with a vaccine passport. I think you’ll find their answers in this part 2 just as interesting as part 1.

Part 1: https://www.malcolmrobertsqld.com.au/vaccine-passports-and-compensation/

Transcript

[Malcolm Roberts] And one that I touched on briefly, the intergenerational effects of the vaccine are unknown, the effect of the vaccine on transmission is unknown, GPs are not even allowed to say which vaccine they have available. Well Australians have a right to know the foundation of informed consent is accurate and full information. How is it possible to achieve real informed consent in this information vacuum?

So, I think the GPs are certainly able to say which vaccines they have available and they provide informed consent-

[Malcolm Roberts] Just to interrupt there, We had a presentation, I attended a presentation by you and Professor Kelly saying that the vaccine injection rooms would not be disclosing which vaccine was given at that time. Where people go to get their injection.

They’re not given a choice. They’re not given a choice

I think you’re talking two different things, Senator, so, clearly, at this stage of the rollout, the GPs are distributing AstraZeneca. The issue would’ve been the choice and perhaps there might’ve been some other issues that…

[Malcolm Roberts] It was certain, nonetheless, Minister, with so many effects unknown, how can there be an informed consent?

Well, Senator, I’m not going to try and give you health advice, and so I’ll prefer to-

Professor Kelly might be able to address that, but just to be very clear that people undergoing the informed consent process are very clear about which vaccine they’re getting, we’re not disguising the vaccine. So Professor Kelly can can go through the informed consent process.

Yeah, so, informed consent is a very important component of any medical medical procedure or treatment. And doctors do that with their patients every day, every time they see them pretty much is talking through the pros and cons of various, in this case, vaccines. As the Secretary has said, it’s pretty clear if you turn up to a GP at the moment with a couple of exceptions, but almost all GPs are only using one vaccine and it’s only for those over the age of 50 if it’s AstraZeneca. And there is some benefits of that in the particular circumstances of the person in front of them would be discussed in great detail. We’ve provided a lot of information, very detailed information based on the ATAGI advice in relation to that risk and benefit equation for GPs and other medical practitioners and nurses to use.

[Malcolm Roberts] Okay, thank you. My first question goes to the, question of mandatory vaccination. Is the government considering mandatory vaccination?

Government’s repeatedly said it is not considering mandatory vaccination for COVID vaccines or any other vaccines.

[Malcolm Roberts] So is the vaccine passport still under consideration?

The only situation that, as we referred to early today, where people might be on a public health, state and territory, for example, may say that they would refuse entry to a residential aged care facility, that’s the position that AHPPC is considering. That is not mandating vaccination, it’s basically saying that in certain situations it may be not possible to participate in a certain activity unless you’ve been vaccinated. But there has not been a position that we’ve taken so far, AHPPC is reconsidering it.

Can I just add Senator? So, obviously the issue of medical advice is the extent to which and whether and when you might want to limit access to aged care facilities, which the Secretary’s talking about, the broader issue of whether there’s a vaccine passport to identify you’ve had a vaccine and what impact that might have, internationally or otherwise, is a matter for the Department of Home Affairs. You should refer it to them.

But we are providing citizens with evidence of vaccination, they can get a vaccination certificate and they can use that in whatever way they choose.

[Malcolm Roberts] So that’s essentially a vaccine passport then isn’t it? Ms. Edwards?

It’d be a certificate. I mean, at the moment, it’s a long… The Australian Immunisation Register has been around for quite a long time, it got expanded a few years ago to cover all vaccinations and it will have the evidence of your vaccination of COVID-19 vaccine in it. And you have access to it in a printed form or electronically. That’ll evidence you’ve had the vaccine. There is no activity, at the moment, of that you’re either permitted or prevented from doing by virtue of vaccine status but as obviously medical information for you.

[Malcolm Roberts] So that vaccine register should be confidential, shouldn’t it?

It is.

It is, but any citizen can print their own certificate and they can use it as they choose fit.

