tag:theconversation.com,2011:/id/topics/vaccine-rollout-98271/articlesVaccine rollout – The Conversation2022-12-11T13:32:42Ztag:theconversation.com,2011:article/1936102022-12-11T13:32:42Z2022-12-11T13:32:42ZBeyond vaccine hesitancy: Understanding systemic barriers to getting vaccinated<figure><img src="https://images.theconversation.com/files/500127/original/file-20221209-40125-cwoufi.jpeg?ixlib=rb-1.1.0&rect=17%2C448%2C3796%2C3037&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Throughout the pandemic, much discussion about COVID-19 transmission focused on individual-level decisions, making it easy to blame the unvaccinated.</span> <span class="attribution"><span class="source">(Pixabay)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/beyond-vaccine-hesitancy--understanding-systemic-barriers-to-getting-vaccinated" width="100%" height="400"></iframe>
<p>The term “vaccine hesitancy” was in wide use years before the World Health Organization (WHO) declared COVID-19 a pandemic. The term focuses on individual-level attitudes toward vaccines. Throughout the pandemic, much <a href="https://doi.org/10.1371/journal.pone.0261942">popular</a> and <a href="https://doi.org/10.1016/j.puhe.2021.02.025">scholarly discussion</a> about COVID-19 transmission focused on individual-level decisions, making it easy to <a href="https://doi.org/10.1016%2Fj.socscimed.2022.114699">blame the unvaccinated</a>. </p>
<p>By focusing on individual decisions, it is easy to overlook other reasons for suboptimal vaccine uptake. These include <a href="https://theconversation.com/politicizing-covid-19-vaccination-efforts-has-fuelled-vaccine-hesitancy-175416">politicization</a>, <a href="https://doi.org/10.2196%2F26874">distrust of the health system due to systemic racism</a>, <a href="https://itpcglobal.org/wp-content/uploads/2022/08/Mapping-Access-Gaps-in-COVID-19.pdf">social inequities, and barriers to access and acceptance</a>. </p>
<p>The perspective that health is the result of only individual behaviours falsely disconnects well-being from important factors like systemic <a href="https://doi.org/10.1016/j.socscimed.2020.113559">social inequities</a>, community well-being and environmental health (such as <a href="https://www.who.int/health-topics/one-health#tab=tab_1">One Health</a>). The <a href="https://doi.org/10.1080/13669877.2020.1756382">focus on individual decisions</a> also reinforces widespread social norms and <a href="https://doi.org/10.1080/09581591003797129">sanctions (such as the stigmatization of the unvaccinated)</a>, which <a href="https://doi.org/10.1080/09581596.2010.520692">make individuals personally responsible</a> for keeping themselves healthy, including getting vaccinated to protect others. </p>
<p>Although there have been efforts across Canada to improve COVID-19 vaccine accessibility and acceptability among underserved populations, the success of these efforts is <a href="https://doi.org/10.1080/21645515.2022.2129827">isolated to specific communities</a> and <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/952716/s0979-factors-influencing-vaccine-uptake-minority-ethnic-groups.pdf">ongoing efforts are needed</a> to reduce inequities. As a result, many individuals who are blamed for being unvaccinated are often also denied equal access to health care and vaccination services, and credible information about vaccines from trusted sources.</p>
<p>We are a group of researchers whose work explores <a href="https://doi.org/10.1371/journal.pone.0071106">inequities</a> in vaccination <a href="https://doi.org/10.1016/j.socscimed.2022.115400">intentions</a>, <a href="https://doi.org/10.1080/21645515.2022.2129827">access</a> and <a href="https://doi.org/10.17269/s41997-022-00641-9">uptake</a> among <a href="https://doi.org/10.1101/2022.04.11.22273644">underserved populations</a>, as well as public health <a href="https://doi.org/10.1080/21645515.2022.2145822">communications</a> and <a href="https://doi.org/10.1080/13698575.2021.1994933">inequities resulting from pandemic responses</a>. We also research <a href="https://doi.org/10.1016/j.vaccine.2022.10.058">vaccine hesitancy</a>, <a href="https://doi.org/10.1016/j.vaccine.2022.11.056">public health communications</a> and the use of vaccine <a href="https://doi.org/10.2196/41012">information and misinformation</a> to show how social inequities shape vaccine uptake.</p>
<h2>What is vaccine hesitancy?</h2>
<figure class="align-center ">
<img alt="People entering a vaccination clinic" src="https://images.theconversation.com/files/500128/original/file-20221209-29029-ih1uju.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/500128/original/file-20221209-29029-ih1uju.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/500128/original/file-20221209-29029-ih1uju.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/500128/original/file-20221209-29029-ih1uju.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/500128/original/file-20221209-29029-ih1uju.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/500128/original/file-20221209-29029-ih1uju.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/500128/original/file-20221209-29029-ih1uju.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Convenience of vaccination includes availability, location accessibility and affordability of vaccination, understandability of vaccine information and appeal of vaccine services.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Jeff McIntosh</span></span>
