Informed, engaged communities for health

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#Govern4Health
#GreenHealthForum21
#HealthClimateSolutions21
#HealthReImagined
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
#WCepi2021
#YHFSummit
Croakey Professional Services
#AKctionKidneyCare
#BetterCareCOVID
#CommunityControl
#COVIDthinktank21
#KidneyCareTogether
ACSQHC series
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#HealthyCOP26
#HousingJusticeAus
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Election 2022
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Health workers
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
housing
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021
Support non-profit public interest journalism
Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#Govern4Health
#GreenHealthForum21
#HealthClimateSolutions21
#HealthReImagined
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
#WCepi2021
#YHFSummit
Croakey Professional Services
#AKctionKidneyCare
#BetterCareCOVID
#CommunityControl
#COVIDthinktank21
#KidneyCareTogether
ACSQHC series
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#HealthyCOP26
#HousingJusticeAus
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Election 2022
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Health workers
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax
tobacco control
transport
vaccination
violence
Web 2.0
weight loss products
Royal Commission
Social determinants of health
discrimination
education
housing
justice
Justice Reinvestment
NBN
Newstart
poverty
racism
social policy
Summer reading 2020-2021
Tasmanian election 2021
The Croakey Archives
#cripcroakey
#HealthEquity16
#HealthMatters
#IHMayDay (all years)
#IHMayDay 2014
#IHMayDay15
#IHMayday16
#IHMayDay17
#IHMayDay18
#LoveRural 2014
Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
#HSR15
#NRHC15
#OTCC15
Population Health Congress 2015
2016 conferences
#AHHAsim16
#AHMRC16
#ANROWS2016
#ATSISPEP
#AusCanIndigenousWellness
#cphce2016
#CPHCEforum16
#CRANAplus2016
#IAMRA2016
#LowitjaConf2016
#PreventObesity16
#TowardsRecovery
#VMIAC16
#WearablesCEH
#WICC2016
2017 conferences
#17APCC
#ACEM17
#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
#OKtoAskAu
#OTCC2017
#ResearchTranslation17
#TheMHS2017
#VMIACConf17
#WCPH2017
Australian Palliative Care Conference
2018 conferences
#6rrhss
#ACEM18
#AHPA2018
#ATSISPC18
#CPHCE
#MHED18
#NDISMentalHealth
#Nurseforce
#OKToAsk2018
#RANZCOG18
#ResearchIntoPolicy
#VHAawards
#VMIACAwards18
#WISPC18
2019 Conferences
#ACEM19
#CPHCE19
#EquallyWellAust
#GiantSteps19
#HealthAdvocacyWIM
#KTthatWorks
#LowitjaConf2019
#MHAgeing
#NNF2019
#OKtoAsk2019
#RANZCOG19
#RANZCP2019
#ruralhealthconf
#VMIAC2019
#WHOcollabAHPRA
Croakey Professional Services archive
#bettercareseries
#CommunityControl Twitter Festival
ACSQHC series 2019
Croakey projects archive
#IndigenousHealthSummit
#IndigenousNCDs
#JustClimate
#JustJustice
Croakey register of influence
Croakey Register of Influencers in Public Health
Croakey Register of Unreleased Documents
Naked Doctor
Poems of Public Health
Summer Reading 2016-2017
Summer Reading 2017-2018
The Koori Woman
Wonky Health
CroakeyGO archive 2017 – 2018
CroakeyGo 2017
#CroakeyGO Adelaide 2017
#CroakeyGO Melbourne 2017
#CroakeyGO Newcastle 2017
#CroakeyGO Sydney 2017
CroakeyGo 2018
#CroakeyGO #QuantumWords 2018
#CroakeyGO #VicVotes 2018
#CroakeyGO Albury 2018
#CroakeyGO Callan Park 2018
#CroakeyGO Carnarvon 2018
#CroakeyGO Marrickville 2018
#CroakeyGO Palm Island 2018
Elections and Budgets 2013 – 2019
#AusVotesHealth Twitter Festival 2019
#Health4NSW
#HealthElection16
Federal Budget 2009-2010
Federal Budget 2010
Federal Budget 2011
Federal Budget 2012-2013
Federal Budget 2013-14
Federal Budget 2014-15
Federal Budget 2015-16
Federal Budget 2016-17
Federal Budget 2017/18
Federal Budget 2018-19
Federal Election 2010
Federal Election 2013
Federal Election 2016
Federal Election 2019
NSW Election 2015
NSW Election 2019
NT Election 2016
Qld Election 2015
Victorian Election 2014
WA election 2021

“Freedom” is the message promoted on all sides, but we need a different conversation

Introduction by Croakey: Australians deserve freedom from misleading communications, and to be informed about some of the COVID complexities expected in the months ahead, including the rollout of a third dose and vaccination of young children.

