Mapping the road to Australia’s pandemic freedom: building confidence in the vaccination process crucial

Public Health Association of Australia

It’s now 75 weeks since Australia reported its first case of COVID-19. It’s fair to say the last week – with half our population in lockdown at some point of time – was really tough. Australians, despite our relatively lucky position compared to other countries during the pandemic, are tired, and are experiencing understandable frustration.

Decisions taken at last Friday’s meeting of National Cabinet, however, give us some cause for optimism. After weeks of division, there was a new-found spirit of cooperation being encouraged amongst our political leaders. There was also a recommitment to rely on medical and scientific advice for all future decision-making. And we now have a roadmap – albeit described by Prof Adrian Esterman as “sensible” albeit “not yet very detailed, and no dates have been set out”. But its purpose – to get our nation back to some sort of normality in the next one to two years might be considered a step forward.

Between now and the end of winter we should know the agreed vaccination threshold – that magic number we need to achieve to allow us all to resume a more normal life again. But as many, including Prof Tony Blakely at the National Immunisation Conference last week, have pointed out, immunisation by itself is unlikely to be the sole solution.

Another major challenge may be getting consensus from all state and territory leaders who to date have chosen to manage the pandemic in their own jurisdictions in their own way. But as PHAA President Tarun Weeramanthri pointed out on ABC Radio Perth last week, the public have a right to expect more from our leaders. The next two months should also see vaccination numbers rapidly increasing as more vaccine becomes available.

Building confidence

Our leaders will already be aware of the importance of building greater confidence in the vaccination process. Getting the first 50% of Australian adults vaccinated should be reasonably within our grasp. There are people who see the various benefits and understand the consequences of not getting enough of us vaccinated and who have already registered for – or already received – their first and second shot.

The next challenge ahead will be to boost participation among that second 50% group. One hundred percent vaccination will never happen, but just how close can we go?

The truth is that last week, our communication and messaging on the vaccine roll out was lacklustre. That’s an area we simply must improve in the second half of this year if we’re to achieve our vaccination targets between now and Christmas and encourage all eligible Australians to get their shot.

This was among the key discussion points at last week’s virtual National Immunisation Conference presented by the Public Health Association of Australia (PHAA).

One common theme running across multiple surveys presented at the conference was that government websites are by far the most trusted place for the public to get information about the pandemic. That’s an interesting finding given our politicians are generally lower on the ‘public trust scale’, especially compared to those in public health and other medical experts who are mostly off the scale in terms of trust.

The views of healthcare workers and prioritised adults

The conference was presented with the findings of an online study, conducted in Victoria, of 3,224 healthcare workers (including aged and disability care workers) and more than 1,800 high risk members of the public (aged 70 and over or those with chronic medical conditions).

Presenter Darren Suryawijaya Ong, from the Murdoch Children’s Research Institute, said worryingly, only 27% from both groups felt they had enough information about all COVID-19 topics. They said their preferred source of information was government websites or sources, and through a discussion with their healthcare provider. The most trusted spokespeople were medical professionals, scientists, or researchers.

The survey participants provided the following ‘beliefs’ about COVID-19 vaccines, being: safe; important for my health; to protect others; and not cause me to have a serious reaction.

Reasons offered to participate in the vaccination program were:

  • to allow me to safely see family and friends again
  • close family and friends would want me to get vaccinated
  • Other adults I know would want me to get vaccinated

The main concerns identified about vaccination were: safety, long-term effects and serious reactions.

The factors which most strongly influenced vaccination decisions were:

  • the reported efficacy of the vaccine from clinical trials
  • the reported safety from the trials
  • if the vaccine was recommended by my professional society
  • if the vaccine is available at my workplace
  • required to travel overseas

The survey participants believed the following were essential components for a successful COVID-19 communications strategy:

  • personalised information about risks and benefits
  • messages from real, trusted people
  • clear, simple, shareable communication materials
  • resources for healthcare workers

And messaging must communicate about:

  • vaccine safety and effectiveness
  • expected side effects
  • benefits of vaccination
  • severity of COVID-19
  • vaccine availability

The views of young people

While so much of the focus in terms of messaging to date has been targeting older, and more vulnerable Australians, research conducted in Perth sought the views of young adults who the World Health Organization identified as the biggest spreaders of the virus during the second and third waves around the world.

Leah Roberts from University of Western Australia, said this cohort, unless in a high-risk workplace or experiencing comorbidities, are among the last group scheduled to get vaccinated in Australia. Across the world, she said there was very little specific data on the attitudes of young people towards getting a COVID-19 vaccine. Her team’s study targeted young adults aged 18-29 living in Perth, WA.

Perhaps not surprisingly given the west has been so COVID free since the pandemic started, the survey, conducted via in-depth interviews, found most participants experienced little change to their lives. The most common impacts were changes to work and education (working from home/going online), changes to travel plans, impact on social lives, and concern about potential to passing on the virus to others.

The vast majority of participants were supportive of vaccinations and trusted the health system. There was a strong sense of personal responsibility with getting the vaccine – ‘duty as global citizens’. The prime motivators for vaccination were:

  • extra protection for themselves and others: ‘the idea of having an additional layer of protection’
  • life to go back to ‘normal: ‘it kind of reopens the world up again…we’ll be able to move again, we can hug our family and friends…’
  • travel to reopen again: ‘you are allowed to travel and, at least in my case, to visit my family’

To give greater confidence, participants were strongly supportive of better communications and an advertising campaign regarding the vaccine rollout, providing:

  • information about vaccines – what’s in them and how they work
  • vaccine progress – how many people had been vaccinated and with which vaccine
  • efficacy of vaccines
  • where and when to get vaccinated
  • general positive stories – particularly for those hesitant about the vaccine.

The majority of the young participants didn’t wish to be prioritised because of their age, and felt more vulnerable groups should get the vaccine. The vast majority were also supportive of the WA Government’s response.

It will be interesting to see what communication strategies and messages our leaders will adopt in this most crucial of periods in the fight to control the pandemic in Australia.


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