Introduction by Croakey: The COVID-19 vaccination rates of Aboriginal and Torres Strait Islander people continues to be about 20 percent below that of the general population, say health leaders who have reiterated calls for a 90-95 percent vaccination target (among those 12 years and older) before relaxing restrictions and opening borders.
The call came as the Victorian Government, in partnership with Aboriginal community controlled organisations, yesterday announced plans to boost efforts to close the vaccination gap in the state.
The plan includes the deployment of mobile outreach vans, culturally sensitive pop-ups, and surge workforce teams across Victoria to provide more opportunities to Aboriginal and Torres Strait Islanders to get vaccinated. The initiative also included a targeted SMS and social media campaign.
“Close to 80 percent of Aboriginal and Torres Strait Islander Victorians aged 12 and over have had one vaccine dose, compared to 90 percent of the wider population. When it comes to second doses, 58 percent of eligible Aboriginal and Torres Strait Islanders are fully vaccinated, compared to 71 percent of the state’s total population,” a media release stated.
Minister for Aboriginal Affairs Gabrielle Williams said of the program: “Aboriginal Community Controlled Organisations are continuing to lead the way in keeping community safe.”
The Aboriginal and Torres Strait Islander OzSAGE working group yesterday reinforced a call to ensure more than 90 percent of Aboriginal and Torres Strait Islander people aged 12 and over are vaccinated, preferably over 95 percent, before relaxation of restrictions and borders opening up.
Speaking at a media conference, Ebony Lewis, Associate Lecturer and co-lead of the Aboriginal and Torres Strait Islander Research Theme at the School of Population Health at the UNSW, said: “Currently, 59 percent of Aboriginal and Torres Strait Islander people over the age of 12 years have received at least one COVID-19 vaccine dose. Forty-five percent are fully vaccinated. Importantly in the ACT, over 80 percent of Aboriginal and Torres Strait Islander people 12 years and over have received at least one dose and NSW and Victoria are expected to pass 80 percent today.
“However, importantly, vaccine data reports around 20 percent lower rates of vaccine coverage in Aboriginal and Torres Strait people compared to the wider population. In the other states and territories, vaccine uptake continues to be lower, particularly in some remote areas which have reported extremely low vaccine coverage.”
She said there had been more than 5,500 COVID-19 cases among Aboriginal and Torres Strait Islander Peoples. “As of the 20th October, NSW had 5,156 cases in the recent Delta outbreak, Victoria has 297 and the ACT has 155. Around 600 people have been hospitalised with 65 admitted to the Intensive Care Unit and more than 10 deaths,” Lewis noted.
“Aboriginal people have been identified as a priority population since the start of the vaccine rollout and all people 12 years and over are eligible for vaccination,” Lewis said. “With easing of restrictions, Aboriginal and Torres Strait Islander people must not be left behind.
“COVID-19 is a disease of the unvaccinated, and with lower vaccination coverage, this can have devastating impacts if COVID-19 spreads through communities, particularly those in remote areas with very low vaccination coverage, as we have seen for example recently in Far Western NSW.”
In the article below, first published in The Conversation, Professor Lisa Jackson Pulver, Professor Jennifer Barrett, and Professor Melissa Haswell of the University of Sydney, and Dr Kalinda Griffiths of UNSW warn that modelling shows the vaccine uptake lag could translate into a doubling of deaths.
Lisa Jackson Pulver, Jennifer Barrett, Melissa Haswell and Kalinda Griffiths write:
Redfern’s Community Chaplain Pastor Ray Minniecon, recently made a compelling video urging people to get the COVID-19 vaccination. Pastor Minniecon regarded the simple act of becoming vaccinated as an act of love for family and community, encouraging all to get vaccinated as quickly as possible.
There have been many barriers for Aboriginal communities to access the vaccine and culturally safe healthcare during the pandemic. However for some communities, access to health services is a struggle that predates the COVID-19 pandemic.
Aboriginal people have faced decades of exclusion from government decision making resulting in poor and inappropriate housing and service provision which has impacted their health.
This did not change when the Commonwealth government declared Aboriginal and Torres Strait Islander peoples as a priority community during the initial roll-out of the COVID-19 vaccine.
All of this has contributed to a lack of trust in governments to ensure the rights and needs of Aboriginal people and communities are met.
A big concern about the current levels of vaccination in community is for younger children, Elders and others ineligible or unable to get the jab. These people could face exposure to COVID and other significant diseases.
Communities take the lead
Communities recognised the threat of this outbreak early on with actions such as developing a pandemic response plan (Apunipima, January 2020) and the development of appropriate language resources for communities (Northern Territory Land Councils, February 2020).
In addition, the National Aboriginal Community Controlled Health Organisation co-chaired the first Aboriginal and Torres Strait Islander Advisory Group on COVID-19 in March 2020.