It’s also important that lessons are learnt from the first phases of the COVID vaccine roll out, with a particular focus on priority populations, including Aboriginal and Torres Strait Islander people, according to a Croakey survey of health leaders that informs the long read below.


Linda Doherty and Melissa Sweet write:

Australians are being urged to embrace freedom – whether it’s Australian Government vaccination messaging using the tag-line #SpreadFreedom – or the placards and blanket advertising of the United Australia Party and others who’ve been protesting against vaccines (as per the feature image above).

Yet, we are so very far from freedom. Some experts, who’ve been watching a fourth wave unfold in Europe and other places, caution that we need to prepare for having three jabs, at least, to be “fully vaccinated” – not two.

Professor Kathy Eagar made the call in her COVID SNAPS column earlier this month, and so did Professor Raina MacIntyre in an online OzSage briefing this week, as well as in this article at The Conversation, ‘Will Australia follow Europe into a fourth COVID wave? Boosters, vaccinating kids, ventilation and masks may help us avoid it’.

Talk of “freedom” grates when young children won’t be vaccinated until early next year (although the Centers for Disease Control and Prevention in the United States describes the vaccine for children as “safe and effective”), and outbreaks have currently closed dozens of schools and childcare services across NSW and Victoria (see this slide presented by MacIntyre at the briefing).

Says Eagar:

The clear message as we approach the end of 2021 is that one person’s freedom is another person’s risk. And the challenge going forward is critical. Can Australians continue to work together for the collective good to keep our most vulnerable safe?

Or, now that freedom is just around the corner, will individual ‘rights’ for freedom override the willingness of Australians to act for the collective good? We do not know the answer to that question (yet).

The one thing we do know is that freedoms and risks are not equitably distributed across the community.”

Meanwhile, the World Health Organization has just issued an interim statement on COVID-19 vaccination for children and adolescents. It concludes that, as a matter of global equity, as long as many parts of the world are facing extreme vaccine shortages, countries that have achieved high vaccine coverage in high-risk populations should prioritise global sharing of COVID-19 vaccines through the COVAX facility before proceeding to vaccination of children and adolescents who are at low risk for severe disease.

Acute and long-term focus

The freedom for some to travel more widely brings serious threats when double vaccination rates in many Aboriginal communities remain low, according to data released today by the Federal Government, showing in many communities less than 50 percent of people have had two doses.

At an OzSage briefing on 22 November, Dr Kalinda Griffiths, an epidemiologist and Yawuru woman, presented data showing that nationally, 57 percent of Aboriginal and Torres Strait Islander people over the age of 12 years are fully vaccinated (read her full statement here).

The Aboriginal and Torres Strait Islander OzSAGE working group said states and territories should not open up until 95 percent of all Aboriginal and Torres Strait Islander people over the age of five were vaccinated to ensure that Aboriginal and Torres Strait Islander lives are not lost.

Governments urgently need to step up long-term investment in the Aboriginal community controlled health sector to support long-term development of a vaccination workforce and the push to roll out a third dose of the COVID vaccine, according to Dr Jason Agostino, medical advisor at the National Aboriginal Community Controlled Health Organisation (NACCHO).

The ACCHO sector will also need greater investment to address the acute and longer-term consequences of COVID’s spread among Aboriginal and Torres Strait Islander people, said Agostino, who also works as a GP at Gurriny Yealamucka, an Aboriginal community controlled health service in the community of Yarrabah in far north Queensland.

He told Croakey that Aboriginal and Torres Strait Islander people account for ten percent of COVID cases in NSW and the ACT at present. OzSage data show there have now been over 8,300 Aboriginal and Torres Strait Islander COVID19 cases. Most have been in NSW with 6,700 cases; 1,329 cases in Victoria; 219 cases reported in the ACT; and 35 cases in the Northern Territory.

Ongoing vigilance

Rather than promoting “freedom”, a range of modelling scenarios for NSW released by OzSage suggests the need to promote ongoing vigilance, through effective contact tracing conducted by public health authorities, and other public health measures, as well as vaccination of young children.

