Vaccine success depends on crucial factor
Опубликованно 07.09.2020 03:30
Australia and most of the world have been put in a holding pattern until a vaccine becomes available, with hopes this will be the silver bullet to return life to normal.
But Mr Morrison’s difficulties this week over his comments that a vaccine would be “as mandatory as you can possibly make it” highlights that success in developing a vaccine does not mean everyone will take it.
On Wednesday, Mr Morrison pulled back his comments on a potential mandatory vaccine saying it was not going to be compulsory.
“There are no compulsory vaccines in Australia,” the PM told 2GB.
“No one is going to force anybody to do anything as a compulsory measure, but we certainly will encourage people to take this up,” he said.
“Everybody needs to understand what we are trying to achieve here.”
It came after Industry, Science and Technology Minister Karen Andrews told 2GB’s Deborah Knight that the PM had made it clear “we are looking at it being a mandatory vaccine”.
“Basically, there will be medical exemptions that will be considered, but the Prime Minister’s made it clear that we are looking at it being a mandatory vaccine,” Ms Andrews said.
She said issues such as penalties for refusing the vaccine will be considered “in due course”.
The PM said during a press conference that about 95 per cent of Australians would need to be vaccinated.
“I‘m advised that we’ll need about a 95 per cent vaccination rate across the country,” Mr Morrison said.
“That is the normal target range for when you’re having a vaccination program and we’ll be seeking to ensure that that is widely implemented with our partners around the country.”
One Nation senator Pauline Hanson quickly opposed the idea saying “you have no right to say that I have to have this vaccination” and many on social media were also against the vaccine being mandatory.
“You know where you can stick that vaccine ScoMo!” one reader wrote on Facebook. “Give it to your squad but don’t you dare come near me or my family with that poison!”
The comments point to the issue of “vaccine hesitancy”, which the World Health Organisation recognised as one of the top 10 threats to public health around the world, even before the pandemic hit.
WHO suggested vaccine hesitancy may have played a part in the 30 per cent increase in measles globally.
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Not everyone is keen to get the coronavirus vaccine. Picture: Chandan Khanna/AFP
“The reasons for this rise are complex, and not all of these cases are due to vaccine hesitancy,” the WHO states. “However, some countries that were close to eliminating the disease have seen a resurgence.”
In Australia, an online survey in June found only 68 per cent said they would get the coronavirus vaccine if it became available.
The survey of 1008 Aussies conducted by comparison website Finder found one in 10 people were staunchly against getting a jab.
A further 21 per cent said they were “not sure” if they would get a vaccination.
This means around 31 per cent of Australian adults – up to six million people – may choose not to be vaccinated.
The Centre for Countering Digital Hate, a non-governmental organisation that works to counter misinformation online, warned in a July report that COVID had been a “growth opportunity for anti-vaxxers”.
“The scale and growth of the anti-vaxx movement revealed by our research is particularly concerning given that scientists estimate that 82 per cent of the population would need to become immune to COVID, either through getting the disease or through a vaccine, in order to safely manage outbreaks,” it said.
WHY ARE PEOPLE AGAINST VACCINES?
There are many different reasons people give for being against a mandatory vaccine, including a debunked conspiracy theory that vaccines will be a vehicle for the government to implant microchips in people’s bodies.
Others say it takes away people’s free choice and they don’t trust the government.
“I’m sure this is a sensible and safe idea,” one woman wrote on Facebook. “After all, our government has shown its wisdom through bushfire crisis and census.”
Suspicion has also been raised about previous medical fails including the use of thalidomide as an over-the-counter treatment for morning sickness, which led to babies being born with birth defects.
Safety appears to be one of the top concerns, with many saying they were not against vaccines but were concerned about the standard of a vaccine rolled out at record speed.
“I’m not an anti vaxxer but I will not be taking a vaccine that’s been rushed through and the long term side effects are unknown,” one man said on Facebook.
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Prime Minister Scott Morrison at the AstraZeneca laboratory in Sydney. Picture: Lisa Maree Williams/Getty Images
The Prime Minister has stressed that the vaccine will need to be proved safe.
“The vaccine will need to satisfy all the same standards that all vaccines are expected to live up to here in Australia before they’re made available to the public,” he told reporters on Wednesday.
“There won’t be any cutting corners, there won’t be undue haste here. There will be the appropriate controls and protections that are put in place.”
WHY DOES EVERYONE NEED TO TAKE IT?
Mr Morrison has said Australia needs a 95 per cent vaccination rate, although it’s unclear yet if this level of immunisation will be necessary.
Through vaccination it’s hoped “herd immunity” can be achieved so that those vulnerable members of the community, who have medical conditions for example and can’t get vaccinated, will also be protected.
The PM said the protection of some individuals “depends on the vaccine’s take-up more broadly in the community”.
“This is an important part of our vaccine strategy, not just on COVID-19, but more broadly so we will be seeking its most widespread application, as we do with all important vaccines,” he told reporters on Wednesday.
University of Melbourne Professor Tony Blakely has said previously that initial studies indicated herd immunity for coronavirus would be achieved, in theory, if 60 per cent of people got a vaccine or had been infected by the virus previously.
