Published in The Sydney Morning Herald, 23 March 2021

It is more than six months since Prime Minister Scott Morrison announced a deal to secure the AstraZeneca vaccine for Australia, and it is three months since the vaccination rollout started in other countries. But it is only one month since vaccinations started in Australia.

Australia’s delay was partly understandable – the virus has not been circulating in the community and so there was not the same level of urgency as in the many countries with high daily infection rates and death tolls.

But every day’s delay in Australia adds to risk – including risk from breaches of quarantine – and delays the return of the economy to normal.

Australia’s vaccine rollout has been slow and fraught. The target for the end of March is four million doses, yet only a tenth of that has been delivered. The end-of-October deadline for full rollout has been deferred by three months already. There have been well-publicised failures – overdosing of patients by a Commonwealth subcontractor and vaccines tipped down the sink.

Vaccine rollout is clearly a Commonwealth responsibility, and the Commonwealth government needs to lift its game.

Australia’s slow performance is in contrast to the massive ramp-up in the United States under President Biden and in the United Kingdom. In just two days last week – including a Saturday – more than 1.5 million people in the UK were vaccinated. The rollout there includes mass vaccination centres – an obvious and necessary strategy to achieve mass vaccination.

High-throughput vaccination centres, a feature of Australia’s flu vaccination program, don’t yet figure here to the same extent as they do overseas. We are entitled to ask the Commonwealth government: Why not?

Electronic systems to support a centralised priority system and decentralised booking – part of the original planning – has turned out to be mere vapourware.

Complaints are mounting in Australia about the first phase of the rollout – to hotel quarantine and frontline healthcare workers and residents of aged care facilities. States – responsible for quarantine and healthcare workers – claim they have been kept in the dark until the 11th hour about how many doses they will get. This has made it almost impossible for them to manage their responsibilities efficiently.

People in the first rollout group are now also complaining that the second phase – strangely named ‘Phase 1b’ – to older and at-risk Australians has started before this first stage is anywhere near finalised.

GPs are complaining about the inadequacy of their vaccine allocation and were caught by surprise when the federal Health Minister launched a booking website which directed people to call GPs to book their vaccinations. This occurred without advising GPs how many vaccine doses they would have and when. When people eventually got through on the busy phone lines, frustrated clinic staff had to cope with explaining that the GPs were in the dark about when they could confidently start booking. They are still in that state of ignorance.

Those who had started taking bookings have had to reschedule them because of the apparently random allocation of vaccines – small practices got plenty but big practices too few. No practice appears to be in the Goldilocks zone. Rules about whether GPs have autonomy about who to give bookings to – for example, can they give priority to their own patients – flip-flop around. GP frustration has hit astronomical levels.

The rollout is of course a huge logistical exercise. But after six months of hype and time to prepare, the community rightly expected good information about when their turn would come, and where they could be vaccinated. People in United Kingdom know their place in the queue and when they can expect to be vaccinated. We don’t.

Unfortunately, the rollout in Australia is still a work in progress.

So what should happen?

Firstly, let’s invest less in hype and photo opportunities and instead focus on actually managing the rollout.

Secondly, the Commonwealth government needs to set real targets – not just vague aspirations – for how many Australians are going to be at vaccinated by when. The government should publish those targets, and then each week publish progress toward achieving them.

Thirdly, the Commonwealth government should more directly engage the states in the vaccination effort. Sure, this means sharing the political glory, but it also means the states will share the political risks.

In line with Prime Minister Paul Keating’s adage – never stand between a state premier and a bucket of money – the Commonwealth should offer the states the same amount as it is offering GPs to vaccinate. In return, it should set clear performance targets about how many people should be vaccinated by when – no jabs, no pay.

Australia has handled its COVID response well so far. We should be able to handle the vaccine rollout well too. But the clock is ticking.