Marie McInerney writes:
Health experts are urging a stronger surge in vaccination rollout for Aboriginal and Torres Strait Islander communities, particularly among young people and in Western Australia, Queensland, and South Australia, where doctors say vaccination rates are “dangerously lagging”.
Aboriginal and Torres Strait Islander health experts have been warning for months about the need to step up community-led vaccination efforts and data availability to protect at-risk communities.
Yet despite an announced surge effort by the Federal Government, the Royal Australian College of General Practitioners (RACGP) today warned there was a more than 20 percent gap in vaccination rates between Indigenous and non-Indigenous people in Australia and that the upcoming Christmas and summer holiday period “could not come at a worse time”.
“The fact that there remains a serious gap in vaccine coverage between Aboriginal and Torres Strait Islander people and non-Indigenous people in our country is a national shame,” said RACGP Aboriginal and Torres Strait Islander Health Chair, Professor Peter O’Mara.
According to the RACGP, while currently 80.6 percent per cent of all Australians aged 16 and older are fully vaccinated against COVID-19 and 89.4 percent have had one dose, that figure sits at 54.5 percent fully vaccinated and 66.2 percent one dose for Aboriginal and Torres Strait Islander peoples.
The gap is worse in certain jurisdictions, particularly those currently less affected by COVID-19 outbreaks. In New South Wales, Victoria and the ACT, vaccination for Aboriginal and Torres Strait Islander people is above 80 percent first dose and 70 percent second dose, but in Queensland, South Australia and Western Australia it is below 60 percent first dose.
And those numbers are even lower in more remote areas, experts say, with the ABC reporting fewer than 10 percent of people in some remote Aboriginal communities managed by NT Health having had both doses.
Delta hit hard
Aboriginal and Torres Strait Islander people had largely escaped the first outbreaks of COVID-19 in Australia, with only 154 cases recorded throughout the pandemic as late as June 2021 and no deaths.
But Delta has dealt a significant blow, as Dr Kalinda Griffiths, a Yawuru woman and an epidemiologist at the Centre for Big Data Research in Health at the University of New South Wales, outlined at this week’s OzSage update.
Griffiths said there had now been more than 7,000 Aboriginal and Torres Strait Islander people with COVID-19: 6,000 were in New South Wales, with nearly 1,000 cases in Victoria, and 200 in the ACT.
“The most recent reporting shows that there had been over 700 Aboriginal and Torres Strait Islander cases hospitalised with 81 people who have been admitted to ICU,” she said. Fourteen Aboriginal people have died, all in NSW.
Griffiths said the Aboriginal and Torres Strait Islander OzSAGE working group’s recommendation is that 95 to 100 percent of Aboriginal and Torres Strait Islander people over the age of 12 years need to be fully vaccinated before states and territories opens up.
Similar calls have been made also by the Australian Indigenous Doctors Association, the Australian Medical Association (AMA) and the Aboriginal Medical Services Alliance Northern Territory (AMSANT).
Griffiths is also calling for better transparency, quality, and availability of dis-aggregated data, broken down and displayed by population group and regions, to identify “who needs what and where”, and urged an assessment of each jurisdiction and a plan for providing boosters shots to Aboriginal and Torres Strait Islander people.
NT modelling
In the Northern Territory, AMSANT is warning that collaboration on the vaccine rollout “is falling short in critical areas”, with concerns also that the way the NT counts its vaccination numbers is inflating its rollout numbers by including tourists and other visitors.
NT Chief Minister Michael Gunner this week said the latest Doherty modelling released by National Cabinet included specific modelling undertaken for remote communities.
He said it showed that at 80 percent fully vaccinated over age 16 – which he said the Territory will hit this week – the NT’s health system could handle 30-100 COVID cases a day with low level public health measures (PHSM) and partial test, trace, isolate and quarantine (TTIQ) measures.
Doherty had set a higher benchmark for all remote communities and homelands – with the 80 percent double dosed target moving to people aged five and over, which would only occur once the Therapeutic Goods Administration had approved vaccination for children aged 5-11, he said.
As a result, he announced additional public health measures, requiring that any worker or resident who enters a remote community with a first dose vaccination under 70 percent from Darwin, Alice Springs, Katherine or outside the NT must wear a mask for seven days at all times in public and receive a negative rapid antigen test within 72 hours of entering a community.
Gunner said the directions would apply to 25 of 52 communities managed by NT Health, and the 29 ACCHO controlled communities in the Northern Territory.
AMSANT has since released a statement saying it has agreed to a revised target of 80 percent vaccine coverage from five years of age up, beginning two months after vaccination becomes available for 5-11 year olds.
But in the meantime, it said the NT needs to stick to “90 percent coverage for Aboriginal people over the age of 16″.
AMSANT said its Board supports home quarantining with regular testing as long as it occurs only in urban areas with vaccine coverage of at least 80 percent double dose and only in households where everyone who is eligible is vaccinated.
But it said it had not been included in discussions about the planned requirement for rapid antigen testing and mask wearing in remote communities and warned that “an overly punitive approach” could undermine efforts to accelerate vaccination in these communities.
Holiday, travel risks
The RACGP has also said it is critical to ramp up vaccination rates for Aboriginal and Torres Strait Islander people, particularly those areas and age groups that are “really lagging behind”, as the holiday season approaches and travel brings with it a real risk of potentially deadly community outbreaks.
“The holiday season is just around the corner, but it couldn’t come at a worse moment because we know so many more people will be travelling and visiting regional and remote Australia; while the tourism is needed, it brings enormous risk to communities not protected by vaccination,” O’Mara said.
O’Mara also called for better data to show where the biggest gaps are in vaccine coverage and for efforts to target these areas, working together with communities and leaders to “tackle the scourge of health misinformation”.
He said improving access to testing, including use of Rapid Antigen Tests, as well as access to novel therapies such as Sotrovimab is also important, as is ensuring Aboriginal and Torres Strait Islander people have access to appropriate medical services and technologies that support telehealth.
See Croakey’s archive of stories on Indigenous health.