Professor Raina McIntyre, who presented the recommendations below, said the modelling showed that without such measures, health services in NSW will hit code black, with the crunch likely in late January or February.

Croakey asked a range of health leaders what can be learnt from the COVID-19 vaccine rollout to date to help inform effective and equitable delivery of the third dose – and how the Federal election might affect its rollout. The full responses are provided here and at the end of this article.

Communications critical

University of NSW researcher Associate Professor Holly Seale said more effective communication was a key lesson to take into the third year of the pandemic.

“Stop spending so much on mass communication ads and start distributing more money into community channels and to those on the ground who will be stepping up again to talk about what is needed,” she said.

She said feedback from community sectors highlighted there was ongoing confusion about the need for multiple doses of the vaccine, and a continuing lack of communication about the second dose before people could even digest the need for a third dose.

“This is reflected in the fact that there are 50,000 people who are overdue for their second dose in NSW,” said Seale, who specialises in public perceptions about infectious diseases, particularly vaccine-preventable diseases.

“The distribution of the third dose will also potentially coincide with ATAGI [the Australian Technical Advisory Group on Immunisation] approving the COVID vaccine for younger children in Australia. It might be worth nudging parents who are heading into a primary care setting for their booster vaccine to consider having a discussion about the vaccine for children. By priming the parents in advance, this may result in more useful consultations with the health provider,” she said.

Another complicating factor in 2022 is that many people will be due for their COVID booster vaccine at the same time that the influenza vaccine will be available, with predictions that the incidence of influenza will increase when state and territory borders are open and there is more domestic and international travel.

Communication void fed vaccine hesitancy

In a scathing assessment of the vaccine rollout to date, the Royal Australian College of General Practitioners (RACGP) detailed a litany of problems, including the lack of a comprehensive public health communication campaign, vaccine delays and difficulties for priority populations, sudden vaccine eligibility changes, missing doses, a confusing online booking system and a communication void that fed vaccine hesitancy and the anti-vaxxer movement.

In its submission to the Australian National Audit Office (ANAO) performance audit of Australia’s COVID-19 vaccine program, the RACGP said a key issue was delays in vaccinating priority populations, including Aboriginal and Torres Strait Islander people, residential aged care workers and people with a disability.

A RACGP survey in June found that 92 percent of members surveyed said ‘public awareness and education’ needed to improve, Price said. GPs were often the target of patient frustrations and aggressive behaviour as official advice changed on vaccine eligibility without doctors being notified, leaving them “learning about changes from our patients”.

“A vacuum was left in which anti-vaxxer groups could disseminate their misinformation. We called on all governments to strengthen their campaigns to boost vaccine confidence for this very reason. The Federal Government did produce a new advertising campaign in July urging people to ‘arm yourself’; however, by that point many were already suffering from ‘information overload’ and vaccine confidence had taken a hit,” she said.

“It’s vital that we learn from this episode so that next time a public health crisis emerges we are ready with a comprehensive, well targeted, nationwide campaign.”

Priority populations

An Australia Institute webinar earlier this month heard that the Government’s prioritisation of vulnerable and high-risk groups proved to be “a nonsense” and simply did not happen for many communities.

Dr Richard Denniss, chief economist at the Australia Institute, said: “Inequality was at the heart of the vaccination rollout.

“We were told that we were going to prioritise certain groups – Indigenous groups, people with disabilities, frontline workers…but what do we know sitting here in November? We know that today Indigenous groups still have lower vaccination rates than the general population; we know that people with disabilities have lower vaccination rates.”

Disability advocate and writer El Gibbs – who spoke at the webinar – has just had her third vaccine dose because she is eligible due to her health status as severely immuno-compromised.

But with the rollout of the third dose now available to some vulnerable groups, Gibbs is seeing the same problems disability groups have been highlighting for almost two years – confusion on eligibility and access to vaccines and a lack of accessible, consistent government health information.

The disability community felt ignored and excluded from the pandemic response and believed people with disability were de-prioritised for vaccines in the 1a and 1b category rollouts earlier this year, Gibbs told Croakey.

The sector was forced to “crowd-source information” in accessible formats to find out where vaccines were available, which types, eligibility and sites that people with disability could access.

“We’re about to repeat the whole thing again with the third vaccine dose because there is no plan to get disabled people vaccinated with the third dose,” she said.

