Press Conference - Australian Parliament House, ACT

Transcript
09 Apr 2021
Prime Minister
E&OE

PRIME MINISTER: Good afternoon. I’m joined by the Minister for Health, the Chief Medical Officer and the Secretary of the Department of Health. Let me start by saying Australia has now had over one million doses administered here and across the country. I’ll come to the issue of the vaccines and National Cabinet in a moment. But let me also advise, and particularly why I’m joined by the Minister for Health today and Aged Care, the Australian Government has secured overnight an additional 20 million doses of the Pfizer-BioNtech COVID-19 vaccine, in line with the advice of the Scientific Industry Technical Advisory Group on Vaccines, led by Professor Brendan Murphy. Now, through our advanced purchase agreement with Pfizer, these additional 20 million Pfizer doses means that Australia will now receive a total of 40 million Pfizer doses in 2021. It is anticipated that these additional 20 million doses will be available in quarter four of this year. That’s our current instruction, and we’ll obviously be doing everything we can to seek to move that forward where we can. But that is very welcome news, particularly in the light of the information that we received from ATAGI last night. Australia has entered into four separate agreements for the supply of COVID-19 vaccines, and these include agreements with Pfizer, AstraZeneca, Novavax and COVAX. And these agreements now total up to some 170 million doses. I particularly want to thank the Minister for what has been a fairly busy evening in working with Pfizer. I also want to thank all of those in the Department of Health, led by Professor Murphy, and I also want to thank Pfizer, who have been a very good partner with Australia in the vaccination program and working with us with a number of challenges, but particularly given the advice that we received from the Australian Technical Advisory Group on Immunisation yesterday, and to be in a position where we can move this quickly the next day to ensure that we can have access to those additional vaccines, which means 40 million Pfizer vaccines in Australia in 2021.

I might now turn to the meeting of the National Cabinet which was held today and James Merlino joining us as Acting Premier for the first time today with the other premiers and chief ministers. The Premier of Tasmania obviously joining us in a caretaker capacity, which has been our convention throughout the operation of National Cabinet since it was first established. High on the agenda today, our first item was to deal with the ATAGI advice that we received last night. It was the opportunity for that to be discussed amongst premiers and chief ministers, as they had already had the opportunity to be briefed by their chief health officers last night and I’m sure again this morning with the information being disseminated, and it was a very useful discussion. The decision of the Commonwealth Government, because it is a matter for the Commonwealth Government to accept the advice of ATAGI on these matters, was understood and supported, and I want to stress again that the advice that has been received, the recommendations that have been received from the Australian Technical Advisory Group on Immunisation is not a ban on the AstraZeneca vaccine. It is not a prohibition on the AstraZeneca vaccine. It recommends and notes that the risk of these side effects are remote. They are very rare. We are talking in the vicinity of five to six per million, which is a rather rare event. But it must be acknowledged, and it’s important so Australians can make informed decisions about their vaccination and their health care with their medical professionals, with their doctor. So there was no instruction not to take that vaccine. There is an acknowledgement of the risk that is there, but as is the case always with these matters, these are decisions for Australians. And certainly for those who are over 50, there is a strong encouragement to be taking the AstraZeneca vaccine, which we discussed today, to ensure that we can continue down the path of the vaccination rollout. We discussed the recalibration of our vaccination program because of the advice from ATAGI today, and that was a very constructive discussion, and indeed already today states and territories are working with the Commonwealth to that end. Our focus remains on the delivery of 1A and 1B cohorts for the vaccination rollout. Now, this is particularly important because we’re substantively talking here about people who are over the age of 50. And as Professor Murphy reminded us today, that includes many health workers, many health workers that are in frontline roles, whether in, working in aged care facilities or otherwise within the health system, and particularly amongst the nursing community. That’s not to say there are not those under 50, of course there are, but we are talking about groups where we can continue to proceed with the vaccination rollout at the pace we are hoping to proceed at and to ensure that we meet the goals we have with those 1A and 1B cohorts. This is important because the goal here is to protect the most vulnerable in our community. If we want to treat COVID-19 like the flu then we need to ensure that we’re vaccinating those in our community who are most vulnerable. The most vulnerable people in our community are not just over 50, they’re actually a lot older than that. And so the AstraZeneca vaccine is well suited, is well suited to address those critical vulnerable groups. We reminded ourselves this morning that the key issue that we were concerned about a year ago, as we feared the overwhelming of our public hospitals and all of these rather dire outcomes, was because of the vulnerability of our most elderly Australians. So vaccinating our elderly Australians remains a key priority that also supports the continued opening up of Australia, because the risk factor of severe illness amongst the most vulnerable is therefore reduced.

We also agreed today, very productively, and Professor Murphy will take you through the first iteration of this, data release and transparency measures that will see both daily release of information, and Professor Murphy will take you through very shortly what those daily info graphics, that daily information will be that will be available to the public and of course to the media, as well as weekly information that shows more detailed data at a state, territory and Commonwealth level, across both the available doses and the administration of those doses. And I’m sure you will all find that very helpful in your own reporting and to the public.

