Trust matters, but we also need these 3 things to augment vaccination coverage

Australia’s Covid vaccine rollout has started slowly due to supply shortages and logistical shortcomings. Once it started, we vaccinated over 95% population.

This week COVID Investigation Report makes a number of recommendations to improve Australia’s vaccine preparedness in the event of another pandemic or public health emergency.

While the investigation found most of the patterns, as vaccine experts we believe the government’s response should be expanded in three areas:

• expanding compensation programs for people who have suffered any post-vaccination effects
• better understanding why people do not keep up to date with their vaccinations
• equipping community health workers in marginalized communities to provide vaccine information and combat misinformation.

Australians should receive compensation for vaccine injuries – not just during the pandemic

Inquiry recommends reviewing Australia’s Covid-19 vaccine claims program over the next 12-18 months to inform future programs during national public health emergencies.

At the beginning of the pandemic vaccine experts called Calls on the Australian Government to establish a Covid-19 vaccine injury compensation scheme.

This meant that people who were injured in a uncommon but stern injury, or the families of people who died, would receive compensation if there was no fault in the production or administration of the vaccine.

Vaccine experts recommended creating such a scheme based on the principle of reciprocity. The Australian public has been asked to take the recommended Covid-19 vaccines in good faith for their health and community benefits. Therefore, they deserve compensation if something goes wrong.

In 2021, the Australian Government announced the Covid-19 Vaccine Claims Scheme. Australia had not previously had such a program, unlike 25 other countries, including the United States, the United Kingdom and Recent Zealand.

Australia diagram Closed on September 30, 2024

The investigation report recommends checking:

• complexity of the complaints process
• overdue or rejected payments
• any links between the program and vaccine hesitancy.

However, this is currently only included in the scope of the program for future responses to an epidemic or pandemic.

Instead, we need a enduring, ongoing compensation scheme for all routine vaccines available through the National Immunization Programme.

As we have learned from similar programs in other countries, this would contribute to the confidence needed to improve uptake of vaccines currently in the program and up-to-date ones that will be added in the future. It is also right and fair, in uncommon cases, to care for people harmed by vaccinations.

The lack of vaccinations is not solely due to lack of trust

The COVID study recommends developing a national strategy to rebuild community confidence in vaccines and improve vaccination rates, including childhood (non-COVID) vaccination rates, which are currently degenerating.

The Covid-19 vaccination program has impacted confidence in routine vaccinations. Coverage of childhood vaccinations decreased by 1-2%. There is also a persistent problem with timeliness, with children not receiving vaccines within 30 days of the recommended date.

National Vaxinsights Project examined the social and behavioral causes of under-vaccination among parents of children under five years of age. Access issues were found to be the main barrier to partially vaccinated children. Other barriers included cost, difficulty in scheduling an appointment, and the ability to prioritize appointments due to other competing needs. Trust was not the main barrier for this group.

However, for unvaccinated children, concerns about vaccine safety and effectiveness and trust in information provided by health care providers were the main issues, rather than barriers to access.

To improve vaccination rates among children, governments must monitor social and behavioral factors that influence vaccination over time to track changes in vaccine acceptance. They must also address barriers to accessing vaccination services, including affordability and clinic opening hours.

It is also imperative that we learn from the lessons learned during the pandemic and better engage communities and priority populations, such as First Nations communities, people with disabilities and people from diverse cultural groups, to build trust and improve access through community reporting and extensive vaccination programs.

To address the decline in adult vaccination rates against Covid-19, we must focus on perceptions of need, risk and value, not just trust. If adults don’t think they are at risk, they won’t get the vaccine. Unfortunately, when it comes to Covid, people have moved on and few people think they need booster doses.

Vaccine changes or improvements (such as combination vaccines to protect against Covid-19 and flu, or RSV, or vaccines with long-lasting protection) could encourage people to get vaccinated in the future. In the meantime, we agree with the study’s findings that our focus should be on those most at risk of stern outcomes, including aged care residents and people with long-term conditions.

Invest in community-led strategies to improve utilization

The COVID study recommended the development of a health emergency communications strategy to ensure all Australians, including those in priority populations, families and industries, have the information they need.

While they do not focus exclusively on vaccination promotion, the suggestions – including the need to work closely with and fund community and representative organizations – are consistent with what COVID research has shown.

However, the government should go a step further. Communication about vaccines must be adapted, translated for different cultural groups and straightforward to understand.

In some situations, vaccine news will have the greatest impact if it comes from a health care professional. But this is not always the case. Some people prefer to listen to trusted voices in their own communities. In First Nations communities, these roles are often combined in the form of Aboriginal health workers.

We must support these voices in future health emergencies.

During Covid-19 it was insufficient support and training for community facilitators – such as community leaders, faith leaders, bilingual social workers and other trusted individuals – to support their vaccine communication efforts.

The government should consider implementing, among others: national training program supporting people whose task (or volunteering) is to provide information about vaccines in health emergency situations. This would provide them with the information and confidence they need to fulfill this role, as well as prepare them to combat disinformation.