Gibbs said the Federal Health Department list on eligibility for immunocompromised people for the third dose had a narrow set of conditions and excluded, for example, people with Down Syndrome who are more susceptible to acquiring COVID-19 and developing severe symptoms.

She said there was still no strategy for highly marginalised people with disability to receive either their second or third vaccine dose. These include people in boarding houses, those who are housebound and bedbound, people with intellectual disabilities, people leaving prison, and people who are homeless.

Lessons from Wilcannia

Also speaking at the webinar was Brendon Adams, manager of Wilcannia River Radio, who said his remote town in NSW was completely unprepared for a serious outbreak of COVID-19 in August that eventually infected more than one-third of the Indigenous population.

Despite local residents and state Aboriginal organisations calling for urgent action to restrict access to remote Aboriginal communities 18 months earlier, Adams said “the Government did not have any appropriate strategies or planning to prevent or protect our people at that time”.

The vaccination rate in Wilcannia, which has severe housing overcrowding that has been on government radars for years, was just 17 percent when COVID hit.

“When people were positive there was no alternative accommodation that we could provide for them,” Adams told the webinar.

The NSW Government brought in 30 campervans where positive people could isolate and the Australian Defence Force arrived to vaccinate and deliver vital supplies to residents but these initiatives occurred up to three weeks after the initial outbreak.

Adams said the lack of coordination of services meant the community had to improvise. He set up a foodbank with a local teacher that took donations from around the country. “We all became the frontline workers with other volunteers to help provide food to our people,” he said.

Before the outbreak Adams said vaccination information from governments was “minimal” and social media fueled fears about the vaccines among the local community. The community, again – and often via the radio station – had to step into this information void to advocate for vaccinations, particularly for the significant number of Indigenous people with chronic illnesses.

“When we got the right information in this community and had consultation then we saw the changing of attitudes,” he said.

The lingering feeling from surviving the outbreak reinforced the view of many remote residents of long-term neglect by governments, who concentrated vaccination efforts on cities and regional areas.

“I feel very strong in my spirit that we were forgotten because we were not the high priority,” Adams said.

Will election campaigning muddle the message?

The ANAO audit to assess the effectiveness of the planning and implementation of the COVID-19 vaccine rollout is due to be tabled in Parliament April 2022, which is likely to be in the middle of an election campaign and too late to influence the rollout of the third dose.

Lesley Russell, Adjunct Associate Professor at the Menzies Centre for Health Policy at the University of Sydney and a Croakey columnist, said there was no indication yet if the Federal Government has actually purchased the doses for children “and thought through how vaccinations can be delivered in ways that are least disruptive for parents and not frightening for young children”.

With the Prime Minister appearing to be already campaigning for the election, Russell said the Government was unlikely to be focused on public health and vaccination issues necessary “to prevent Australia experiencing the fourth virus wave such as is now being seen in Europe”.

But high vaccination rates and appeasing the far right and their ‘freedom’ calls risked a narrative of “job done” when a key election issue should be the ongoing need to ensure all Australians are protected against COVID-19 by vaccination, with forward planning for future booster needs, she said.

Rural Doctors Association of Australia (RDAA) president Dr Megan Bolt said the focus should be on raising the first and second dose vaccination rate.

“This phase of the vaccination campaign is far from over in some areas of rural and remote Australia, and it is critical that the Federal and State Governments do not lose sight of this,” she said.


Survey

On 24 November, Croakey asked health leaders what can be learnt from the COVID-19 vaccine rollout to date to help inform effective and equitable delivery of the third dose – and how the federal election might affect the rollout of the third dose. The full responses are provided below:

Invest in primary healthcare

Dr Jason Agostino, GP at Gurriny Yealamucka, an Aboriginal community controlled health service in the community of Yarrabah in far north Queensland, and medical advisor at NACCHO.

What we’ve learnt from the rollout of COVID vaccination to date is that we should be investing more in the primary healthcare system for the vaccine delivery. There is good data showing that most Aboriginal and Torres Strait Islander people didn’t access state-run vaccination clinics. Primary healthcare did most of the heavy lifting. Yet in the first round of the vaccine rollout, we saw resources going away from primary healthcare into state run clinics.

We need long term investment in workforce solutions for vaccination efforts going forward. We have this perfect storm coming up of chasing up the latecomers, doing childhood vaccination early next year and doing boosters as well as flu vaccine. This is a long term problem and we are going to need long term workforce solutions to address it. Staffing is a critical concern, we have really struggled to get staff into our clinics due to closed borders and due to competition from state-run clinics.