Finally, the other issue that was discussed today, as we tabled our response to the Respect@Work Report of Kate Jenkins, the Roadmap to Respect. That was well received and noted today. All states and territories have agreed to our request to make their own responses to the Respect@Work Report by the end of June. So I welcome their enthusiasm for doing that and their cooperation to do that. As you know, the Respect@Work Report deals not only with Commonwealth responsibilities, but many state and territory responsibilities. So the Commonwealth having been the first Government to respond, that will now be followed by all the states and territories, and that will be concluded by the end of June. I was also pleased today to discuss with the states and territories the next phase of the COVID family and domestic violence package. We are working through that information. As you will be aware, it was $130 of the $150 million that the Commonwealth put in place as an urgent COVID response last year. That terminating program, that emergency support, runs to 30 June. As I indicated, I think it was yesterday, that we are looking at the next phase of that program, but in order to do that I have asked from the states to give us an urgent update on their spending, their acquittal, if you like, of the funds that have already been provided to the states and territories this year, highlighting what their ongoing spending programs are in this area, so we can ensure that any Commonwealth program is adding, adding to the overall effort here, and of course wouldn’t be replacing any effort. This remains an urgent issue because COVID is still happening and the impacts, particularly for vulnerable Australians, particularly women and children, as a result of many of the impacts of COVID, are ongoing. And so we are looking at that favourably, but I intend to do that in partnership with the states and territories, equally sharing the challenge both fiscally and in the delivery of programs.

Finally, we noted that yesterday the Women’s Safety Ministers met and they have put in place the date of 29 and 30 July for a women’s safety summit. That is part of the national plan, remembering the national plan process that began under Prime Minister Gillard a decade ago. An excellent initiative, one supported on both sides of politics and in fact right across the political spectrum, I believe. That program is coming to the end of its run and there will be a new national plan on women’s safety, and the women’s summit is a key stepping stone in getting to that next national plan. What we agreed today, and I welcome the recommendation by the Premier of Queensland Annastacia Palaszczuk, it was warmly received by premiers and chief ministers and myself, that our first step would be to have a National Cabinet meeting at our meeting in July. That will be a face-to-face meeting and we will be holding that in Darwin. That National Cabinet meeting will bring together all of the initiatives, all of the spending programs that are being run by states and territories and the Commonwealth in relation to women’s economic security. There will be a special package brought together by the Secretary of Treasury that will be identifying the issues that relate to women’s workforce participation, gender pay gaps and issues related to those to aid that discussion. The purpose here, and what we will consider in July, is whether we can then move, and I hope we do and I think that’s the shared view of premiers and chief ministers, that we can embark on a similar national plan process on women’s economic security, as we have on the protection of women against violence. That has been a very successful model, the women’s violence national plan, because it respects and it acknowledges the roles of all governments. No single government has full carriage of the issues that impact on women’s safety. No single government has full carriage of the issues that impact on women’s economic security. We all have a role to play, so we’re going to work off the information base of all the existing programs and activities, particularly post the development of most state and territory budgets and certainly the Commonwealth Budget, and that provides us with, I think, a very good point at which to then move into a national plan process, which I would expect would also have a summit on those issues as part of that program. So I thank Premier Palaszczuk for that. I thank all the premiers and chief ministers for their enthusiastic engagement with that agenda.

I am going to, I think, I think, why don’t we go particularly to the vaccine Pfizer announcement, which is obviously very significant, with the Minister, and then we will go through what is our more normal National Cabinet run down from Professor Murphy and Professor Kelly.

THE HON. GREG HUNT MP, MINISTER FOR HEALTH AND AGED CARE: Thanks very much, Prime Minister. And as the PM set out, we have been able to secure an additional 20 million doses of Pfizer by exercising the capacity within our contract and with rapid negotiations with Pfizer Australia and Pfizer Global. I do want to thank the head of Pfizer Australia Anne Harris and all of those within the Department for being able to complete this process for purchasing within such a short period of time. We already had 20 million Pfizer doses which had been committed for delivery in 2021, and this brings an additional 20 million doses on top of the Novavax 51 million, the AstraZeneca 53.8 million and the COVAX facility 25.5 million, taking it to a total available pool of 170 million doses. Significantly, the context, I think, is very important here. And another day of zero community cases of transmission thankfully in Australia, against a figure of over 800,000 cases globally, on the advice we have. 800,000 cases globally, zero in Australia for community transmission, and of course 13,500 lives lost. So the comparison is very stark. What it also means is that the vaccination program has, I think, very importantly continued. We have seen 81,297 doses in the last 24 hours and that’s a record. So in the midst of all of this discussion, all of these discussions, Australians have still come forward. Our general practices, our states, our aged care vaccinators have been able to deliver these vaccinations, making it, as the PM says, well over one million with 1,077,511 doses. So those numbers are increasing very significantly, with the states having delivered over 536,000 and the Commonwealth 541,342 through the primary care or GP program of 408,000, and the aged and disability care of 133,000, including over 1,052 aged care facilities with first doses and 475 aged care facilities with second doses.

