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For people with chronic illness, some COVID-19 vaccine challenges

Reports today that fewer than 50 percent of over-50s in Australia are willing to get the AstraZeneca COVID-19 vaccine have raised concerns about whether vaccine hesitancy among the Australian population could threaten the vaccine program’s goal of ‘herd immunity’.

If herd immunity cannot be achieved, there will be consequences for all Australians but the implications for people with chronic conditions are particularly serious, particularly for those who are unable to be vaccinated.

Seth Ginsberg is an advocate for the arthritis and chronic disease community and president and co-founder of the Global Healthy Living Foundation, and its digital communities, CreakyJoints® and CreakyJoints Australia.

Below he discusses the implications of the recent changes to the COVID-19 vaccine program for people with chronic illnesses and argues that more intervention to assist with vaccine uptake and reducing vaccine hesitancy will be needed for some patient communities.


Seth Ginsberg writes:

The recent changes to the national COVID-19 vaccine program raise some important questions about Australia’s response to the pandemic, with particular implications for people with chronic conditions.

There are worrying signs that vaccine hesitancy is growing in Australia.

A 2020 study found that 65 percent of Australians would get a vaccination with 27 percent uncertain or in the “maybe” category.

However, more recent reports indicate that vaccine hesitancy rates could be as high as 36 percent, prompting warnings from experts that Australia risks never achieving herd immunity to COVID-19 unless it ramps up its strategy for engaging with vaccine-hesitant populations.

Today The Guardian reported on the latest Essential poll  which showed just 46 percent of those over the age of 50 said they were willing to take either the AstraZeneca or the Pfizer vaccine, with 39 percent saying they were unwilling to take the recommended AstraZeneca jab. Another 14 percent said they were unsure.

More intervention needed

There is clearly work to be done to help Australians understand the vaccines, the vaccination program, how to book an appointment for a vaccination, and more, as we navigate COVID–19 and its new variants in the evolving pandemic.

This is particularly important for the 50 percent of the Australian population who are serious chronic condition sufferers.

Observation of comments made in Australian online patient communities tells us many patients are generally happy to receive vaccinations, yet many still have questions they have not had answered.

Patients are also reporting concerns that they will be grouped with anti-vaxxers or stigmatised if they are not vaccinated.

Issues for people with chronic diseases

Some people with chronic health conditions will hesitate to get vaccinated, unsure if they can generate the antibodies required for the vaccine to work. Many don’t know if they can receive a COVID-19 vaccine due to their immunocompromised health. Recent changes to the vaccine rollout have further fuelled this uncertainty.

It is important that people with chronic health conditions discuss their concerns with their GP and specialists, particularly if they are anxious about the risks and whether they should be vaccinated now, later, or at all.

However, updated clinical guidelines in this area are only starting to become available, so clinicians may only be able to provide advice based on their professional judgement.

Where to find support

Last year Global Healthy Living Foundation (GHLF) launched a COVID-19 Patient Support Program to reach patients living with chronic conditions and diseases including the immunocompromised members of communities worldwide.

The program was informed by a patient council made up of people living with a wide range of chronic illnesses, and now serves more than 30,000 people in the US and other countries.

The program asked members of the patient communities about their experiences during COVID-19 and what they are doing to cope during lockdowns, and heard their questions.

It became a superhighway for listening to patient concerns and provided two-way conversations on COVID-19 and related subjects that have now morphed into vaccine and vaccinations conversations. This successful program continues to address the constantly evolving issues related to COVID-19 vaccines for the broader patient community.

By accessing the COVID-19 Patient Support Program, Australians with chronic conditions will soon be able to safely ask questions and find evidence-based information about the vaccine which can help them make informed decisions about their health care choices.

CreakyJoints Australia is currently working on more ways to support our patient communities that keep patients at the centre of everything, including a new podcast series called the Patient PrepRheum.

Patients can also benefit from trusted healthcare communities like the Australian Rheumatology Association, which recently shared COVID-19 vaccination advice for rheumatology patients.

The role of herd immunity

It’s also vital that Australia continues to aim for herd immunity through the vaccination program by supporting its roll-out with targeted and comprehensive information, education and support. This needs to address the concerns of people who may be vaccine hesitant, particularly in the light of the recent changes to the program.

For those Australian chronic condition patients who cannot, or choose not to, receive a COVID-19 vaccination for medical reasons, herd immunity is their only hope for protection against the disease, and the pathway for safe return into their family, community and workplace.

An earlier version of this article was published on the CreakyJoints Australia website on 14 April 2021.


See previous Croakey articles on vaccination.

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