We also need consistency across the jurisdictions so Aboriginal Health Workers can deliver vaccines, they are an essential part of our service. Some progress has been made in some jurisdictions but under emergency declarations, not embedded. Our services already had a lot to do before COVID, we’ve got even more to do now. At the moment one in ten COVID positive people in the ACT and NSW are Aboriginal and Torres Strait Islander people.

We are working on how we improve surveillance of Long COVID in children, and we need to address adults too.

The third dose is essential for Aboriginal and Torres Strait Islander people. If we keep calling it a ‘booster’, there will be a perception that it’s optional.

Change up the communications

Professor Kathy Eagar, Director of the Australian Health Services Research Institute at the University of Wollongong, and COVID SNAPS columnist. 

The key lesson from the rollout to date is that, despite the political and media beat-up, Australians are not ‘vaccine hesitant’. A very tiny (but vocal) minority are ‘anti-vax’. They will probably never change. Some people have also been ‘AstraZeneca hesitant’ and there are lessons to be learned from that to ensure that that problem doesn’t happen again. Aside from AstraZeneca, only a small group were truly ‘vaccine hesitant’.

The overwhelming evidence is that Australians readily jumped at the opportunity to be vaccinated once the vaccine was actually available. Vaccine for 12 to 15 year olds only became available on 13 September – just over two months ago. But 74.7% of this age group have already had one jab and 63.5% have already had two. Two thirds of all young people aged 12 to 15 years being vaccinated in less than two months is extraordinary.  Even more extraordinary are the rates for 12 to 15 year olds in jurisdictions with COVID outbreaks – 95% double vaccination in the ACT, 77% in Victoria and 76% in NSW.

A key lesson based on international evidence is that we need to mind our language. “Double vaccinated” is not “fully vaccinated”. We will all need three jabs, and probably more, to be fully protected. We have been too slow changing our language and our policy settings to reflect this reality. It is time to stop using the percentage of the population double vaccinated as the benchmark to ease COVID restrictions. We need to bring the community with us to accept multiple COVID vaccinations as being part of the ‘new normal’.

Australians have always embraced vaccination. We have one of the highest childhood vaccination rates in the world and, after a painfully slow start, we have now had one of the fastest COVID vaccination take up rates in the world. We need to build on that track record going forward.

On the federal election question:

Australia did well in the early days of 2020 when all sides of politics, and both tiers of government worked together to steer us through the first stages of the pandemic. Sadly those days are now well and truly over.

The major lesson going forward is not to leave the third dose program in the political hands of the federal government. States and territories need to work with GPs, the aged care sector and the disability sector to ‘own’, manage and ‘sell’ the third dose rollout.

The third dose rollout is too important to be left to the political whim of federal politicians in the year of a national election.

Prioritise vaccination of children

John Gregg, CEO Australian Healthcare and Hospital Association

The COVID-19 vaccine rollout to date has shown us that vaccinating our younger populations, ensuring clear vaccine communication and supporting international vaccine efforts are critical to maintaining a COVID-safe Australia.

Vaccinating our 5- to 11-year-old age group must be prioritised over third dose vaccinations for the 12 and over population to assure maximum vaccine protection for all our communities.

We have seen a significant increase in primary schools listed as exposure sites. Uncertainties, lockdowns and missed developmental and socialisation opportunities have impacted on the wellbeing of children. Vaccinating our children will be critical to reducing the risk to the broader community as vaccinations have clearly demonstrated significant benefits in lower transmission and reducing serious complications of COVID-19.

Lessons we have learnt from the vaccine rollout to date show us that communication must be clear, consistent, concise and inclusive. AHHA’s Principle Statement on COVID-19 Vaccination Program Communication and Engagement provides government, health and community sectors and media with guiding principles to deliver clear and effective communication that will support the ongoing successful delivery of a COVID-19 vaccine strategy.

Developing countries including neighbouring Pacific nations have been hard hit by the pandemic, yet global vaccine coverage is inequitable. In order to overcome the impacts of COVID-19, there must be vaccine justice. Countries should be empowered to produce and distribute their own vaccines, without relying on wealthy nations to donate excess supply. Vaccinating the world’s population will be our key defence in overcoming the emergence of new, and more threatening variants of the virus.

The COVID vaccine rollout should not be affected by an election or politicised. Messaging should come from credible and trusted health bodies – not from political parties.

