Australia, we're not making the most of a medical miracle - Grattan Institute

We’re in yet another COVID wave, but Australia is neglecting one our best defences.

Cases have been rising. Earlier this month, about 40 WA aged-care facilities had a COVID outbreak, 10 times the number of a month earlier. It’s the wrong time to drop the ball on vaccination, but that’s what we’re doing.

Only about four in 10 aged-care residents in WA have been vaccinated in the past six months. Among all Australians older than 75, fewer than three in 10 have had a recent vaccination.

It’s easy to see why. Some people are sick of thinking about vaccinations or confused by changing rules. Others think the COVID threat is over or are swayed by misinformation.

But COVID remains dangerous, vaccines are very safe for people who are recommended to get one, and regular boosters are crucial to maintain protection.

The vaccination problem goes beyond COVID. 

Just half of Australians in their 70s have had their recommended shingles vaccinations, and only one in five is vaccinated for pneumococcal disease. Most years, at least a third of older people aren’t vaccinated for flu. 

A new Grattan Institute report shows the problem gets worse when you zoom in. Whether you get vaccinated depends on factors such as where you live, where you were born, and what language you speak.

Even within Perth, the differences in COVID vaccination are stark. At the start of winter, about half of older people in Cottesloe and Claremont had been vaccinated in the previous six months. In Kwinana, the rate was just 31 per cent.

Across Australia, high-risk people who don’t speak English at home were half as likely to be recently vaccinated. The rates for some language groups are very low, in some cases just a fifth of the average. Poorer neighbourhoods, Aboriginal people, and people living in regional and remote areas are all more likely to miss out.

And all these groups are more likely to get seriously sick from infectious disease.

Fortunately, many building blocks for higher and fairer levels of adult vaccination are in place.

Governments did a lot of work during the pandemic to stock up on vaccines, improve data, expand pharmacy vaccination, and increase uptake in the most vulnerable communities. GP clinics and pharmacies worked hard too, giving tens of millions COVID vaccinations and reaching almost all high-risk people.

Australia can build on these strengths, but there’s no time to lose. Trust in vaccination is waning due to misinformation and COVID fatigue. Even before the pandemic, adult vaccination was too low. It’s time for governments to lead a vaccination reset.

First, Australia should set clear goals. About 25 years ago, we set targets for child vaccination, with goals for the whole population and for areas that lag. Child vaccination soared to hit targets and surpass some. We should set goals for adult vaccination to help repeat this success.

Second, vaccination must get easier. There should be vaccination surges in the lead-up to winter, to reduce the burden on hospitals. At those times, people at high risk should be eligible even if they’ve had a recent injection or infection. 

Surges should be accompanied by advertising that explains vaccination and makes the benefits clear. And everyone at high risk should get an SMS reminder.

That won’t work for everyone, including people in cultural groups that are missing out. Almost all of them see a GP, and many visit a pharmacy, so GP clinics and pharmacies should get more support to explain and encourage vaccination, overcome language barriers, and dispel misinformation.

For people in poverty, or who deeply distrust the health system, a different approach is needed. During the pandemic, we saw what worked. Vaccine champions spread the word in their community and language, vaccination vans visited the homeless, and vaccination tents were outside places of worship. 

These programs should continue, with secure funding, and monitoring to ensure results. All these policies should be enshrined in a national deal that provides funding and clarifies federal and state responsibilities.

COVID vaccines saved tens of thousands of lives in Australia during the pandemic. Like the other vaccines recommended, they have low risks, protect people from serious illness, and take pressure off hospitals. 

But we’re not making the most of a medical miracle.

Governments should put Australia back on the front foot by making vaccination easier for everyone, and reaching out to those who need it most.

Peter Breadon

Health Program Director
Peter Breadon is the Health Program Director at Grattan Institute. He has worked in a wide range of senior policy and operational roles in government, most recently as Deputy Secretary of Reform and Planning at the Victorian Department of Health.

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