In terms of the continuity of the program, I think it is very important to emphasise that the basic settings, as we progress through 1A and 1B and even phase 2A, are largely unchanged. In 1A we will have the aged care residents. We will have the front line workers and the quarantine workers. Those programs in the case of the quarantine and the front line health workers are largely completed and we thank the states for that. The aged care, as you can hear, is progressing very significantly with now over 133,000 people vaccinated, and then we would have to make a change with regards to ensuring those who are under 50 that still haven’t been vaccinated have access to Pfizer. With regards to phase 1B, this is the over 70s and the over 80s and the over 55 Indigenous Australians. All of those can continue to receive, with the strongest medical advice, the AstraZeneca vaccine. And that, I think, is important and we are seeing that in those numbers coming through. For those who may be immunocompromised or front line workers who are under 50, then right now we’re working with the states and territories and the medical authorities to revise that part of the program, so as they have access to Pfizer. That will take time. We recognise that, as those Pfizer doses become available, but we’re working on that front. And then as we move into phase 2A, that itself is also focused on the over 50s and over 60s, and their access to AstraZeneca remains unchanged. It’s really after that with regards to the under 50s, and that is the same time as we start to have very significant doses of Pfizer come onboard. And so that’s how we’re managing the program. PM has said we will provide more advice once the planning is finished, but with the extra 20 million doses I think that should provide very significant reassurance, and in the meantime the program continues with record numbers in the last 24 hours.

PRIME MINISTER: Before I ask Professor Murphy to come forward, there was another very important item which I also need to bring to your attention. The National Cabinet agreed today the principles for Australia’s COVID-19 management and reopening, importantly. So states agreeing and territories to the following principles about prioritising the vaccine rollout, maintaining readiness to ensure suppression, so that goes to the COVID safe behaviours for testing, tracing, etc. Ensuring that measures are proportionate in responding to outbreaks and are consistent, that are focused also on protecting national wellbeing that goes not just to health issues but the economic wellbeing of Australians. Clear and effective and coordinated communications, with a focus on maintaining confidence. The vaccination rollout should be proceeding as efficiently and quickly as possible, that jurisdictions should continue to improve their quarantine management. They agreed to adopt the AHPPC advice of easing venue restrictions to be no stricter than the one per two square metre rule. So that is a maximum now, a maximum. And I know that states have already moved to make it even less restrictive than that, and others will be doing so very soon. Agree to adopt the AHPPC advice that large, ticketed and seated gatherings can have 100 per cent capacity. That the AHPPC advice that the easing of restrictions can occur on the basis of international borders remaining substantively closed and a reduction in the risk of incursion through the vaccination of quarantine staff and their close contacts and health care workers. They agreed to prioritise local containment measures and aim for outbreak responses that keep internal borders open, was agreed today. And they further agreed to task the AHPPC with specific health advice regarding the implications for quarantine arrangements and reopening of Australia of a successful vaccine rollout for the most vulnerable Australians, that is phase 1A and 1B, and the current evidence around the effect of TGA approved vaccines on transmissibility of COVID-19. What we’re asking the medical expert panel to tell us is, what are the thresholds that we need to be able to meet to do things such as the following: Australians who are vaccinated being able to travel overseas and return to Australia and not go into hotel quarantine, potentially go into home quarantine, or not even into home quarantine at all. That will be a major change, and to the extent to which Australians returning from overseas who have had recognised vaccines also approved here in Australia with appropriate accreditation can return to Australia on that same basis, and to enable potentially down the track, travel from low-risk countries with similar vaccine arrangements. Now, no one is saying that any of those things are coming in today, but what we are working and planning for and have tasked the medical professionals who advise us on, is what are the marks we have to meet to enable us to start opening up Australia more than we are now. Now we already have the New Zealand open arrangement. We welcome that and we look forward to the success of that in the coming months. That will give us a greater deal of confidence about when we can move to other countries. I’ve mentioned Singapore before as an obvious next choice, but at this stage that is still some time away. So the message from National Cabinet is, we want to open up more, we want to do it safely, we want to ease restrictions, we want to do that in a consistent way across the country, and we want to do that because we know we’re not just managing the health but we’re managing the economics as well for people’s livelihoods and wellbeing, and this is going to be an ongoing and increasing focus of the National Cabinet. We noted the work that is being done in New Zealand and we also note that of course at the end of the day every state and territory is responsible for public health in their own jurisdiction, so they haven’t offered up their sovereignty on those issues, that wasn’t likely, but I do very much welcome their agreement to those principles today. But now to Brendan.

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: Thanks PM. So I’m just going to briefly go through a new daily data set that we will be releasing everyday in the vaccine program. National Cabinet also agreed to a weekly, more detailed data set which we will be releasing from next week. Now, Minister Hunt’s covered some of these numbers so I will go through fairly quickly. So the first of this pack will just show the overall picture, and you can see the over one million total doses broken down by Commonwealth in primary care, Commonwealth in aged and disability care, and the vaccines delivered by the states and territories. And all of these sectors are increasing significantly, and as Minister Hunt said, we are growing our vaccination rate. Next slide.

So this just shows the proportion by sector. And again you can see how exactly as we planned there has been a ramp up by the jurisdictions, the states and territories, in the first weeks and a steady progressive ramp up in residential aged care and disability, and the most significant thing you can note there is the rapid rise in our general practice, our primary care, GPRC, Aboriginal community controlled health sector, exactly as planned as we are rolling on more and more of these sites every week and people are turning up to get their vaccines. Next slide.

This just shows, there’s been a bit of chatter about the rate of rollout in Australia, it just shows in that line there that our rollout is pretty consistent with many similar countries. Certainly the UK and the US rolled out more quickly because they have been trying to save lives. The UK estimates they’ve saved 10,000 lives from their vaccination program. Fortunately we haven’t been in that emergency situation but our program is going well and ramping up, along with many similar countries. Next slide.

PRIME MINISTER: And bettering some, I note.

