COVID vaccine Australia: The outbreak Australia had to have

http://www.afr.com/politics/federal/the-covid-19-outbreak-australia-had-to-have-20210603-p57xrl

For Rachael, 40, the spectre of a continuing lockdown drove her to seek a jab, even if some of her vaccine-hesitant friends said she was “crazy”.

“We just can’t do that again,” she says. “I want a life so we don’t have to do this and keep doing it, and this [getting vaccinated] is something we need to do so that stops.”

Her partner Trent said the lockdown, now extended to 14 days, hurt. Just two weeks into a new hospitality job, he cannot work.

“I was OK with a week but as soon as it looked like it was going to go longer, that really hit hard. It looks like nothing will go back to normal again until we get herd immunity, so that’s why we’re here.”

People queue for the COVID-19 vaccine at the  Sunshine Hospital hub.  Scott McManus

He’s still under 40, meaning he is not yet eligible for a vaccination in Victoria, but hoped his patience in the three-hour queue would be rewarded with a jab.

The couple’s experience illustrates the challenge facing the Morrison government and premiers around the national cabinet table. Health Minister Greg Hunt has talked up the increasing pace of the vaccine rollout, but the missed targets, growing vaccine hesitancy and international supply challenges have handed Labor a strong new attack on the Coalition’s pandemic management.

Opposition Leader Anthony Albanese stepped up his attacks on the government after it was revealed there was no reliable data on the number of vaccinated aged care workers.

The government’s best data – showing about 32,000 people working in residential aged care who had at least one dose – revealed a key gap among priority workers.

By early June, more than 4.7 million people across Australia had received a jab, barely more than the original target for the end of March. Frontline health, aged care and quarantine workers, as well as elderly and vulnerable people, were meant to be vaccinated by Easter.

Instead, more than 110 days into the rollout, only about 64 per cent of aged care residents nationally have received two doses, Senate estimates was told. In Victoria, where there are at least four cases linked to aged care, the number is below 60 per cent.

Roderick McRae says the new outbreak in Victoria is a “slap in the face”.  Joe Armao

Health Department boss Brendan Murphy said on Friday Victoria’s outbreak was helping drive down vaccine complacency. “It has been unfortunate that complacency had to be shaken up a bit by a small outbreak in Victoria but that is the silver lining in the cloud of our friends in Victoria that people are turning up.”

Challenged earlier in the week by Labor over whether the rollout strategy was reliant on a new threat to public health, Murphy said no. “The outbreak has focused attention, particularly in those over-50s people, some of whom have been a bit hesitant.”

He said the hesitancy would be addressed in the next stage of advertising, set to include carefully crafted messages. Created by agency BMF, the next stage is due to launch in July, with the goal of driving up vaccination rates among people under 40.

It will run across major outlets, at shopping mall sites and on social media platforms, and seek more cut-through using celebrities and humour. The bulk of the federal government’s $40 million advertising budget will go towards spending in the second half of 2021, coinciding with a boost in vaccine supply.

For the newly appointed head of the Australian Medical Association’s Victorian chapter, Roderick McRae, the current outbreak is the wake-up call the country needed.

“It’s a slap in the face and we’ve shaken off the complacency,” McRae, an intensive care doctor, anaesthetist and qualified lawyer, says. “We’ve been so well protected and lucky in Australia, there’s been a lot of comfort that ‘there’s a virus but it’s not here’, so people go ‘she’ll be right’ and put off vaccines and increase movement.

“If you look at it like bushfires, it’s like going ‘it’s glowing over in the next valley’. But now it’s like ‘my god, the flames are at my letterbox and it’s too late to grab my wedding certificate’ and we’ve got to do something.”

He believes Australia squandered the chance to cement its freedoms with vaccines when local transmission was low. However, he hopes the current outbreak will prompt state and federal authorities alike to act.

“Our behaviour has to modify, and part of the complexity before [the Victorian outbreak] was people were wanting to live life normally.

“But this virus is probably going to stay with us as a species forever, and traditionally every mutation is bigger and stronger. So now we need to take this chance to look at how we’re going to manage this and accept that we’re going to have to adapt.”

