Vaccine hesitancy is contagious, so make the jab mandatory

By Sam Lovick

Published in the Australian Financial Review 21 May 2021

Four weeks ago, my wife and I got our first shots of the AstraZeneca COVID-19 vaccine, most likely made here in Australia by my alma mater, CSL. We jumped the gun. Our group, Group 2a, was not due until mid-May. But my daughter runs a GP Saturday vaccination clinic, and no-shows and low demand meant there were doses going to waste. We volunteered. Even so, there were spare doses, so we rang around our friends to advertise the surplus, to no effect. “I’ll wait”, “I’m not sure” were the typical replies.

That fits in with recent surveys. Apparently, one third of unvaccinated Australians aren’t planning to get the vaccine. If you add this to the those under 16 for which there is no vaccine as yet, we face a final vaccination rate well below 60 per cent; Australia will fail to achieve community protection through herd immunity.

Herd immunity is the best safeguard for border opening. But if we don’t achieve it, the Commonwealth still has to work out how to open up. A charitable view is that they will do so cautiously. A less charitable view is that borders will stay closed. We will all bear the costs. Home buyers in Victoria are already facing the bad news of higher stamp duty to pay off burgeoning government debt, making a bad tax worse. And it is only a matter of time before the Commonwealth discovers it cannot grow its way out of its fiscal profligacy.

To my mind, Commonwealth policy has contributed to this vaccine hesitancy. The Commonwealth used the TGA to mask the slow pace of vaccine supply. In truth, our rollout was not delayed because we were waiting for TGA approval but because we bought too little too late, the result of both bad luck and poor planning. But politicians focused on safety, not supply, for vaccines that were safe for purpose by any sensible measure.

The Commonwealth insists that vaccination is voluntary because some (largely misguided but outspoken) have a jaundiced view of vaccine safety. It compounds the problem by knee-jerk restrictions, screamed from the rooftops, on the use of the only available vaccine because of blood clots, the rates of which barely rise above the baseline level and are a fraction of the rates for women on the contraceptive pill. What message does this send to the hesitant that struggle to picture what 6 in a million means compared to others risks?

I do not suggest that adverse events should be ignored, only that they should be understood in context and weighed against other costs, not least the cost of closed borders. And if the Commonwealth can subsidise Qantas, surely it can alleviate some of the potential harm by compensating the tiny number of those that do suffer severe adverse events.

Contrast this with childhood vaccines. Ninety five per cent of our children under 5 are vaccinated with barrage of vaccines ranging from mumps to measles. Some of these vaccines have rare but serious side effects. We administer them none the less and rightly so. We don’t achieve these rates because children under 5 make better vaccination decisions but because we compel. Unvaccinated children in Victoria, absent a bona fide medical reason, can’t attend kinder!

This vaccine hesitancy appears to be contagious. Influenza has not gone away but vaccination rates are way down. Vaccination rates are half the 2019 levels for the under 5s, two-thirds the rate for school age children and 20 per cent down elsewhere. They are half the levels of last year, when COVID-19 vaccination was the great hope and flu vaccination basked in its light, before the reality of the botched rollout. It is so bad now that GP clinics are trying to resell, at a loss, the doses they have bought.

We don’t screen returning Australians for flu; flu bubbles away in the community; and last year’s social distancing measures that slowed its spread are a thing of the past. If this year’s flu season is as bad as 2017 or 2019, expect a thousand deaths, the very young and old, more still if vaccination rates do not recover.

The Commonwealth must get on the front foot for all our sakes. It should rethink voluntary COVID-19 vaccination. If children cannot attend kinder without a measles vaccination, why should we keep the borders closed so that COVID-19 unvaccinated adults can attend the footy? Governments need to re-emphasise the importance of influenza vaccination, lest a bad season becomes a disaster.

Above all, this government needs the courage to be candid about the trade-offs between health and economic outcomes. In that sense, Virgin CEO Jane Hrdlicka is correct, we don’t close borders to prevent a thousand flu deaths a year, although we could. Why? Because it makes no economic sense. The government should ask and then tell us, what level of vaccination and other measures are needed to keep COVID-19 deaths below a thousand a year? But with the borders open.