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: And better. So the Commonwealth aged care doses, and again you can see this is now broken down by each state and territory. You can see the number of facilities that have had first doses and second doses and you can see that we’ve had 133,000 doses in aged and disability care facilities, and we’re getting very large numbers of visits to facilities every day and we are on track to complete that program as planned. Next slide.

This is showing the, probably the most exciting recent development in weeks has been the huge ramp up of vaccinations in primary care. And these are mainly, these are the 1B population, mainly the 70s, over 70s and over 80s, and other people with underlying medical conditions who are turning up in droves to their GPs where they are known or in their local area to get vaccinated and this has been with the AstraZeneca vaccine. And this is a really, really good news story, and you can see we had over 47,000 in this setting alone in the past 24 hours. And you can see on the map there, and we’ll continue to show that map, what facilities have been stood up each week.

PRIME MINISTER: Just before you move off that one I just want to note that that’s the number of Commonwealth-administered does that are occurring in the states, they’re not doses being done by the states, they’re doses being done within those states by the Commonwealth program.

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: So finally I do want to just say one thing. The people who are turning up to these clinics are the people who need protection from the AstraZeneca vaccine. As I said last night, I have absolute complete confidence that this vaccine is highly effective and is highly recommended and safe for people over 50. And even under 50, as we’ve said already, it is a very highly precautionary preference statement. This condition is seen more commonly in younger people and the risk of COVID as you get over, as you’re over 50 exponentially increases. The ratio of benefit to risk is massively in favour of getting vaccinated. We need to protect our people, particularly those over 70 and 80 who are the most at risk of COVID. I am completely confident, as are all the medical experts who’ve come out recently, that people should turn up with the greatest of confidence and take this vaccine. I’ve had it, I’d have it again, I’d recommend it to any of my family. Thank you.

PRIME MINISTER: My mum’s getting it in a couple of weeks. She is back at The Lodge at the moment and we had that discussion last night and she told me she’s booked in and she’s looking forward to having her AstraZeneca vaccine and she was pretty happy for me to tell people about that, obviously. These are conversations that families have. My family’s no different. We have it and she’s off to the doctor. Speaking of doctors, Professor Kelly.

PROFESSOR PAUL KELLY, CHIEF MEDICAL OFFICER: Thank you, PM. So my dad doesn’t want to bother anyone so he, I keep telling him to ring his GP. But I will continue to advise him. He’s 86, he has health conditions and I’ll advise him to take the AstraZeneca. It’s very safe for him and the benefit of him having that vaccine, the two doses of that vaccine, far outweigh any of the risks, even the issues that we’ve been raising today. Which brings me to one important point I’ll make about the vaccine, which is the consent process. So you can imagine through the night, and you saw that we all, the four of us stood up last night within half an hour of having that advice given by the medical expertise to talk about what needs to happen, to change. Of course there’s a lot of processes that have had to go through overnight and thanks again, as others have said, to the staff in Health and also our colleagues in the states and territories in relation to certain matters. One of those key ones is the consent process. So one of the recommendations from ATAGI was to make sure that that informed consent process was absolutely and totally informed by this new information and so that will be available today. In some states there was an issue there because of the lack of that new informed consent process being available. They’ve made changes to the program today. But that’s a temporary matter and administrative. To reiterate, as we’ve all said, that the benefit of the vaccine outweighs the risk, particularly and specifically in that over 50-year-old age group.

Just to a couple of matters in relation to National Cabinet. The PM’s gone into all the issues in relation to the AHPPC advice. Again I want to really acknowledge and thank my colleagues, the chief health officers in the AHPPC that I Chair, who came to that consensus opinion, advised their state premiers and chief ministers to go with that approach, which is going to really help in the reopening aspects. In terms of what’s been asked in one of those elements that the PM has mentioned in relation to the future work for AHPPC, this is really just acknowledging the things that are not currently known and the recommendations that we put to National Cabinet were based with those caveats, and so the task in the coming months is to try to identify those issues - what is the role and the nature of the effect of the vaccine program in relation to transmission of the virus, what about variants of concern, how that, how may that change these matters, and what do we need to do, specifically for those that have been shown to be, to cause more severe disease or more highly transmissive virus, what is the length of protection that is given by the various vaccines that are being used, what about children, when they should be vaccinated, how many Australians have been vaccinated, so that relates to the vaccine rollout, and also the particular vaccines being used. So that’s the task we have been given and we’ll work through that in ways that we can and provide that advice so that that can support future reopening.

JOURNALIST: Can I please ask about the pacing of the Pfizer imports. You said the 20 million extra doses will come in the fourth quarter, will the original 20 million doses be brought forward at all and how many doses of Pfizer are you expecting per week in the second and third quarters?

THE HON. GREG HUNT MP, MINISTER FOR HEALTH AND AGED CARE: What's Pfizer's indicated is that we will see an expansion in April. They have asked that we provide the numbers when we have confirmation and so at this stage they are indicating an expansion in April as opposed to the figures which have been approximately 130,000 plus a week. Again an expansion in May, quite a significant expansion in May. Then in June there's likely to be a near doubling - sorry July, there's likely to be a near doubling which will track through to the rest of the year and that would see the full 20 million. I apologise, at the request of the company because they haven't confirmed the exact figures that they’ve asked that we speak in indicative terms. Then the 20 million which has just been purchased, at this point in time is settled for the fourth quarter but we are working with them on the possibility of bringing forward as many of those doses as possible. There's no false promises on that.