Ongoing community education is needed

Leanne Wells, CEO, Consumers Health Forum of Australia

Assured timely supply through accessible services like GPs, pharmacies, ACCHOs and community health centres is clearly the first prerequisite – and then there’s the need for ongoing community education. Communication about the importance of vaccination and boosters etc should come through multiple and trusted channels, not just advertising campaigns.

The Consumers Health Forum is rolling out a national community engagement strategy: “It’s worth the shot” to address COVID vaccine hesitancy in rural and regional Australia through story and discussion with Primary Health Networks, supported by the Australian Department of Health. This is a vital complement to current advertising media campaigns.

Services Australia is also developing the capability to send out booster notifications. However, GPs who are able to get lists from Medicare of the vaccination records/status of their patient lists for most vaccines do not yet have this for COVID vaccines.

The important lessons from the earlier vaccine rollout are having the supply and equitable spread across the country and access (types and locations). We also need to recognise that not everyone who wants to (or can be persuaded to) have their first and second doses have done so, either because of a lack of supply or because of a lack of urgency. That means there will have to be clear messaging for two different audiences.

On the approval of vaccines for 5- to 12-year old children, the Minister has made clear that vaccines for this group won’t be available until early next year. The effect of that is the lost opportunity to have children protected at the start of the new school year.

The pandemic has highlighted the links between a healthy population and our economy. The toll of extended lockdowns economically has been enormous, and that includes the toll of loneliness and mental health problems exacerbated by the pandemic on health service demand and loss of productivity. Young people, as our Youth Health Forum has told us, have been particularly hard-hit. It is in the government’s and community’s interests – election or no election – to continue to encourage high vaccination rates.

Tailored responses needed

Dr Megan Belot, President, Rural Doctors Association of Australia (RDAA)

Given there will be a staggered rollout for the third dose of the vaccine, due to the different times that individual patients had their first and second doses, we don’t foresee any major issues in the equitable or timely delivery of the third dose in rural communities.

What is of much greater concern, however, is the continuing low rate of vaccination in some areas of rural and remote Australia – particularly remote Aboriginal communities in Queensland, Western Australia and the Northern Territory.

Governments and health departments must not lose focus on getting the first and second vaccination rates at the very least above 80 percent in communities where this is lagging.

In Aboriginal communities, this means actively engaging with local elders to underpin the message about the importance of getting vaccinated, as there remains a mistrust of the vaccine in some communities.

But more widely across rural Australia, it also means ensuring that vaccination clinics are tailored to the needs of particular communities.

In some cases, it might not be the reluctance of individuals to be vaccinated but their inability to get to the nearest vaccination clinic during its opening hours, or because it is too far away. For example, the annual muster or harvest waits for nothing, so if you are trying to run a vaccination clinic during business hours at a distant regional hub at the time of year that is occurring, you probably won’t see many farming families turning up for their jab.

Take the clinic closer to the smaller outlying communities or directly onto the remote cattle stations, and make the times that people can get vaccinated more flexible, and you should see a greater uptake.

Local knowledge continues to be key in determining the best fit for a successful rollout of the vaccine in rural Australia.

How might the timing of the federal election and associated political imperatives affect rollout of the third dose?

We are confident that, in the lead-up to a federal election, the Federal Government will want to do all it can to support a high rate of first and second vaccinations – and also ensure the third dose is readily available – in order to reduce the impact of COVID across the country.

It will be critical, though, that the focus remains on getting more people vaccinated with their first and second doses. This phase of the vaccination campaign is far from over in some areas of rural and remote Australia, and it is critical that the federal and state governments do not lost sight of this.

Focus on rollout in low and middle income countries

Professor Jeffrey Braithwaite, Founding Director, Australian Institute of Health Innovation, Macquarie University

Anyone taking an international perspective, rather than a narrowly-construed, self-interested, nationalistic view will immediately see the dilemma inherent in Australians having a third vaccination.

The majority of the rest of the world, many of whom live on subsistence incomes of three dollars a day, is not even close yet to getting their first vaccination. The pandemic has taught us many things, but inequities across countries has been shown in stark realism.

It’s quite likely not a production problem, as the pharmaceutical companies are geared up to manufacture sufficient vaccines for all. But which countries serving their local population, especially wanting to please electorates if they are close to going to the polls like Australia, will send sufficient resources offshore to help?

Instead, wealthy governments have a laser focus on pleasing their domestic population rather than doing more of what is right.

