Why Australia needs to pick up the pace on third doses

It wasn’t long ago that Australians lined up around the block to receive a COVID vaccination. Yet the vaccination rate for third doses has almost stalled.

Given Anthony Albanese campaigned on better pandemic management, giving the vaccination program a shot in the arm will be his first test.

Join Kat Clay, Head of Digital Communications, and Peter Breadon, Health and Aged Care Program Director, as they discuss Australia’s vaccination program.

Transcript

Kat Clay: It wasn’t so long ago that Australians lined up around the block to receive a COVID vaccination, yet the vaccination rate for third doses has almost stalled. Given Anthony Albanese campaigned on better pandemic management, giving the vaccination program a shot in the arm will be his first test. I’m Kat Clay and here to talk about all things vaccinations with me on his very first Grattan podcast is our new Health and Aged Care Program Director Peter Breadon. Welcome, Peter.

Peter Breadon: Thanks, Kat. Great to be on the pod.

Kat Clay: Peter, we were practically on top of the world when it came to second dose coverage, but our third dose isn’t going so well. What’s happening there? And what’s made us so complacent?

Peter Breadon: Yeah, you’re right. I think everyone will remember that the, the vaccination program got off to a slow start, but ultimately, we did get to really high rates of coverage for a second dose, up there with the best countries in the world.

Which was great, but you’re also right with the third dose. we’ve really slowed down to almost a standstill. we’re now ranking around the middle or actually just below the middle of the, the other rich countries in the world. And we’ve slowed down so much that if we were to keep going at the current pace, it would actually take us about two years for everyone who’d had a second dose.

to get their third dose, which is obviously way too long to get, any protection ahead of winter, which we’re heading into.

Kat Clay: I mean, that leads me into my next question is why does a third dose matter so much if we’ve already got two?

Peter Breadon: Yeah, it does feel with COVID that we’re moving to goalposts all the time, but the reason things have changed is because of the new Omicron variants.

So previously with Delta, two doses would give you a really, strong protection. against, particularly hospitalization. Now with Omicron, it actually takes a third dose to get you back up to what the second dose gave you because the second dose protection, it wanes really quickly. So that’s the reason it’s really important to get the third dose because a few months out from your second dose, you’re rapidly losing the benefits.

Kat Clay: So, you mentioned winter is coming. it sounds very Game of Thrones, but is there a hard deadline on lifting these third vaccination rates?

Peter Breadon: It’s recommended to get your third dose, three months after your second dose. That’s because of the waning that I spoke about, but we’re also facing, a bit of a problem with the pandemic.

It’s gone out of the headlines. It’s probably not atop of people’s minds anymore. A lot of the public health restrictions have gone. We can largely do what we want, but the cases are high, and the hospitalizations are high. So, around the nation, you’ve got, as we record this, over 2, 800 people in hospital.

And we’re heading into winter, which does have that portentous Game of Thrones vibe. But what it means is, we’re getting other respiratory diseases. They come up in winter. And they lead to higher hospitalizations. And you’ll be hearing if anyone, who works in hospitals or in the health system, the hospital workforce is really strained.

They’re looking after these. additional patients, in there for COVID. they’ve had a lot of stresses and pressures throughout the pandemic, and now they’re looking into flu season and more admissions again. So, this is a good time to get those third doses to reduce that pressure on the system, reduce hospitalisation, as well as just the benefits you get from it in terms of reducing your own risk of severe disease.

Kat Clay: And not to mention the flu vaccine itself. I went and got mine last week and I’m really pleased I did because I’ve been a bit worried that along with COVID, the flu is going around as well, and you don’t want to get either of them.

Peter Breadon: That’s right. It is looking like it could be it. A bad flu season.

Kat Clay: So, you’ve recently done some research and put out an article with the conversation around where there are gaps in this vaccination coverage. I was wondering if you could take us through where are those specific areas where that third vaccination rate is really low?