JOURNALIST: Can you explain now why your Government didn't sign contracts with Johnson & Johnson and Moderna to protect Australians against exactly this circumstance?

PRIME MINISTER: We took the advice of the scientific advisory group as we have done all through this process. Our entire approach has been to follow the advice of the medical experts who have assessed these matters in great detail and provided their recommendations to Government. That group is led by Professor Murphy so I think he is best placed to answer your question.

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: Thanks, so the Scientific and Technical Advisory Group strongly recommended that we have a stake in the mRNA vaccine and we went with Pfizer mainly because of its capacity to deliver and it was not a new company. And experience has shown that they have delivered a lot more vaccine than Moderna. Had we had a contract with Moderna we would have had not very much delivered at this time, at the moment. So we’re focusing on increasing our Pfizer, the two vaccines are very similar. Johnson & Johnson we have been in discussions with. We have had the AstraZeneca vaccine which is an adenovirus vector vaccine, Johnson & Johnson is one too. We still don't know what the cause of this adverse effect is, whether it relates to just this vaccine or other adenoviruses, we have to wait and see. So at the moment we are still exploring with Johnson & Johnson as we have with every other company but every single recommendation of the Scientific and Technical Advisory Group that has been made to Government has been accepted.

JOURNALIST: Last week and this week you said that the problem was supply and yet overnight you seem to have magiced 20 million new doses of Pfizer. Can you understand why some voters would be scratching their head a little bit in relation to how that's occurred? Can you tell us which country they come from, how much they cost taxpayers, and if you have extra left over from the CSL contract from AstraZeneca where will they be going?

PRIME MINISTER: I will let Greg deal with the matters that you raised at the end. The additional vaccines we have been able to secure for the fourth quarter of this year are not vaccines that obviously would have been available here and now. Here and now we have the availability of vaccines of Pfizer from our original contract which is for 20 million as well as the contracts with AstraZeneca. And so supply is the fundamental factor. And the supply of that vaccine and how it's been used in our vaccination roll out obviously is impacted by the events of the last 24 hours, events that were not foreseen. These issues did not come up in the trials as was said last night. And they are quite rare circumstances where these side effects become apartment. And I stress again, that there is no ban or prohibition on the use of the AstraZeneca vaccine across the adult population. There is a recommendation for a preference but these are matters that individuals can discuss with their doctor. Even when we get to the next phase, in Phase 2, we are still talking about millions and millions of Australians over the age of 50 for whom the AstraZeneca vaccine is recommended. Not recommended against, recommended for, that AstraZeneca is a vaccine that can be very effectively used and is very effective in supporting Australia's vaccination program. So all up now we have 170 million doses contracted. Prior to today we had 150 million doses contracted. But when there are events that require us to be fleet footed, to shore up our supplies then we have taken those decisions. But in terms of the roll out and the timing I will leave that to the Minister.

THE HON. GREG HUNT MP, MINISTER FOR HEALTH AND AGED CARE: Very briefly Sam, I think the key phrase is the timing of supply. So it is the timing of the initial supplies right around the world. Those countries that were producing their own, in particular the United Kingdom and the United States, had access to very large volumes. Obviously I think everybody will be aware of the challenges that Europe has faced. We have been in the fortunate position, just as Professor Murphy has shown with the ramp up, because we have had AstraZeneca with home-grown production through CSL allowing us to ramp up that supply earlier. I think there have been some figures put about but I see it as about 5.5% of the adult population which has now been reached which has multiplied by more than fourfold in just over two and a half weeks. In terms of the origins, it is for the individual companies to identify if they wish to identify the source, the commercial arrangements are such, and the security arrangements are such, that we have been asked not to identify the particular sources. I apologise for that but that is understandable. In terms of the investment, our total investment in vaccines alone is over $4 billion and our total investment in the vaccine program is now over $7 billion.

JOURNALIST: Prime Minister, with the budget coming up in May, how has the change to the health advice surrounding AstraZeneca jabs affected the Budget's parameters? And is the Government willing to pay AstraZeneca so CSL can get out of its contract once it's made enough doses for everyone over 50 so it can start producing Novavax vaccine?

PRIME MINISTER: I’ll allow Professor Murphy to speak to the issues around Novavax, but the parameters for the Budget are being brought together now and so they haven't been finalised. The Budget is not that far away now and the Budget parameters always take account of the factors at the time of preparing the Budget. On the basis of the medical advice that we've received and the programs particularly that we have and the supplies that we've particularly been able to secure in the last 24 hours to supplement what was already there, I wouldn't be expecting any major impact through those parameters. This is my seventh Budget so I’ve got somewhat of an understanding about the things that impact on these issues and we've always taken a very conservative position when it comes to the parameters. That's the Treasury's way, and I think that is very prudent when it comes to putting these Budgets together. Already the budget is significantly outperforming the parameter estimates that were set in the mid-year statement. Unemployment is well below where we'd anticipated it to be, and the many other things that flow from that, impacts on payments et cetera, on social security and so on, are all impacted by those effects. So I wouldn't consider this to be terribly material with its impact on parameters. Again, I stress and I'm sure Professor Murphy because he has said it enough times to me in the last 24 hours, the AstraZeneca vaccine remains a critical component of Australia's vaccination program. It is particularly essential in those 1A and 1B components of the program which ensures that we are protecting the most vulnerable in the community in a safe way. If we are in a position to have vaccinated 1A and 1B then that has implications for being in a position where we can begin starting to treat COVID-19 like the flu. That's where National Cabinet wants to be. We want to get Australia to a position where we can treat COVID-19 in the same way as we treat many other viruses. That doesn't mean the virus can't be present, it just means that the virus is not going to lead to the disastrous outcomes we are seeing overseas. The flu every year, sadly has impacts on Australians including fatalities sadly, but that being the case we haven't engaged in mass lockdowns of our country because of the flu. But we’re not at that point yet and I think we soon will be. So we'll continue to roll out the vaccines from CSL. We will continue to secure the other vaccines that we have from the other sources and where we have vaccines that we can make available, particularly in our own region as part of the Quad initiative and in the Indo-Pacific and especially for our Pacific family we will certainly be doing that. In fact, I already have diverted a number of those vaccines to assist the effort in both Papua New Guinea and Timor-Leste. Brendan.