And we use it for aggregated data. So a lot of the data we’re getting about how many people have been vaccinated not just for COVID-19 vaccine, but for the range of vaccines that we know is drawn out of the Australian Immunisation Register in a de-identified aggravated form.

[Malcolm Roberts] So a vaccine passport, though, could be established for restricting movement of people or entry of people to a specific venue?

Well, it’s a hypothetical question, not one within the remit of the health department. All that we’re talking about is having evidence that you’ve had the vaccine, which is really important, apart from anything else, so that people know what your risk is if you come into contact with COVID-19. And also, it’s used in vaccination clinics to check that it’s your second dose. So if you turn up for your second dose they’ll check the register to check that, yes, Senator Roberts has had one dose of AstraZeneca and here’s the time for the second one. So used for those safety reasons for an individual and it’s evidence of the medical treatment that you’ve had. But any further use of it, one’s not in contemplation that I’m aware of, we’re certainly not involved in that. And the questions about how it might be used internationally, or so on, is a matter for Home Affairs.

[Malcolm Roberts] So Home Affairs, where would they get their advice from? It would be from you, wouldn’t it?

They seek health advice from us,

[Malcolm Roberts] Yes.

and also advice about how the Immunisation Register works and so on, together with Services Australia, and they would be engaging with other agencies as well.

[Malcolm Roberts] So as I see it, threatening Australians with the loss of privileges of free movement, or a job, or even a livelihood without a vaccine passport, that’s really a digital prison.

I’m not aware of any proposal to do any of those things, Senator.

[Malcolm Roberts] You’re not aware of any? So is the government enforcing vaccination through coercion, if that would occur?

[Secretary] Well, Senator, that’s a hypothetical and it’s an opinion, Senator, and I don’t think it’s appropriate to ask the officials that question.

[Malcolm Roberts] So, going back to the vaccine, people expect the vaccine to do more than prevent deaths, more than not cause deaths, people expect the vaccine to bring back life as we know it, the removal of all restrictions and the resumption of international travel. Clearly, while acknowledging the many unknowns that you commendably and openly acknowledged this morning, what percentage of vaccination unlocks the gate and removes the restrictions, and when?

I think Professor Kelly can address the fact that that’s still an unknown parameter and our knowledge is evolving, but Professor Kelly has been asked this question on many occasions.

And I’ve since answered it. Thank you, Secretary, just on the-

[Secretary] They’re still asking it.

Yeah, I will get to your question just on the proof of vaccination. On my phone through my Medicare app, I have proof of my vaccination, it arrived within 24 hours of that vaccination happening, and it’s just shows that this is already happening. Anyone who’s had a vaccination will be able to access that, and if it’s needed to be shown it’s there.

[Malcolm Roberts] We’re not worried about that. My constituents are very worried about it becoming a condition of entry to a venue or to travel or something like that.

Well, as the associate Secretary has mentioned that it’s a matter for other parts of government to consider but we will provide medical advice about how that information can be verified in terms of a vaccine that we trust and know that works. So, to your question about where’s the target, this has come up on multiple occasions, I guess my answer is that these are non-binary states. So every single extra person that’s vaccinated in Australia is part of our path to the post-COVID future you’re describing. There’s no magical figure that says when we get to that, we’ve reached herd immunity and everything will be fine, rather it’s a process of getting towards that. We do need quite high coverage, though, to be able to get to the situation where, for most of the time, a seeding event, such as what we’re experiencing in Victoria, right now, will not lead to a large outbreak. So, that is, modelling that is being done at the moment by colleagues at the Doherty in Melbourne, and others. It’s part of the work that AHPPC has been asked to do to provide information into Mr Gaetgans’ committee, which is in turn providing information and advice to the national cabinet.

