DoH COVID pages for diverse communities months out of date

The official ‘COVID-19 vaccine information in your language’ resource is one of the most prominent links on australia.gov.au, the landing page at the centre of the Federal Government’s current campaign to boost vaccination rates across the country.
 
However, the pages – which have information in 63 different languages – contain out-of-date details and have omitted important new advice from the Australian Technical Advisory Group on Immunisation (ATAGI) related to the AstraZeneca vaccine.
 
It comes as varying groups, including the Doherty Institute and ATAGI itself, urge a sharp focus on populations most at risk of COVID-19, which include many CALD communities.
 
Key changes that have not been updated online include still referring to AstraZeneca as the preferred vaccine for people aged 50 and older – advice that was changed almost eight weeks ago by ATAGI on 17 June.
 
The pages also lack any reference to ATAGI’s increasingly urgent advice to residents in outbreak areas to consider getting any available vaccine, while there is no reference to GPs offering Pfizer, nor to pharmacies offering AstraZeneca.
 
Pfizer is also still listed as being the preferred vaccine for over-50s, and there is still no detail on the recent ATAGI changes allowing at-risk children aged 12–15 to be vaccinated.
 
The outdated information was first highlighted by newsGP to the Department of Health (DoH) on 29 July. At the time of writing on 10 August, it still has not substantially changed. All 63 language pages include a note that the information is being updated, requesting that readers come back later.
 
On 30 July, a DoH spokesperson said the advice would be amended imminently. However, its most recent response confirms that this has still not taken place.
 
‘Updated in-language vaccine web content is being finalised and will be published on the Department of Health website by this Thursday,’ the spokesperson told newsGP.
 
‘A range of in-language resources have [sic] been developed to assist with COVID-19 outbreaks, particularly in Greater Sydney.
 
‘These resources, including a poster on the updated ATAGI advice about COVID-19 vaccines, have been provided to stakeholders to use and distribute and are available on the Department of Health website.’
 
The spokesperson also said other communication resources are available in diverse languages, including radio and print editorials, videos, social media content and posters.
 
They said that fact sheets ‘continue to be reviewed and new content is regularly added as new information on COVID-19 vaccines and the COVID-19 vaccine rollout is available’.
 
Many of the diverse language fact sheets published on the DoH website highlight the Translating and Interpreting Service (TIS) designed to help patients book vaccine appointments.
 
Meanwhile, the vaccine eligibility checker provided by Health Direct is now translated into a variety of languages, and the DoH has noticeably increased the number of posters and publications released in different languages.

The DoH spokesperson also said that the department has recently hosted two media briefing sessions with a large number of multicultural media, including media outlets in western Sydney, which provided ‘key information’ about the least COVID-19 outbreak advice and vaccine rollout updates.
 
Dr Mukesh Haikerwal, whose clinic is located in Melbourne’s west at the centre of the latest COVID outbreak, was also critical of the outdated website information and called for greater coordination across agencies.
 
‘You should not have inconsistency, language-to-language, on the website,’ he told newsGP.
 
‘There are good people working on this. It’s important state and federal committees working in this area triangulate and have the same messaging and same clear guidance, which I think is lacking.’
 
DISEASE OF THE UNVACCINATED
The impact of vaccination inequity within national borders is already becoming clear in places such as the US, where COVID-19 is disproportionately affecting unvaccinated communities.
 
A similar pattern may already be showing in Australia. Recent vaccine rollout information released by the Government and broken down by geography shows areas most hit by recent outbreaks in New South Wales include areas with low vaccination rates and high levels of linguistic diversity.
 
The statistical area (SA4) covering south-west Sydney, for example, remains one of the least vaccinated in New South Wales with just 17.9% of eligible residents over the age of 15 having had two vaccine doses according to the latest DoH data.
 
That is well below the national average of 23.09%, as reported on 10 August. Linguistically, the 2016 Census shows that more than one in 10 households (11.8%) speak Vietnamese at home in the area, with 8.9% speaking Arabic, while Assyrian Neo Aramaic, Spanish and Cantonese are significant minority languages occurring in more than 2% of households.

Dr Mukesh Haikerwal says it’s important for state and federal governments to have the same messaging and guidance.
 
The recent Doherty Institute modelling, provided to National Cabinet at the end of last month to help define vaccination rollout targets, underlined the importance of focusing on rates in diverse areas.
 
‘This phase of reporting defines aspirational coverage targets to minimise the consequences of community transmission,’ the report authors said of the 70% target to reach the transitional ‘Phase B’ part of the plan.
 
‘Achievement of these targets at small area level will be critical to ensure equity of program impact, as ongoing outbreaks in under-vaccinated populations are reasonably anticipated from international experience.
 
‘Particular attention should be paid to groups in whom socioeconomic, cultural and other determinants are anticipated to result in higher transmission and/or disease outcomes.’
 
It was an approach stressed by the institute’s Director of Epidemiology Professor Jodie McVernon on the ‘Infection and Immunity’ podcast earlier this week.
 
She said the 70% coverage target ‘was based on a very artificial scenario of even coverage across Australia as a single mass population’.
 
‘We know from all infectious disease programs and immunisation programs that small pockets of low vaccination coverage still allow infections to spread,’ Professor McVernon said.
 
‘We know that in many parts of the world – and we anticipate here – that many of our hard-to-reach communities are sometimes those who have higher risk of transmission because of poorer living arrangements, and they also have underlying health conditions that expose them to greater risk of severe outcomes.
 
‘So we have also strongly emphasised that those aspirational targets need to be met and perhaps even exceeded in groups of the population that do experience a higher burden of disease.
 
‘Often they are the people who are our essential workers, as we have seen in our recent New South Wales outbreak.’
 
BARRIERS TO ACCESS
One GP in Sydney said the focus on multicultural communities is not yet strong enough and that the messaging is not getting the priority it deserves.
 
Another GP working in CALD communities highlighted ‘significant’ barriers in providing COVID-19 vaccine information to their patients and described Medicare funding – which does not reimburse additional time needed to work with interpreters for example – as ‘inadequate’.
 
The same GP also highlighted the current inability to bill vaccine-specific items over the phone and the fact that GPs outside of hotspot areas are limited to billing short phone consultations only.
 
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AstraZeneca CALD COVID-19 culturally and linguistically diverse communities Pfizer vaccination vaccine hesitancy vaccine rollout