Peter Breadon: Yes, throughout the pandemic we’ve often focused just on the national or sometimes state average levels of vaccination and driving them up which has been crucially important, but it does disguise the variation in different, communities and neighbourhoods around the country. So nationally, about 3 in 10 of people who got their second dose have so far failed to get their third dose, even though they’re eligible. So that’s a lot of people. But as you mentioned, the rates vary a lot. In the most disadvantaged neighbourhoods, that figure is over 4 in 10 people, whereas in the least disadvantaged neighbourhoods, it’s closer to 2 in 10 people.

So that’s a, that’s almost double the difference. And it’s really perverse because the protection should be highest in the lowest income and most disadvantaged neighbourhoods. Those are the communities where they’re more likely to be exposed in the first place. They tend to have larger households, more service industry jobs, where you’re interacting with more people.

And then in those communities, you’re also at higher risk if you catch the virus, because there’s higher rates of chronic disease and other risk factors, which are likely to lead to severe illness if you catch the virus. So, we’ve actually got the reverse of what we need. We need the highest coverage rates in the most disadvantaged areas.

And in fact, on average, we’ve got the opposite. It’s time to focus in on those variations. We do need to drive up, the dose uptake across the board, but we also need to look at, where the rates are low and how to turn that around.

Kat Clay: Now, I’d really like to dig in a little more about how to turn it around, and we might break this question down a little bit, but what are the ways that we can actually boost these vaccination rates, especially in poorer or remote areas?

Peter Breadon: I think it’s important to do that combination of things that are at a national or state level across the board with really intensive, tailored, local solutions. So, for the sort of across-the-board stuff, we know that, just governments talking about it again is important and leaders talking about it, promoting third dose vaccinations and also government advertising, that’s worked before and we can, ramp that back up.

And there’s always going to be this important role for state vaccination centres and aged care and disability providers to make sure those. vulnerable cohorts in particular, get their recommended doses, but with this big variation in these different pockets of the country that have low dose uptake, I think we can do more there.

And what I’m proposing is that the Commonwealth government set some standards. let’s get a minimum level we want to get to in all parts of Australia. And then let’s support the primary health networks. which manage the sort of GP and primary care systems in these local areas around Australia.

Let’s give them the targets and the accountability to get those low rates up. But let’s also give them a bit of funding, to do things that’ll work in those local areas.

Kat Clay: I think one of the other things you mentioned in your piece was talking about, setting up clinics in areas where there might not be primary health access.

Could you talk a little bit about that?

Peter Breadon: That’s right. There’s a lot of things that these primary health networks could do to try and increase, increase vaccination in their neighbourhood. So, these experience here throughout the pandemic and overseas to draw from clinics can reach out to people and give them reminders.

there’s good evidence that works, working with different community leaders and community groups, particularly if there’s fear or hesitation or misinformation, working with those leaders, to turn that around. And also, as you say, it’s setting up vaccination places that are convenient in different places like workplaces, community settings, schools.

I don’t think the barrier here is that people are really anti vaccination. I think the barrier here is more about, convenience, reminders, information, and access. But they would vary from place to place. So that’s why it’s important to give these local primary health networks the opportunity to find out what’s the problem in their area and fix it.

Kat Clay: Look, I still remember Queensland’s great idea to set up clinics at the Bunnings so you could get your sausage alongside your jab. It’s still not a bad idea, I think.

Peter Breadon: That’s right. Yeah. there’s, that could be a pretty strong incentive for some people.

Kat Clay: So, Peter, is there any advice or anything you’d like to say to our listeners at home?

Peter Breadon: It’s really important as a community that we increase this uptake of the third vax, both to protect we and to protect others. But while it’s recommended for almost everybody, there are exceptions, you might have concerns, you might want to better understand if impact is going to have, for you.

And so, I do encourage you if you’ve got any of those questions, the best place to go is your GP. And they’ll be able to help you understand whether and how to get your vaccination.

Kat Clay: Thank you so much, Peter, for coming on this short and sweet podcast, breaking down the third vaccination and why it’s so important to look into getting it done if you haven’t already.

If you’d like to continue the conversation with us on social media, you can find us on Twitter at Grattan Inst and all other social media channels at Grattan Institute. As always, please take care and thanks so much for listening.