[Malcolm Roberts] Thank you. Where’s the government’s plan for managing the COVID virus because, the six components we discussed, the three of us discussed at the last Senate estimates, isolation lockdown, testing, tracing quarantining, restrictions, treatments, such as cures and prophylactics, and the fifth was vaccines. And then I think Professor Kelly added personal behaviours as number six. Perhaps we could add a seventh, and that is prevention through health and fitness because we’re seeing now that obesity and comorbidities are a big predictor of people dying from COVID. When will we see action in number four, which is treatments, cures and prophylactics, and health and fitness?

I can perhaps address treatments. The Scientific and Technical Advisory Committee, which is the committee that looks at the vaccines also as a watching brief on all treatments and has considered whether there are any treatments that we are recommending government to purchase. There’s also the TGA obviously also is reviewing treatments as they appear at this stage. And we also have an evidence taskforce that looks at the real-time evidence of treatments. At this stage there really is very limited options for treatment other than vaccines, but Professor Skerritt can perhaps give you more information.

Thank you Secretary. So, at the moment in Australia, the Clinical Evidence Taskforce endorses three TGA-approved treatments. The first is, and may depend on how sick you are, whether you need oxygen and so forth. So if you’re in hospital requiring oxygen, corticosteroids are recommended for use with COVID patients. And I would venture to say that, globally, they’ve probably been the most successful intervention. A drug called Remdesivir is approved for moderate to severely ill patients who don’t require oxygen or ventilation. And more recently, there’s a drug that was originally an arthritis drug, known as Tocilizumab, T-O-C-I-L-I-Z-U-M-A-B, I don’t get to name them.

[Malcolm Roberts] You barely get to pronounce them.

No, no, no, no. But it’s tricky, If they have unpronounceable names, everyone uses a trade name. That’s the trick. But Tocilizumab is for people who do require oxygen. Now, what we don’t have yet, and I think I may have said this at last estimates is a antiviral drug that’s up there as effective as the recent antiviral drugs for Hepatitis-C or for HIV. But trust me, there’s a major effort of companies working on that area. The other thing that has been coming through the system, and seem to be getting better, are these antibody-based treatments. And we’re currently looking at a drug, or an antibody, called Sotrovimab. It’s S-O-T-R-O-V-I-M-A-B and it has some very promising early results, and we’re currently assessing that. But we have always said that antivirals and other treatments will be important for a range of reasons. One of which is that even with the greatest adherence to, say, the three week gap for Pfizer vaccination, or the 12 week gap for AstraZeneca vaccination, neither treatment is 100% effective against catching or transmitting the virus. They seem to be very effective against death or hospitalisation, but we do know that treatments will play an important part in getting on top of this virus.

[Malcolm Roberts] Okay, just building on that, you didn’t address item number seven, which I suggested, health and fitness. But the focus on the vaccine is not addressing the end to end from prevention to resiliency to treatment. Don’t we need the full gamut? A comprehensive and complementary approach, what would that look like? And would it not include Ivermectin, assuming someone sponsors it and other treatments for those who want alternatives to vaccines? Because there are people who want alternative.

Well, very briefly on general health, the fact that people are going to many general practitioners and having the COVID vaccination is always an opportunity for the GP to have a quick discussion, “well, hey, smoking doesn’t actually help your respiratory chances with COVID.” There are some mixed messages out there and some mixed results. For example, a lot of people with asthma were very worried early in the COVID pandemic, but some of the asthma drugs, there’s a drug called Budesonide an orally inhaled steroid, inhaled steroid, which is actually quite effective in the early stages of COVID. People with asthma, for example, in general, especially if they’re on those drugs don’t seem to have been affected. But it is true that if you have co-morbidities such as diabetes and so forth, your risks of COVID infection are greater. And that’s why in Phase 1b a number of people who, for example, had drug resistant hypertension or had diabetes and so on were prioritised early for vaccination. Going back to other therapies, we’re always interested in evidence-based submissions for any other therapy. The challenge is that some of the early papers that suggested, for example, with hydroxychloroquine there was a lot of promise, when the blinded trials were done objectively the early promise very sadly didn’t hold up.

[Malcolm Roberts] Okay. Thank you, Chair. I’ll leave it there.