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: So, just on that issue, what we need CSL to do now, is to continue to churn out AstraZeneca. We need this vaccine in significant quantities to protect our over 70s and 80s. We have to finish that program. Of course, we will work with CSL as we work out planning to see just what production rate they need to keep up over the coming year. Now, in terms of Novavax, sure, CSL can only make one vaccine at a time. We have discussions with CSL about making other vaccines but we want them to focus on AstraZeneca at the moment. At the moment with Novavax they are producing overseas and they are likely to be able to provide us some vaccine in quarter three. It may be the quickest way to get it. We're working through all of the options of potential home production versus international supply with all of our vaccines. But at the moment, CSL is making AstraZeneca. We need it and our elderly Australians need to have in their arms.

JOURNALIST: Prime Minister, you stress there is no ban on the AstraZeneca vaccine, indeed your mother is going to get it.

PRIME MINISTER: Correct.

JOURNALIST: Rightly or wrongly though, isn't the damage already done here in terms of vaccine hesitancy? We're already hearing reports that people over the age of 50 are pulling out of scheduled appointments. How do you intend to combat that now?

PRIME MINISTER: Doing exactly what we’re doing now, being very clear in the communication about what the medical advice is and to place that in context. And I’ve got to say, the media has a role to play in that as well. The information is very clear that if you're over the age of 50, it is recommended that you do have the vaccine. COVID-19, if there were to be another wave in Australia the people most vulnerable to death from COVID-19 are those who are in 1B. And so you would be putting yourself at risk, you would be putting yourself at risk if you didn't get the vaccine, because you would be exposing yourself to the more likely event of a COVID contracted condition that could result in serious illness. So COVID is a much greater threat by a factor many, many, many times over than the AstraZeneca vaccine. The AstraZeneca vaccine is a life-saving vaccine and particularly for vulnerable Australians. That's why I want my mum to get it, and that's why I want your mum to get it, and your dad, and your uncle, and your aunt, your brother, your sister. That is a life-saving vaccine.

JOURNALIST: On the GP rollout Prime Minister, we are ramping up, there's lots more GPs providing vaccines, but they're providing AstraZeneca and the pharmacies are also meant to provide AstraZeneca. What does this new requirement of Pfizer mean for the GPs and the pharmacists? Will they be able to use Pfizer vaccines or is there going to be a change to the rollout at that stage?

PROFESSOR BRENDAN MURPHY, SECRETARY OF THE DEPARTMENT OF HEALTH: The GP program continues. There are, most of the people the GPs are vaccinating are over 50s, mostly over 70s and 80s. They need the vaccine, we're providing the vaccine, they're turning up to get vaccinated. So the GP program right throughout 1A and 1B will continue exactly as it is. Then when we get into 2A, there's people over 50 and over 60 who will also be able to go to their GPs to get vaccinated. It's true that we planned in Phase 2 to roll out pharmacies and we are looking at how we will do that now. As we said last night, we need to recalibrate and see, if we can get more Pfizer, how we will deal with the under 50 as we get into phase 2B which is the under 50s when that will become an issue. So we’ll work through that as we’re replanning and recalibrating the program at the moment.

It is certainly true that the Pfizer vaccine now can be, there's TGA registration changes that allow the Pfizer vaccine to be transported and stored at refrigeration temperature for a longer period of time which will make it easier from a logistic capacity if we were to use Pfizer in mass vaccination clinics or in pharmacies. But we're considering all those options at the moment.

JOURNALIST: Given that people are pulling out of appointments as Pablo was mentioning before, the New South Wales state government announcing they were pausing AstraZeneca for all age groups today, are you concerned you are losing control over the vaccine rollout to those voices and giving voices to the anti-vax crowd? And can you stand here today with any certainty and say that all adult Australians would have at least one jab by Christmas?

