How high can Australia’s vaccination rate go?

For Dr Kerry Chant the goal is clear.
 
The New South Wales Chief Health Officer, an ever more familiar public face since the pandemic began, wants Australia to be an outright world vaccination leader.
 
She recently told the ABC she hoped Australia could be ‘the world’s most vaccinated country’. This week, Dr Chant again promoted the possibility of reaching a 90% vaccination rate.
 
‘Maybe I’m being too optimistic, but I actually think we can,’ Dr Chant told reporters. ‘And I would like the community … to be with us.
 
‘We’ve got access to incredibly effective vaccines. We’ve a great system for administering vaccines … and we generally are a community that embraces the opportunities afforded by vaccines in preventing infectious diseases.’
 
Over-optimism or ambitious realism? Several experts have spoken to newsGP about what the overall vaccination rate could eventually look like, and what it depends upon.
 
Australia currently sits well behind the world vaccination leaders, with the rate of first doses now approaching two-thirds of the eligible population.
 
In terms of the overall population, the United Arab Emirates is the currently the world leader, with 88% of the whole population now covered, according to OurWorldInData (Australia is shown at 51%).
 
However, all those who spoke to newsGP echo Dr Chant’s optimism and believe Australia is well placed to have one of the highest coverage rates anywhere in the world.
 
But as the country’s vaccination rate shows its first signs of slowing down, all qualify their outlook by mentioning the accompanying challenges, including political unity, access, and facilitating a successful campaign to identify and convince those who remain hesitant.
 
Associate Professor Holly Seale, a University of New South Wales infectious disease social scientist, believes the vaccine rollout – well-publicised supply issues notwithstanding – has enjoyed a relatively uncomplicated phase until now.
 
‘Getting to the 70% [mark] was going to be somewhat easier because we had already had that forecast that there was at least 70% of the community willing to receive a COVID vaccine,’ she told newsGP.
 
‘Whether or not they had some concerns about which vaccine they got, they were still willing to come on this journey to receive a vaccine.’
 
Associate Professor Seale believes the key targets will be around 15% of ‘fence-sitters’, the population who have not declared either way if they will roll up their sleeves for the vaccine. It is a figure she believes will vary substantially in different places.
 
‘In some groups it may represent closer to 40% of the community,’ she said. ‘That is where we need to be mindful.
 
‘There’s a proportion of the community who are not confident about this vaccine, and they need support to understand the elements of the vaccine and to address misunderstandings about so-called long-term side effects.’
 
‘There is still – and I hear it every time I do a training session with community leaders – people who are being impacted with misinformation.
 
‘If we are not bringing all the different community groups along with us, we are going to have some trouble.’
 
It is a sentiment echoed by Professor Robert Booy, an infectious disease and vaccine expert at the University of Sydney, although he believes the current circumstances place Australia in a good position.
 
‘We can do better than US and UK,’ he told newsGP. ‘We need to do better. We need every community to hit 80%, not just a national average.
 
‘We can get at-risk communities to 90%: disability homes, schoolteachers, aged care residents and staff.
 
‘Those places where death is a real, lurking possibility, we need to be aiming for 90% not 80%.’
 
Professor Booy said the country’s burgeoning vaccine supply is one of the factors that gives him confidence that level of coverage is possible, as well as the perception of the ‘clear and present danger’ in New South Wales and Victoria.
 
‘We have got a growing percentage of people who are pro-vaccination,’ he said.
 
However, he gives the proviso that in-fighting between different levels of government needs to improve.
 
‘What we need is better cooperation and less sniping,’ he said.
 
University of Western Australia epidemiologist and biostatistician Dr Zoë Hyde also believes Australia is in a position to be ‘world-leading’.
 
‘Although it sometimes seems like anti-vaccination sentiment is common, it’s really only a small segment of the population with these fringe views,’ Professor Hyde told newsGP.
 
‘We currently achieve 95% coverage in children as part of our regular vaccination program, and so I think we’ll ultimately get good take-up of the COVID-19 vaccines as well.’
 
Professor Hyde describes a lot of the talk about vaccine hesitancy as ‘unfounded’, although she acknowledges the dragging effect of concerns over the AstraZeneca vaccine and the publicity about its very rare side effects.
 
She believes uptake is likely to ‘rise dramatically’ with greater supply of the mRNA Pfizer and Moderna vaccines, with the ongoing outbreak situation proving ‘a powerful incentive’.
 
‘That said, there are definitely some fence-sitters out there, but I think they just need to feel reassured that it’s safe,’ she said.
 
‘When they see more of the people they know getting vaccinated, I think they’ll take the plunge.’
 
However, Professor Seale believes the rollout is approaching a trickier phase.
 
There are already indications that the vaccination rate – which surged so dramatically from July to August – is showing signs of reaching a plateau, or even slightly dipping. In previous weeks, the number of vaccine doses had consistently reached more than 300,000 each day, but recently have been lower.
 


‘After 70% [vaccination rate], we are entering this point at the sharper end of the vaccine uptake program, where we are going to encounter more people who are uncertain,’ Professor Seale said.
 
‘We will see a levelling off at some point. That’s why we have got to be looking at the ongoing factors that are causing people to be fence-sitting around those vaccines.’
 
In the meantime, Professor Hyde has been advocating for vaccination rates to include a greater part of the population, including children.
 
‘It’s becoming quite clear from overseas experience that a very high proportion of the population has to be vaccinated before epidemics will end,’ she said.
 
‘We’re dealing with measles-level transmission now, and so we shouldn’t be surprised that measles-level coverage is required.’
 
The past week has brought some significant developments in Australia’s rollout and the timescales for reaching the greatest possible coverage, including the swap deal with the UK which will bring four million Pfizer doses into the country ahead of schedule.
 
COVID-19 Taskforce Commander Lieutenant General John James Frewen this week indicated the move had shifted the rollout into a transitional phase, where building towards the target rates will no longer hang on arranging new shipments.
 
‘There will be plenty of mRNA vaccines,’ he said. ‘Supply isn’t the great challenge now; it really is about people coming forward.’
 
Log in below to join the conversation.

AstraZeneca Pfizer vaccine hesitancy vaccine rollout