Wake-up call working for testing

That includes reducing barriers to vaccination, improving QR code check-in compliance, minimising movement, and people stepping forward to get tested at the slightest symptom.

The wake-up call already seems to be working for testing. In the week before Victoria’s outbreak took off, 65 per cent of respondents to the government-run FluTracking survey said they had not got a COVID-19 test despite having multiple symptoms.

But by this week, several of Melbourne’s coronavirus testing centres had wait times of more than three hours – despite extended hours and new pop-up sites – prompting many to stop accepting new patients.

Hassan Vally, Associate Professor in epidemiology at La Trobe University, says the outbreak is driving action on vaccination.

“We’ve seen already in countries like Singapore and Taiwan that were seen as dealing the best with COVID-19 that there’s now waves of new virus strains coming through, and that could happen here as well,” he says.

“So this has provided a bit of an impetus to get vaccinated for a large group of people who just seemed to be putting it off because there didn’t seem to be any need to hurry.”

But he warns that the lack of local COVID-19 cases is not the whole story behind the low levels of vaccinations, and says the government and public health groups need to address broader vaccine hesitancy, including fears over small numbers of serious blood clot cases.

“You have this reporting of a rare side effect that may kill you and that’s a reasonable concern,” Vally says. “But the human brain is bad at risk perception and we see things as riskier than they actually are, so it’s our job to communicate just how minute that risk actually is, and what the other benefits of vaccination to put in that risk calculus are.”

Victoria’s outbreak has thrown the illness part of that risk calculus into stark relief, as well as the continuing threat of closed schools, shuttered restaurants and the economic damage of lockdowns.

Following the new local cases, advertising experts say the federal government’s vaccine advertising campaign has failed to communicate the risks and benefits. With the spectre of sickness seemingly far from our shores and growing fear of possible side effects, it is criticised for failing to offer either a carrot or a stick to incentivise vaccinations.

People wait to get vaccinated at the Homebush mass vaccination centre in Sydney.  Dean Sewell

Jessica Kaufman, a research fellow in the Murdoch Children’s Research Institute’s vaccine uptake group, says the government needs to push out communications that deal with the concerns people have regarding the vaccines and highlight the benefits of immunity.

“People want to see someone who is 50 and has diabetes talking about why they decided to get it – real people talking about the side effects – instead of a few politicians getting the jab on TV,” Kaufman says. “It’s also a mistake to have been ignoring the younger generation in the communications campaign. Even if there isn’t [Pfizer] supply for them to get the vaccine yet themselves, they talk to their parents and their grandparents and maybe convince them to get it.”

National push

Although some states have engaged more diverse communities in their vaccine communication – Victoria, for example, runs training sessions with faith leaders on vaccine risks as part of its community engagement strategy – Kaufman says the push ultimately needs to come from the national level.

“The communication materials are dictated by the federal government, which makes some sense, but it means they need to produce more adaptable and simple and translatable materials so they can reach people all over the country.”

Experts say the next stage of the advertising rollout needs to be accompanied by more streamlined access to vaccinations and guaranteed supply.

“It’s great that people want a vaccine enough to wait for three hours in Melbourne, but they shouldn’t have to wait even 30 minutes. We need to remove all those barriers to vaccination, starting with aged care and disability support workers,” McRae says.

La Trobe’s Vally says the behaviour is easily explained.

“It’s nudge economics. You just have to keep making it easier for people to get vaccinated and harder for them not to. At some point, there’s got to be benefits for those who get vaccinated that reflect their risk of getting infected and passing it on is reduced, and by extension that means those without those protections don’t get those benefits.”

Consultant and long-time political adviser Terry Barnes says there has not been enough information about how the vaccine works, where to get it and why over-50s have AstraZeneca and under-50s have Pfizer. “I don’t think people understand that.”

Case numbers this weekend will be critical in determining the length of Victoria’s lockdown, and probably the trajectory of the pandemic around the country.

With winter officially here, Chief Medical Officer Paul Kelly has many more early morning meetings ahead.

“Widespread vaccination will give Australians more certainty we won’t have to impose snap lockdowns or close domestic borders,” he says. “Every person who is vaccinated will be helping to protect the health of their family, friends and community.”

Leave a Reply

Your email address will not be published. Required fields are marked *