Huge disparities in speed of vaccine rollout revealed

Jolyon Attwooll

20/08/2021 2:10:04 PM

Regional differences in vaccination rates have become clearer since more detailed information was published for the first time earlier this month. How does your area compare?

Map of Australia showing vaccination rates
Percentage of eligible people who received a COVID vaccination from 2–15 August.

As Australia’s worst ever COVID-19 outbreak grows more severe, the increase in vaccination rates is still varying widely, recent figures show.
As previously reported, remote regions are proving among the most difficult to cover, but recent figures also show concerning gaps in metropolitan areas – particularly in west and north west Melbourne, which are among the most slowly increasing areas in urban Australia.
Fewer than one in 10 eligible people in the Melbourne North West Statistical Area Level 4 (SA4) came forward for either their first or second dose of the vaccine in the first fortnight of this month, well below the national average of 13.7%.
The figure was also only marginally higher in Melbourne West, despite that area having some of the highest rates of active COVID-19 cases in the city.
Janelle Devereux is the Executive Director, Health Systems Integration, of the North Western Melbourne Public Health Network, which covers North West and West Melbourne. She told newsGP the data on what is driving the slower uptake in these parts of the city compared to other areas is not ‘completely clear’.
But by working with closely with the Western Public Health Unit, Ms Devereux said a number of difficulties are becoming apparent.
‘In terms of the challenges in our region, we know that we have got growth corridors to the west and the north, which tends to then indicate a higher proportion of younger people compared to the national average,’ she said.
‘So we are currently looking at data to see if that matches up in terms of what we’re seeing at SA4 [Statistical Area 4] level in terms of those lower rates.
‘We know that up until fairly recently, younger people have not been eligible for the vaccine unless they have been in one of the priority cohorts.’
And while Ms Devereux believes more younger people in the area are coming forward for the AstraZeneca (now Vaxzevria) vaccine, she said there is also anecdotal evidence of older people waiting for Pfizer to become available.
‘There has been a challenge in terms of the messaging of who was eligible for which vaccine, the process for them to be able to have a conversation about what the best vaccine is for them and to help them make those decisions and then access that locally,’ she said.

Dr Sanlakshi Liyanagama, a GP working at a clinic in Melbourne’s western suburbs, echoed that assessment.

‘There has been a lot of AstraZeneca hesitancy,’ she told newsGP. ‘To health professionals, we know why ATAGI changed age guidance; but to a layperson, it may not make adequate sense. It made more people suspicious.
‘My experience is that it is harder to convince the older age group. I feel like they are more resistant than the younger group.
‘Once the government opened up AstraZeneca access to 18–39-year-olds, I encountered a lot of young people who were happy to get either vaccine once they went through the relevant counselling.’
Dr Liyanagama had not seen the recent statistical area detail until newsGP brought it to their attention.

‘The figures on geographic vaccination rates were a bit of an eye-opener,’ she said. ‘The Melbourne western suburbs have been hit hard from the start of the pandemic, so the fact that they are lagging behind is concerning.’
Ms Devereux said there has been a need for better information in languages other than English earlier on, and highlighted a series of Goodbye COVID videos that has now launched in 20 different languages featuring community members encouraging vaccination.

She also praised the part GPs have so far played in the process.
‘We have had a fantastic response from the general practices in our region – [they are] really highly engaged and showing a really strong willingness to participate in the vaccine rollout and support local access in the community,’ Ms Devereux said.
‘We have got about 365 general practices participating in the PHN region, which is about 90% of those that are eligible.’
Dr Liyanagama said she would like to see a stronger national campaign showing the impacts of contracting COVID-19.
‘I would like to use more people who have had COVID and suffered through it for the messaging,’ she said. ‘That’s more real, rather than a doctor saying “Get this” or a politician saying it.
‘Australia hasn’t seen the worst of COVID, and I think that’s a big hindrance to the vaccine take-up as well. We haven’t seen the way other countries are suffering from it – I don’t know whether we can use that in the messaging to increase take-up.’
In the meantime, Ms Devereux is hopeful more granular detail will become available soon, allowing greater understanding of where the vaccine rollout gaps are.
‘We don’t have any more data than what you have access to in terms of general population,’ she said.
‘Any additional data that could give us an insight at a really local level [would be] absolutely welcomed.
‘I know the Commonwealth Department of Health [DoH] is really working on making that information available to us and we’re really looking forward to receiving that and being able to use that in partnership with state and general practice services.’
The DoH first began publishing rollout statistics by SA4 geographical areas at the start of this month.
These gave a snapshot of vaccination rates, but with no previous data available they gave no initial sense of any acceleration or changes in the rate of people receiving the vaccine.

Two weeks’ of data has now been published for SA4s, allowing a broader picture to form of the recent speed at which vaccination is taking place in different areas.
In some areas, particularly in and around Greater Sydney, the picture is changing remarkably swiftly. Two weeks ago, parts of Sydney at the centre of the recent outbreak were among the least vaccinated urban areas in the country.
In South-West Sydney, for example, barely a third of eligible residents over the age of 15 had been even partially vaccinated at the start of the month. That has now soared to 46.6%, with more than one in five residents stepping forward for a vaccine dose in the first two weeks of August.
NSW Health this week launched its own, much more detailed and up-to-date picture of the vaccine rollout by postcode.
In response to a newsGP enquiry, the DoH did not specify when more detailed data would be available more broadly. A spokesperson said the department undertakes ‘regular comprehensive modelling and analysis to identify projected COVID-19 vaccine gaps across Australia’, and provides data to PHNs to help ‘plan and identify any access gaps or issues’.
Dr Liyanagama is clear about the urgency of the task ahead.
‘Getting up the vaccination rate is absolutely vital,’ she said. ‘It boils down to increasing supply everywhere. If we don’t get adequate supply, and if we are not able to reach out to the masses and convince them to speed this up, we definitely could end up where Sydney is now.
‘Especially when people are going through lockdown fatigue now in Melbourne.
‘Things change overnight.’

This article has been updated to include Dr Sanlakshi Liyanagama’s name.
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