There's a lot of people willing to be vaccinated who won't take mRNA
In a nation once defined by its robust pandemic response, Australia now offers its citizens only a single COVID-19 vaccine — Pfizer's Comirnaty JN.1 — a quiet narrowing of choice that arrived not through scandal or failure, but through the ordinary mechanics of commerce and supply. Moderna's approved alternative was never restocked; AstraZeneca was recalled; Novavax withdrew, finding the Australian market too small to justify the effort. What remains is a public health system where the architecture of protection has been shaped as much by pharmaceutical economics as by medical science — and where those most in need of alternatives are left with none.
- Australia's COVID-19 booster program has quietly collapsed to a single option, leaving pharmacies and clinics with no alternative to Pfizer's mRNA vaccine since January 2025.
- Novavax — the protein-based vaccine favoured by those wary of mRNA technology or recovering from prior adverse reactions — withdrew its Australian application in 2024, citing insufficient commercial viability rather than safety concerns.
- Vaccination rates have fallen to alarming lows: only 35% of Australians over 75 and a mere 3% of working-age adults have received a booster in the past six months, even as two COVID variants circulate nationally.
- Experts warn that the absence of choice is itself a barrier — people willing to be vaccinated but unable or unwilling to accept mRNA technology are effectively being left unprotected.
- A potential turning point looms: Moderna's planned Melbourne production facility at Monash University could restore supply diversity by late 2025, but the vulnerable remain exposed in the interim.
Walk into any Australian pharmacy today seeking a COVID-19 booster and you will find exactly one option: Pfizer's Comirnaty JN.1. It has been the country's sole available vaccine since the start of 2025 — not because alternatives were deemed unsafe, but because the supply chain quietly dismantled itself around them.
The disappearance happened in stages. AstraZeneca was withdrawn globally after the company acknowledged rare adverse effects. Moderna's JN.1 vaccine received regulatory approval in late 2024 but was never restocked, after the government judged existing supplies sufficient — a calculation that proved short-sighted. Novavax, the protein subunit vaccine that had built a loyal following among those cautious of mRNA technology, withdrew its updated application in May 2024. According to experts, the decision was less about science than economics: Australia's low uptake made the market commercially unviable for the company.
The distinction matters because Novavax works differently. Rather than instructing the body's own cells to produce spike proteins — as mRNA vaccines do — it delivers harvested spike proteins directly, using an adjuvant derived from soapbark tree extract to stimulate immunity. For people who have experienced reactions to mRNA vaccines, or who distrust the technology on principle, this difference is not trivial. As infectious diseases physician Dr Paul Griffin put it, there are many people who are not opposed to vaccination but simply cannot or will not accept an mRNA product — and they are now left without recourse.
The human cost is visible in the numbers. Only 35 percent of Australians over 75 have been vaccinated in the past six months; among those aged 65 to 74, the figure is 22 percent. For working-age adults, it is just 3 percent. Two variants are currently circulating. Professor Adrian Esterman offered a plain-spoken diagnosis: a functioning public health toolkit needs more than one instrument.
There is a distant prospect of relief. Moderna is establishing a production facility at Monash University in Melbourne, with local manufacturing of up to 100 million doses annually expected by late 2025. But that future offers little comfort to the elderly and immunocompromised navigating a narrowed present — protected, if at all, by a program that has traded resilience for simplicity.
Walk into a pharmacy or a doctor's office in Australia looking for a COVID-19 booster, and you will find exactly one choice: Pfizer's Comirnaty JN.1 vaccine. Since the start of 2025, it has been the only option available to Australians seeking protection against the virus. No alternatives. No second opinions. Just Pfizer.
This wasn't always the case. For years, Australians could choose between multiple vaccine brands—Moderna, AstraZeneca, Novavax—each using different technology, each appealing to different people for different reasons. But one by one, those options have vanished from the shelves. The story of how Australia arrived at this single-vaccine moment reveals something about how medical supply chains work, how commercial decisions shape public health, and why experts believe choice itself matters when it comes to getting people vaccinated.
Moderna's JN.1 vaccine received approval from the Therapeutic Goods Association, Australia's medical regulator, in late 2024. It was ready to go. But the Australian government made a deliberate choice not to replenish its supply. A Department of Health spokesperson explained at the time that the Commonwealth had sufficient stocks of alternative vaccines for 2024—a statement that proved premature. AstraZeneca's vaccine, meanwhile, was withdrawn globally in 2024 after the company acknowledged it could cause adverse side effects. That left Novavax, the protein subunit vaccine that had been available since early 2022 and had developed a devoted following among people wary of mRNA technology.