PRIME MINISTER: Again, I said last night, that we're not in a position at the moment to reconfirm a timetable. We're not in that position. And I'm not going to do that, regardless of the invitation. We're going to work through the implications of this most recent medical advice, for the calibration of the rollout. And the fact that we've now been able to secure an additional 20 million Pfizer vaccines for Quarter Four is very encouraging. In terms of, you make reference to the statement by New South Wales today, I spoke to the Premier about that today. This is an administrative issue, not a medical issue. They are updating their systems to have the new consent arrangements put in place, and the other consent forms are coming out from the Commonwealth today. This happened last night. So to characterise it as some sort of medical ban on New South Wales would be false. It would be incorrect. It would be misleading. And I don't think that would be a good way to describe it in those terms. I have spoken to the Premier. They have put this in place simply to update their forms. It's an administrative process. It's not about the vaccine. I've had that directly from the Premier. So, I would caution people not to be concerned by that process. It is simply a matter of updating the systems, to reflect what has occurred overnight, to ensure the appropriate consent forms are in place, and that we can ensure that that consent provision is being respected by the governments, at a state and federal level, and individuals can have that appropriate consent.

THE HON. GREG HUNT MP, MINISTER FOR HEALTH AND AGED CARE: I think, Jonathan, there’s one very important number in the midst of lots of them, might assist with the confidence question. And that is 81,297 Australians were vaccinated yesterday. That was a record number. And it's in an Easter week where many people will still be on leave. It’s when obviously, the day that there had been the reports which were well traversed and understandably so, from the European Union and the UK, and the fact that Australia was going through a consideration process. And yet that number of people came out. And so there will be people who reflect. Our job and with your support, your job is to help convey the medical advice and the confidence and that's a national partnership. So, we've been through hard times in COVID. And there are difficult days and challenges and this is one of the many challenges. But the fact that those numbers are continuing, the fact that the rollout is growing, we would encourage people to have confidence in the medical advice. The people who have kept us safe, they're right here. They're the ones who are backing this vaccine, for the over 50s.

JOURNALIST: Prime Minister, Just to clarify something you just said, you talked about diverting some vaccine doses…

PRIME MINISTER: Yeah, AZ.

JOURNALIST: And how many and to which country?

PRIME MINISTER: At this point it was 10,000. That decision was taken yesterday, early yesterday. And we'll continue to review that.

JOURNALIST: To which countries, sorry?

PRIME MINISTER: Papua New Guinea, and we believe we’ll be able to make them available to Timor-Leste as well.

JOURNALIST: Does this new advice on AstraZeneca change how we help our region with AstraZeneca doses? Are you still seeking the one million doses from Europe for PNG?

PRIME MINISTER: Yes. I’m just going to move across and we’ll finish up over here.

JOURNALIST: You mentioned once we completed 1A and 1B, we can start treating this more like the flu. If that’s the case, what is stopping the international borders being reopened at some point this year?

PRIME MINISTER: Well, what I said was we need to get to that point before we can consider that. That's what enables us to get into that position. And so, we need to get into that position. And what I've asked, and the Premiers and I have asked the AHPPC to do, the medical expert panel, is to give us advice, that when we reach that, what we can then do. One of the key issues, and either Paul or Brendan may want to speak to this as well, is still at this point we do not have the evidence to support the position on transmissibility. That is the critical factor that relates to the ability to change how we would do quarantine. That's an important factor in allowing people to travel overseas and borders and so on. But the key issue of protecting against our most vulnerable and then being in a position where we can contain and suppress any outbreaks, they are the other factors that are part of this. But Brendan, Paul sorry.

PROFESSOR PAUL KELLY, CHIEF MEDICAL OFFICER: Yes, so it was the issues that I mentioned earlier, before the questions, the transmission of the virus, what is the effect of the vaccine on that, there's positive signs that it does affect, but that isn't completely known. The variants of concern, we know that some of the vaccines do not work as well against some of the variants of concern and there's more variants coming every day. So there's another element. The length of protection of the vaccines themselves. That's an unknown. No-one in the world has had a vaccine in their arm for more than a year. And so, that is another factor we need to put in. So there's a range of issues we'll be putting into some modelling over the coming weeks and we'll be discussing that as part of it. But I think it's important to not rush this component. At the moment, Australia is mostly open internally. And that is the agreement as the PM has mentioned about the response to outbreaks that will come from incursions from quarantine. That’s the situation at the moment whilst the vaccine rolls out, to protect our most vulnerable people. That’s the crucial point.

JOURNALIST: Prime Minister, you and the Premiers have made a virtue of accepting medical advice. Why shouldn't some of us see that advice now as being bad advice, terribly risk averse advice, because our regulators here are now taking a…

PRIME MINISTER: Sorry, I can't quite hear you Chris.

JOURNALIST: Our regulators here are taking a more risk averse attitude than they are in the UK at the moment. And obviously they're measuring the risk against zero. But aren't there other factors they should have taken into account? So why is this good advice? And why can't you reject advice, if you all think it's safe for most of the population, why can't we just do that?