Particularly for those living in communities outside of urban and regional areas, the risks related to COVID-19 are exacerbated by many factors. These include existing chronic illnesses and disabilities, mobility of people between communities and regions, poor and overcrowded housing and reliance on health outreach for regular health care.
Much of the care to communities is through the 143 local Aboriginal community controlled health organisations and their 300 clinics.
Recent gains by the health sector in the National Agreement on Closing the Gap offers a new era of collaboration between government, non-government organisations and community-controlled organisations. Recently in Western NSW we saw the positive impact of such collaboration when combined efforts resulted in an increase of COVID-19 vaccine doses from 20 percent first dose coverage to 70 percent in a month.
However, these organisations — like many other healthcare providers in Australia — are dealing with significant staffing shortages because of COVID-related workloads, furloughing of staff and of staff themselves becoming sick.
Highlighting service gaps
The current outbreaks of the COVID-19 Delta variant have highlighted the gap in health services for communities already under-serviced. Some of these communities have witnessed the virus “rip through communities”.
This is what has been seen in NSW and many other parts of Australia, despite the tremendous vaccine uptake of Aboriginal community members. Aboriginal people continue to be vaccinated at a rate that is 20 percent lower than the general population. This indicates devastating outbreaks will continue; not only in remote regions, but in communities closer to towns and cities.
Modelling shows this vaccine uptake lag could translate into a doubling of deaths.
Pat Turner, CEO of the National Aboriginal Community Controlled Organisation, argues that to protect communities, the aim must be to vaccinate as close as possible to 100 percent of Aboriginal people over the age of 12. Auntie Pat, whom Indigenous people will often title thus as a mark of respect, also describes how overcrowded housing and lack of places to quarantine has enabled the wildfire-like spread of COVID in some remote NSW communities, causing sickness and loss of life.
COVID is causing a further housing crisis in places where many Aboriginal people live. One example is the NSW North Coast where jobs have become precarious. This is due to long and fluctuating lockdowns and property demand from wealthy Sydney-siders anxious to escape to regional areas.
Escalating house prices diminished the already stressed stock of affordable rentals held by multiple housing organisations. In addition, rent rises under these conditions have pushed families into homelessness, poverty and higher risk of COVID infection.
These challenges and others have been years in the making, with calls from Aboriginal organisations’ for a centralised housing support strategy falling on deaf ears.
The pandemic has amplified ongoing inequalities for Aboriginal and Torres Strait Islander people. Communities have been placed at risk of losing their jobs and roofs over their heads at the same time. Overcrowding and homelessness bring multiple risks to health and well-being. These risks range from infectious diseases to mental health and safety concerns.
Uncle Ray’s and Auntie Pat’s messages, along with those of many other Aboriginal and Torres Strait Islander epidemiologists, researchers, doctors, nurses, health workers and community leaders, are exactly what Australia needs right now.
Why? Because not leaving anyone behind is a characteristic of how we care for one another.
As Auntie Yvonne Cadet-James says:
People shouldn’t be listening to gossip, there’s a lot of that in the media […] the more we get vaccinated, the more we build up that immunity as a community, so that protects everybody. The message is clear; get vaccinated, look after one another, don’t leave anyone behind. Find love in your heart and act to protect yourself, your family and your community.”
For government, Auntie Pat says, the time for others to make decisions for Aboriginal and Torres Strait Islander people is over.
Now is the time to address the longstanding inequities in health, wellbeing and the ongoing housing and employment crisis impacting Aboriginal people.
During this age of COVID, Australians must show the world our full capability to listen, get behind and champion the rights and needs of Aboriginal people.
We have never been so strong. And we can’t leave anyone behind.
Lisa Jackson Pulver is Deputy Vice-Chancellor, Professor of Public Health and Epidemiology, University of Sydney.
Jennifer Barrett is Pro Vice Chancellor Indigenous (Academic) and Director, National Centre for Cultural Competence, University of Sydney.
Kalinda Griffiths is Scientia lecturer, UNSW.
Melissa Haswell is Professor of Practice in Environmental Wellbeing, Office of the Deputy Vice Chancellor (Indigenous Strategy and Services), University of Sydney.
The authors acknowledge contributors to this article:
Emma McBryde, Professor of Infectious Disease and Epidemiology, James Cook University
Ian Ring, Professor, James Cook University
Dr Michael Doyle, Senior Research Fellow, University of Sydney
Reviewer: Dr Jason Agostino, Senior medical advisor, NACCHO, GP, Gurriny Yealamucka Health Service; Lecturer and Research Fellow, Australian National University
This article was first published in The Conversation.
Jennifer Barrett has received funding from the Australian Research Council.
Kalinda Griffiths receives funding from the National Health and Medical Research Council and the Australian Research Council. She is also Thinker in Residence at the Australian Health Promotion Association.
Emma McBryde, Ian Ring, Jason Agostino, Lisa Jackson Pulver, Melissa Haswell, and firstname.lastname@example.org do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
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