Australia’s Covid vaccine review recommends expansion of Novavax eligibility amid fears of Moderna shortfall

Australia's vaccination advisory body is investigating whether to expand the availability of the Novavax Covid jab, amid concerns tens of millions of doses could be wasted due to recommendations it not be used as a general booster shot.

It comes as a review of Australia's Covid vaccine procurement found the former Coalition government's actions were "consistent with other high-income countries", but warned of a potential shortfall in Moderna unless the Labor government orders more supply.

The review, by respected public servant Prof Jane Halton, said Australia had not reached what she called "Covid-stable", where regular ebbs and flows of the virus could be predicted. Halton said Australia was "likely to continue to be challenged" by emerging virus variants and recommended advertising campaigns encouraging vaccination should continue until 2024.

In June, Halton was commissioned by the federal health minister, Mark Butler, to investigate Australia's Covid vaccine strategy. At the time, Butler said the review would not examine potential mistakes made by the former government, which had come under fire for vaccines arriving late and initial shortfalls in supply. Australia has since gone on to have one of the highest vaccine rates in the world.

Halton said she only investigated prior vaccine purchases to examine lessons that could be learned. The review does not make any critical findings about the Coalition.

Asked at a press conference about Labor's criticisms of the former government, Butler reiterated his position that the Coalition should have been faster in securing vaccine deals.

"When the issues associated with AstraZeneca became a problem in terms of the speed of the vaccine rollout, we were left without Moderna and a very slow delivery schedule of the Pfizer vaccine," he said on Tuesday.

"Our criticism was very much about timing. Our criticism was that frankly, the former government had not acted quickly enough to secure deals with Pfizer."

Halton found that despite Australia's earlier success in keeping deaths and cases low, "relative performance is beginning to wane".

"The need to mitigate the effects of Covid-19 is likely to remain," she said in the report.

"It is not possible to accurately predict the further evolution of the virus and Australia is likely to continue to be challenged, at least in the short term, by emerging variants and new waves of disease."

The shadow health minister, Anne Ruston, noting those comments, said she was "disappointed" the Albanese government had wound down the Operation Covid Shield vaccine taskforce.

"The government must show Australians how it plans to address the criticism that their relative performance in protecting Australians from Covid-19 is waning," she said.

Halton said coming months would give more certainty about the future of Covid.

"While we are hopeful and while we can see the end of the pandemic, we can't yet tell exactly what the next few months or indeed the next six months will take," she said. "What we are hopeful is that the northern winter, which is coming, will actually enable us to monitor what happens with the virus."

Regarding specific vaccines, Halton's report said Australia would probably have an oversupply of Novavax, a protein-based vaccine of which the former government contracted 51m doses. Recent health department data showed only around 13m had arrived and 200,000 shots had been given.

Novavax supplies first arrived in Australia after the majority of the population already received a primary two-dose course, and the vaccine is not recommended as a preferred booster by the Australian Technical Advisory Group on Immunisation (Atagi). Halton suggested "more permissive eligibility settings" could increase uptake and reduce pressure on mRNA supplies from Pfizer and Moderna.

Halton recommended the government contract more Moderna doses for next year, ahead of an "anticipated shortfall in the number of mRNA vaccines required".

Butler said the health department was investigating issues around Novavax, including discussions with the company about shifting delivery schedules to minimise wastage. He said the company's global leadership had asked Atagi to reconsider its recommendations around Novavax's booster shot potential.

"I am encouraging [Novavax] to provide that clinical data to us and for Atagi to come together and to be able to consider that data and see whether or not that warrants a change to the recommendation," Butler said.

Halton said she herself would seek a Novavax shot as a booster when she was able to get another vaccination, calling it a good vaccine.

But she said it may be "unlikely" Australia would be able to donate excess Novavax doses to foreign countries instead of letting the doses expire.

"There is not a huge opportunity to donate many vaccines into the global context at the moment," she said. "COVAX has delivered 1.7bn doses of vaccine globally. But there is a pretty sufficient supply for most of the countries, particularly low-income countries.

Butler agreed, calling the global vaccine market "saturated".