PRIME MINISTER: That's what the advice says. The advice does not put a ban on its administration of the doses across the population. It doesn't do that. It informs as to a very remote risk. And I would think Australians would want to know that. And it advises a preference, where there is a choice of vaccines. And that's what it does. I wouldn't agree, and Professor Murphy or Professor Kelly may wish to speak to this as well, that the advice that we receive is inconsistent with what is happening in other places. I would say, but that is not the case across Europe. In some cases it's even more than where it is in Australia. But our position on 50, as recommended to us, is very consistent with the medical advice across Europe. And if all of those European countries had gone down that path, and Australia had taken a different position, at a lower age group, and our understanding from ATAGI, they're the experts, is that the medical advice supports the age advice of 50. And that means that over 50, they're very, very strong of the view that those over that age are not faced with that same remote risk as there is for a younger population. In fact, the reverse. Not having the vaccine, particularly for elder Australians, is a greater risk to their health. And that's why I encourage them to take the vaccine. So when it comes to medical advice, I think we've been served very well. You don't get to choose the medical advice, that's provided by the medical experts. And as a Prime Minister or a Premier, we consider that advice and we make decisions. We haven't gone beyond the advice, we haven't gone below the advice on this occasion. It is important that we do consider other factors in terms of the impact on the economy and things of that nature and we regularly do. But in relation to this advice, it is sufficiently precautionary. But at the end of the day, it leaves it in your hands, or anyone else's hands, to ensure they can take the advice from their own doctor and ensure that they're vaccinated. Because the more Australians that get vaccinated, the more that happens, then the more options the Premiers and I have. And I think that's what Australians want. And that's why I want to continue to encourage Australians to speak to their doctors and to participate in the vaccination program. At present, we're substantively dealing with populations that are not directly impacted by this advice. Of course there are frontline health workers and others who are, and I'm confident that we’re going to be able to deal with their needs through the supplies we have, more or less in the time frame we hoped to do that by. When we move to the next phase, well we'll be addressing that in the weeks ahead.

JOURNALIST: PM, on the international border...

PRIME MINISTER: Sorry, did you want to add anything to that in terms of the consistency with the international advice?

PROFESSOR PAUL KELLY, CHIEF MEDICAL OFFICER: PM I’d only just say that all of the advice that has been given across all countries in Europe and the UK and here in relation to AstraZeneca is based on the same data. And it's the context specificity which is important. Back to one of the previous questions about what that means for our aid to PNG for example, in a completely different context they only have AstraZeneca available. They don't have a choice, and their risk from COVID, a large COVID-19 outbreak of severe infection, hospitals being overwhelmed, and death, is a real thing. For us it's a different thing. And the medical advice is based on that current context.

JOURNALIST: On the international borders and the possibility of vaccinated travellers being able to come and go from the country, would you anticipate that would be a situation where people would only be able to go if they've got a purpose, like going for business, or be reunited with a terminally ill family member, international students who have been vaccinated coming in, or would it be more broadly for people who want to go overseas for a holiday? And related to that, you’ve got people overseas who are, particularly in Asia, who are getting the Chinese made vaccines. Is there any work being done to recognise their vaccination in the way you might recognise Pfizer and AZ?

PRIME MINISTER: I’ll ask Professor Murphy and Professor Kelly to deal with the latter matter. I mean, that very much depends on the ability of source data for the TGA to be able to make those assessments. Ad so that presents challenges for the issue you nominate. On the broader question, on whether it can mean being able to go overseas, whether to Fiji or for a holiday or something like that, or to go on urgent business, or to visit a very ill loved one overseas, or important business activity, I mean, we're vaccinating people currently who had to go up to Papua New Guinea to be part of the health teams working up there. So there are a range, rightly of circumstances where this may be useful. All we have done today, I want to stress, is ask the medical advisors what are the health implications of these types of options, and what are the preconditions that we would need to be comfortable about before going down that path. And so you're right, the risk may be such you might limit it to exempt categories. And that would be the sort of thing that we would currently allow people to travel for, which is occurring right now, but that could be done with greater confidence because of the vaccination and when they return they may not then have to take up valuable places in hotel quarantine. Or it could be more broad as you say. But I can tell you one thing, this is very much the case, the more Australians who are vaccinated, the more likelihood there is of being able to have the types of arrangements that I’ve mentioned. If the vaccination population is lower, then that of course limits the options of borders, and of the other things that we've spoken about. So all of those options are on the table. But we want to know what the key gateway thresholds are from a medical point of view that could allow those things to happen. Last question.

JOURNALIST: Do you see Australians who have been vaccinated coming home for Christmas? Essentially, are we in a position to make a call?

PRIME MINISTER: I'm pleased to know that since the September meeting last year, more than 120,000 Australians have come home. Around 12,000 vulnerable Australians in particular have come home. That's four times, or thereabouts, what we were trying to achieve at that time. And I’m pleased to note that in the more recent figures we're seeing a reduction, thankfully in the number of people registered to come back. And so that's welcome. And that's actually been achieved at a time when we've had constraints on arrivals coming in. I'm pleased that Victoria is opening up to flights again, that's really going to assist the task. I'm looking forward to Queensland going back to their capacity. I'm forever thankful to New South Wales for, despite having the challenges they've had from time to time, they have kept those flights coming in. If it wasn't for the New South Wales Government, there would be tens of thousands of Australians who would not be home now. And we thank them for the great work they have done to support the Commonwealth in achieving those outcomes, as others states have. So I look forward to that occurring. And I look forward to the time, as more and more Australians are vaccinated and there's greater certainty about the effects of the vaccination, particularly on transmission, that we're able to take these additional steps that National Cabinet wants to take. We really want Australians to know that. That A, we're living in a country at the moment in a way that very few others around the world are living. We are in a position that others envy. If you move around the country, from the west coast to the east coast, people are going out, they're enjoying getting together as families, they're going to sporting and cultural events, they are returning at least domestically to a life they knew before the pandemic. The international borders aren't open yet. Those sort of things are not occurring yet. But if we keep going down this path, we will continue to lead the world in our response to the pandemic and the economic comeback which is growing each and every day. Thank you very much.