How to tackle vaccine hesitancy

by Stephen Duckett

19.05.2021 News

Published in The Sydney Morning Herald and The Age, 19 May 2021

New data published by The Age and Sydney Morning Herald suggests about a third of Australians are hesitant about getting a COVID-19 vaccine. That’s a worry for all Australians, because eventually Australia will have to reopen its border to the world.

International travel, international tourists, and international students make Australia a better and more prosperous nation. Thousands of Australians are stranded overseas, at risk of being infected, and desperate to get back home.

Reopening the border relies on so-called herd immunity, which is achieved when a sufficient majority of the population is vaccinated so that the virus can no longer spread easily. But high levels of vaccine hesitancy make it virtually impossible to achieve herd immunity.

The federal government needs to do three things to inspire confidence in the vaccination program and to tackle vaccine hesitancy. Firstly, it has to lift its game. The vaccination rollout has so far been a train wreck.

Australians need to be confident that the program is well-managed – if they see mistakes being made on a daily basis, they may suspect there are other mistakes behind the scenes that they can’t see.

Secondly, the federal government must lead efforts to lift the low vaccination rates in culturally and linguistically diverse communities. It should fund the states to work with specific communities to tackle hesitancy and misinformation in those communities.

This will require working with trusted local leaders, developing and distributing educational material in community languages, and ensuring easy access to vaccines in local communities and public housing estates.

Thirdly, the federal government needs to focus on other groups in the broader population where vaccine hesitancy is high. Right now, many Australians feel they have little reason to get vaccinated – our COVID-free status means there is little risk of getting COVID currently and so little personal benefit from getting vaccinated.

But the strong public support for the 2020 lockdowns show that Australians are not selfish. Everyone suffered – some more than others – to stop the spread of the virus.

Governments should appeal to this community solidarity to highlight the social benefit of a high level of vaccination: our parents and grandparents, and those at high risk of serious COVID-related disease, will be protected.

The federal government’s vaccine promotion campaign also needs to address the specific reasons for vaccine hesitancy, particularly the significant proportion of the public who say they are hesitant because they don’t know enough about the vaccine.

Risk communication is a science, and much is known about how people judge risks and why they may be prepared to take on some risks and not others. This knowledge needs to be used to shape public messaging, including messaging about the benefits and risks of the different vaccines. The campaign should not simply be another opportunity for politicians to hector in 30-second media grabs but rather be properly designed to change behaviour.

A public campaign can only be effective if the vaccine rollout is going smoothly and people can be vaccinated with minimal delays.

Unfortunately, that is still not the situation three months into the program.

The private calculus about vaccination will also be changed if and when the government announces the border reopening. The reopening is inevitable, but it should not occur before every Australian who wants to be vaccinated has been vaccinated.

The good news is that a significant minority of Australians who are hesitant think there is no risk so no need to be vaccinated, or that there are vaccine shortages. These people could be expected to respond well to carefully targeted messaging.

This brings us to a fourth action the federal government needs to take – it needs to overcome its own border-opening hesitancy.

Despite pressure from business and industry leaders, the government is equivocating about border reopening. The budget assumes a reopening in the middle of next year, but the Prime Minister and other senior ministers appear to have put it onto the never-never, or at least until after the next federal election.

The government appears to have weighed the private calculus of border re-openings against the potential political opprobrium of new local transmissions of COVID caused by importing the virus back into the country along with returning Australians, international students and tourists.

This border-opening hesitancy has to end. The government needs to accept that border reopening is inevitable and desirable. It should be clear about the criteria that are going to be used. That should increase the number of Australians who are willing to be vaccinated, because it would remove some of the reasons for their vaccine hesitancy.

New programs and campaigns must be developed now to address vaccine hesitance and lift vaccination rates.

Australia needs to make the transition from its current COVID-free status to a COVID-normal status, where the country learns to live with the virus circulating but in a vaccinated nation where the consequences of infection are minimal and the benefits of an open economy have been restored.