However, in practice more than 60 per cent may be needed due to the diversity in the population when it comes to contact patterns. There are also studies suggesting higher infection rates for the virus, which means herd immunity would also need to be higher.
The figure also assumes a vaccine is 100 per cent effective and this is rarely the case. For example, the effectiveness of the annual influenza vaccine usually varies from around 40 to 60 per cent.
“That means if we are relying on a vaccine to control COVID-19, we will need much higher coverage than 60 per cent – or permanent changes to how we socialise and interact so that a mix of changed social behaviour and an OK (but not perfect) vaccine together can get us to herd immunity,” Prof Blakely wrote in an article in Pursuit.
Behavioural scientist Julie Leask of the University of Sydney also questioned the claim that 95 per cent of the population had to be vaccinated.
She told the Sydney Morning Herald this was based on measles, which was more infectious than the coronavirus, and that herd immunity could be achieved through 40 to 80 per cent of the population receiving the vaccine.
IS IT POSSIBLE TO MAKE IT MANDATORY?
During his 2GB interview on Wednesday, the Prime Minister said there were “no things that force people to do things”.
“There are no mechanisms for compulsory, we can’t hold someone down and make them take it,” he said of a coronavirus vaccine.
“That doesn’t happen anywhere in Australia today under any of those systems.”
However, asked during a press conference earlier in the day about how he could make a vaccine mandatory, Mr Morrison pointed to his record on ‘no jab, no play’.
“I have a pretty strong view on vaccines, being the Social Services Minister that introduced ‘no jab, no play’,” he said.
The ‘no jab, no play’ program aims to improve vaccination rates among children and each state has different rules on whether non-immunised children can attend childcare and other early childhood centres.
It complements the Federal Government’s ‘no jab, no pay’ scheme, which denies parents the Family Tax Benefit Part A or child care fee assistance if their children aren’t immunised.
Exemptions for medical reasons are allowed but vaccination objection is not a valid reason.
Australia’s acting chief medical officer Professor Paul Kelly said the vaccine would at first, be voluntary and there would be strong campaigns to encourage people.
But he also noted that “we’ve had experience before of linking vaccination with other programs and all of those things will be looked at over time”.
In a later interview, Liberal MP Trent Zimmerman told ABC’s Patricia Karvelas on Thursday that it was “open to discussion” whether people would need to demonstrate they’ve had the vaccine if they went to mass events for example.
“It’s not unreasonable that for example in workplaces with large numbers of employees, big events, childcare facilities, schools etc that people will need to be able to demonstrate that they’ve had the vaccine to be able to participate in those events,” Mr Zimmerman said.
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Prime Minister Scott Morrison says a vaccine won’t be compulsory but has pointed to his record on ‘no jab, no play’. Picture: Lisa Maree Williams/Getty Images
In an article for The Conversation, Monash University senior lecturer Dr Maria O’Sullivan, a member of the Castan Centre for Human Rights Law, suggested it was not possible to subject someone to medical treatment without consent in Australia but there were some exemptions under state and territory public health laws.
She pointed to the Victorian Public Health Act that allows orders to be made to compel people to undergo a medical exam, testing and treatment without consent if it is required to address a public health issue.
Some states and territories also have mandatory vaccination policies for staff working closely with patients or infectious materials.
“In the ACT, for example, all ACT Health staff are subject to an ‘occupational assessment, screening and vaccination procedure’, which requires them to be immunised against diseases including influenza, diphtheria and hepatitis B,” she wrote.
Businesses could also require an immunisation card to be presented as a condition of entry and this could include airlines.
More complex questions existed around whether schools or universities could restrict students because children also have a right to education.
“Despite differing rules around the country, all states and territories have fairly consistent rates for childhood vaccinations — with a nationwide coverage rate of 91 per cent,” Dr O’Sullivan wrote.
“Whether the same rate could be reached for a COVID-19 vaccine remains to be seen.”
VACCINE DEBATE PREMATURE
Grattan Institute’s Stephen Duckett, a former secretary of the federal health department, told news.com.au, it’s possible the government could tie the vaccination to certain benefits, in a similar way to ‘no jab, no pay’.
“But a mandatory vaccine is probably not really consistent with the Australian ethos,” he said.
However, he said he didn’t think it was worthwhile talking about mandatory vaccines yet as it wouldn’t be an issue for another eight months at least.
“The issue about making it compulsory is a distraction as we are not going to have to address that issue for months, we probably won’t be in a situation to think about that until this time next year,” he said.
Mr Duckett said it was probably more relevant to be talking about who will get the vaccine first instead.
Prof Leask said the tough talk from the PM about a mandatory vaccine was premature and could also risk a backlash.
She told the SMH it was “far too early to be talking about mandating anything when we don’t even have a vaccine that we know actually works.”
“The public haven’t even had a chance to learn what’s on offer, how effective and safe it is, who it’s offered for and when,” she said.
charis.chang@news.com.au | @charischang2
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Vaccine success depends on crucial factor