Novavax's updated vaccine, designed to target the XBB.1.5 variant, never made it through the approval process in Australia. The company withdrew its application in May 2024. This wasn't a matter of safety concerns or efficacy problems, according to Dr Paul Griffin, an infectious diseases physician at Brisbane's Mater Health Services. The data simply wasn't sufficient to meet approval requirements. But there was another factor at play: commercial viability. Professor Adrian Esterman, chair of biostatistics and epidemiology at the University of South Australia, suggested that low uptake in Australia made the vaccine economically unviable for Novavax. "It's not so much that the vaccine doesn't work, but it's simply not commercially viable for them," he said. The company has since developed a JN.1 vaccine approved in several other countries but has shown no interest in pursuing Australian approval.
Why does this matter? Because Novavax works differently than Pfizer or Moderna. It's a protein subunit vaccine—the company takes the genetic material of the virus, inserts it into moth cells, and harvests the spike proteins those cells produce. An adjuvant derived from soapbark tree extract is added to amplify the immune response. This is fundamentally different from mRNA vaccines, which instruct your own cells to manufacture spike proteins. For some people, that difference is everything. Those who have experienced adverse reactions to mRNA vaccines—myocarditis, for instance—or who simply distrust the technology have found Novavax to be a viable alternative. "There are a whole host of people who have had reactions to mRNA vaccines," Griffin said, "and it's thought that perhaps that's a lower risk with Novavax. Or people who just don't like the thought of a vaccine based on the mRNA technology."
The loss of choice has real consequences. Current vaccination rates tell the story. Only 35 percent of Australians aged 75 and over received a vaccine in the past six months. For those aged 65 to 74, the figure drops to 22 percent. Among working-age adults, just 3 percent have been vaccinated this year. These numbers are lower than public health experts consider acceptable, particularly given that two COVID-19 variants are currently circulating across the country. Esterman used a simple metaphor: "It's best to have several tools in your tool case. You wouldn't have one type of hammer; what if it doesn't work? You need something different."
Griffin was blunt about the human cost. "There's certainly a lot of people that aren't opposed to being vaccinated who just don't want, or can't have, an mRNA vaccine, and so are likely to remain unvaccinated, which is a huge issue." These are not vaccine skeptics or conspiracy theorists. These are people willing to be protected but unable or unwilling to accept the only option available to them. The result is that a segment of the vulnerable population—the elderly, the immunocompromised—remains unprotected.
There is a glimmer of possibility on the horizon. Moderna is building a technology centre at Monash University in Melbourne, expected to begin local production of 100 million vaccines per year in late 2025. That could change the supply equation. But for now, Australia's vaccination program rests on a single pharmaceutical product, administered by a single company, available through a single mechanism. Two COVID-19 variants are still circulating. The virus has not gone away. And the people most at risk have fewer tools to protect themselves than they did a year ago.
Citações Notáveis
It's best to have several tools in your tool case. You wouldn't have one type of hammer; what if it doesn't work? You need something different.— Professor Adrian Esterman, University of South Australia
There's certainly a lot of people that aren't opposed to being vaccinated who just don't want, or can't have, an mRNA vaccine, and so are likely to remain unvaccinated, which is a huge issue.— Dr Paul Griffin, infectious diseases physician
A Conversa do Hearth Outra perspectiva sobre a história
Why did the government decide not to restock Moderna if it was already approved?
The Department of Health said they had sufficient supplies of alternatives for 2024. But that calculation proved wrong—they didn't anticipate that other options would disappear. AstraZeneca got recalled globally, Novavax withdrew because it wasn't commercially viable in Australia. Suddenly there was no alternative left.
So Novavax wasn't rejected for safety reasons?
No. The data just wasn't complete enough to meet approval standards. But the real issue was that uptake was too low for the company to justify the cost. They developed a JN.1 version that works in other countries, but Australia wasn't worth the effort to them.
Why would someone prefer Novavax over Pfizer if both work?
It's a completely different technology. Novavax uses moth cells to produce spike proteins, then adds a natural adjuvant. mRNA vaccines tell your body to make the proteins. Some people have had reactions to mRNA—myocarditis, for example—and Novavax might be safer for them. Others just don't trust the mRNA approach.
And now those people have no option?
Exactly. They're not anti-vaccine. They're willing to be protected. But they won't take an mRNA vaccine, and there's nothing else available. So they stay unvaccinated, which is particularly dangerous for elderly people and the immunocompromised.
What would it take to bring another vaccine back?
Moderna is building a local manufacturing facility that could start producing vaccines in late 2025. That might change the supply situation. But right now, Australia is betting everything on a single product from a single company.
Is that a problem if Pfizer's vaccine works well?
It works, but it's not about whether one hammer works. It's about having options when different people need different tools. And when vulnerable populations see no choice, they're less likely to get vaccinated at all.