It would produce much benefit if we funded a vaccination rollout in low- and middle-income countries. The paradox is we have sufficient wealth to do both. Yet I don’t see this being addressed this side of the election by the current Australian Government. Maybe the next one?

We can’t live in a bubble forever, and as the World Health Organization has pointed out, none of us is safe until we’re all safe.

Learn from experiences to date

Terry Slevin, CEO, Public Health Association of Australia

The first thing to say when it comes to third or subsequent doses is to remind everyone that too many parts of the world have not had a chance to have their first or second dose.

Boosting Australia’s contribution to COVAX, and ensuring we continue to produce the AZ vaccine as a means of ensuring supply for low- and middle-income countries is a vitally important starting point.

When it comes to third and subsequent doses domestically, learning the lessons of ensuring easy access to all Australian and having provisions for priority groups is key, as is capturing and learning from the intelligence of the current rollout.

The rollout of vaccines should never be politically driven. It should be driven by public health need, sound evidence and principled policy prioritising those most vulnerable to disease, and those with greatest disadvantage.

Forward planning needed

Associate Professor Lesley Russell, Adjunct Associate Professor at the Menzies Centre for Health Policy at the University of Sydney, and Croakey columnist, The Health Wrap

The Morrison Government has made pretty much every error and oversight that could be made when it comes to Australia’s vaccine rollout.

There’s no pre-existing roadmap for how to manage a pandemic that involves a new and unpredictable virus, but the combined expertise of federal politicians, bureaucrats, highly paid consultants, and the military man brought in to oversee the vaccine rollout has failed to foresee even the most obvious needs of a national vaccination program.

This is exemplified by the consistent lack of appropriate public awareness and education resources that are suitable for and able to reach every Australian and provided in a suitable timeframe.

On more complicated issues relating to the immunisation of children under 12, there is no indication that the Government has actually purchased the needed doses and thought through how vaccinations can be delivered in ways that are least disruptive for parents and not frightening for young children.

It seems that Morrison, increasingly nervous about his popularity with voters and his standing in the party room, is already in campaign mode for the election that must be called by May next year.

That means neither the Prime Minister nor his Ministers are focused on the public health and vaccination issues that together are necessary to prevent Australia experiencing the fourth virus wave such as is now being seen in Europe.

They want to take the high average vaccination numbers across the nation as signalling “job done” and move on to the issues they see as driving their election success.

Australia can only safely open up nationally and internationally when all Australians who are able to be vaccinated are fully immunised. That means paying special attention to those who are too often neglected by Government on a range of issues – Indigenous Australians, the disabled, the frail elderly and their carers, refugees and those who live on the fringes of society.

It’s imperative that a key issue in the forthcoming election campaign is the ongoing need to ensure all Australians are protected against COVID-19 by vaccination, with forward planning for future booster needs.

Confusion even on second dose

Associate Professor Holly Seale, University of NSW  

Feedback from some community sectors has highlighted that there remains ongoing confusion about the need for multiple doses of the vaccine and a lack of communication about the role of the second dose. This is reflected in the fact that there are 50,000 people who are overdue for their second dose in NSW.

In looking at the online information regarding the ‘booster dose’, it is acknowledged that the two doses “provide very good protection, especially against severe disease”.

The messaging about what is gained by the additional dose needs to be strengthened but would potentially benefit from reminding people that booster vaccines occur for other vaccine preventable diseases. This is not something unique to COVID, but that we have to do this for MMR, pertussis and Tdap.

Looking into 2022, we will have a large number of people needing to receive their COVID booster vaccine at the same time the influenza vaccine will be recommended and available.

Having some clear language and guidance around this early will be useful, especially as there are predictions that influenza activity will be increasing aligned with borders opening and increased travel.

After two very low flu seasons, we also need to have some great minds (and some dedicated funding) starting to think about how to promote the flu vaccine to the community!

The distribution of the third dose will also potentially coincide with ATAGI approving the COVID vaccine for younger children in Australia. It might be worth nudging parents who are heading into a primary care setting for their booster vaccine to consider having a discussion about the vaccine for children. By priming the parents in advance, this may result in more useful consultations with the health provider.

Lastly, as we move into the third year of this pandemic, time to apply lessons learnt around communication. Stop spending so much on mass communication ads and start distributing more money into community channels and to those on the ground who will be stepping up again to talk about what is needed.

• The date of the OzSage briefing was corrected after publication. It should have stated 22 November, rather than 23 November


See Croakey’s extensive archive of stories on health communications.

 

Related Posts

Leave a Reply

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

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Search by: Categories or tags

Search
Generic filters
Filter by Categories
@WePublicHealth2021
#CroakeyLIVE #Budget2021Health
#MHReform
#OutOfTheBox
#QldVotesHealth
#RCIADIC30Years
#RuralHealthJustice
#ShiftingGearsSummit
#TRIPSwaiver
2021 Floods
Budget2020Health
Bushfires
codesign
community control
COVID-19
Croakey Conference News Service
#2020ResearchExcellence
#21OPCC
#BackToTheFire
#FoodGovernance2021
#GiantSteps21
#Govern4Health
#GreenHealthForum21
#HealthClimateSolutions21
#HealthReImagined
#HearMe21
#IndigenousClimateJustice21
#NNF2021
#RANZCP2021
#SAHeapsUnfair
#ValueBasedCare
#WCepi2021
#YHFSummit
Croakey Professional Services
#AKctionKidneyCare
#BetterCareCOVID
#CommunityControl
#COVIDthinktank21
#KidneyCareTogether
ACSQHC series
Healthdirect Australia series 2019
Lowitja Indigenous knowledge translation series
Croakey projects
@WePublicHealth
@WePublicHealth2020
#CommunityMatters
#CoveringClimateNow
#CroakeyLIVE #USvotesHealth
#CroakeyREAD
#CroakeyVOICES
#CroakeyYOUTH
#HealthyCOP26
#HousingJusticeAus
#JusticeCOVID
#LookingLocal
#MRFFtransparency
#OutOfPocket
#TalkingTeeth
AroundTheTraps
Caring for the Frontline
COVID SNAPS
COVIDglobalMHseries
Croakey longreads
CroakeyEXPLORE
Gavin Mooney
Inside Story
Journal Watch
PIJ Commissions 2020
Summer Reading 2019-2020
The Conversation
The Health Wrap
TOO MUCH of a Good Thing
CroakeyGO
#CroakeyGO #NavigatingHealth
#GamblingHarms
#HeatwaveHealth
Mapping CroakeyGo
CroakeyNews
Cultural determinants of health
Digital platforms
Elections and budgets
Federal Budget 2019-20
Federal Budget 2020-21
Federal Election 2022
Federal Budget 2021-22
Global health and climate change
2019-20 climate bushfire emergency
asylum seeker and refugee health
Climate emergency
disasters
Ebola
extreme weather events
flooding 2011
global health
NHS
NZ Election 2017
WHO
health
Health workers
Healthcare and health reform
abortion
adverse events
aged care
allied health care
Australian Medical Association
cancer
cardiovascular disease
child health
Choosing Wisely
chronic diseases
co-payments
Cochrane Collaboration
complementary medicines
conflicts of interest
death and dying
diabetes
digital technology
disabilities
e-health
emergency departments and care
Equally Well
euthanasia
evidence-based issues
general practice
genetics
health & medical marketing
health and medical education
health and medical research
Health Care Homes
health ethics
health financing and costs
health reform
health regulation
health workforce
HIV/AIDS
hospitals
HRT
infectious diseases
influenza
international medical graduates
journal articles
LGBTIQ
medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
National Health Performance Authority
naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
organ transplants
out of pocket costs
pain
palliative care
paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
pharmacy
Pregnancy and childbirth
primary health care
Primary Health Networks
private health insurance
quality and safety of health care
rural and remote health
screening
sexual health
social media and healthcare
suicide
surgery
swine flu
telehealth
tests
TGA
trauma
women's health
youth health
Indigenous health
#CTG10
#NTRC
Acknowledgement
cultural safety
Indigenous education
Lowitja Institute
NT Intervention
social and emotional wellbeing
Uluru Statement
WA community closures
News about Croakey
PIJ Commissions 2021
Public health and population health
#PreventiveHealthStrategy
#UnmetNeedsinPublicHealth
air pollution
alcohol
consumer health matters
COVIDwrap
environmental health
Fetal Alcohol Spectrum Disorders (FASD)
food and nutrition
gambling
Government 2.0
gun control
health communications
health impact assessment
Health in All Policies
health inequalities
health literacy
human rights
illicit drugs
injuries
legal issues
marriage equality
Media Doctor Australia
media-related issues
nanny state
National Preventive Health Agency
obesity
occupational health
physical activity
plain packaging
prevention
public health
public interest journalism
road safety
sport
sugar tax