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<p>The Strategic Advisory Group of Experts (SAGE) on Immunization at the WHO defines vaccine hesitancy as a “<a href="https://doi.org/10.1016/j.vaccine.2015.04.036">delay in acceptance or refusal of vaccination despite availability of vaccine services</a>” for various reasons, including convenience. Convenience refers to the absence of barriers to accessing and accepting vaccines. This includes availability, location accessibility, affordability of vaccination, understandability of vaccine information and appeal of vaccine services. </p>
<p>Systemic social issues affect vaccine access and acceptability. Yet, <a href="https://doi.org/10.1016/j.vaccine.2017.08.004">the term vaccine hesitancy often overlooks these, and reduces the multiple factors that affect vaccine uptake</a> to individual-level decisions. Researchers have also <a href="https://doi.org/10.1038/d41586-022-00495-8">critiqued the focus on vaccine hesitancy</a> because it distracts from the responsibility of government institutions to <a href="https://doi.org/10.1016/j.vaccine.2022.10.058">ensure vaccines are accessible</a> and acceptable to the population.</p>
<h2>Social inequities create barriers to vaccination</h2>
<p>Pre-pandemic research shows <a href="https://doi.org/10.4161/hv.24427">substantial barriers to getting vaccinated exist</a>, especially for certain populations. These include racialized and <a href="https://doi.org/10.1371/journal.pone.0071106">Indigenous Peoples</a>, people with disabilities, people living in rural and remote areas, and those with low income. For example, a recent review of studies about barriers to adult vaccination listed access <a href="https://doi.org/10.1177/17151635221090212">among the most frequently reported barriers</a>.</p>
<p>In Canada and internationally, the uptake of COVID-19 vaccines has been much higher than for other <a href="https://www150.statcan.gc.ca/n1/pub/82-003-x/2010004/article/11348-eng.htm">pandemic</a> and routine vaccines. Yet, it has been harder for those with fewer resources to get vaccinated. </p>
<p><a href="http://dx.doi.org/10.1080/21645515.2022.2129827">Participants in our research</a> identified many barriers to getting vaccinated in Spring 2021 when COVID-19 vaccines first became widely available across Canada. These barriers include technology access, language requirements, accessible transportation and childcare, <a href="https://doi.org/10.17269/s41997-022-00621-z">gaps in accommodations for disability</a> or health conditions, rigid work schedules and feeling unsafe. </p>
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<img alt="A vial of vaccine and a pile of syringes" src="https://images.theconversation.com/files/499587/original/file-20221207-4043-o3hgzd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/499587/original/file-20221207-4043-o3hgzd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/499587/original/file-20221207-4043-o3hgzd.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/499587/original/file-20221207-4043-o3hgzd.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/499587/original/file-20221207-4043-o3hgzd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/499587/original/file-20221207-4043-o3hgzd.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/499587/original/file-20221207-4043-o3hgzd.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Uptake of COVID-19 vaccines has been much higher than for routine vaccines or other pandemic vaccines (such as H1N1 flu).</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Justin Tang</span></span>
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<p>Similar barriers have been previously recognized with <a href="https://doi.org/10.1016/j.vaccine.2015.07.004">routine childhood vaccines, adult vaccines</a> and seasonal <a href="https://doi.org/10.1177/17151635221090212">vaccines</a>. </p>
<p>For racialized and Indigenous populations, whom Canada’s National Advisory Committee on Immunization identified as being at <a href="https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/guidance-prioritization-key-populations-covid-19-vaccination.html">increased risk</a> of severe illness from <a href="https://doi.org/10.1503/cmaj.202353">COVID-19 disease</a>, major <a href="https://doi.org/10.1080/17441692.2021.1912809">barriers to accepting COVID-19 vaccines</a> also include <a href="https://doi.org/10.1186/s12939-021-01410-9">contemporary</a> and <a href="https://doi.org/10.1503/cmaj.210112">historical</a> medical racism, disregard and mistreatment.</p>
<h2>Improving vaccine access and acceptance</h2>
<p>Throughout the pandemic, local non-profit, community and Indigenous organizations tailored vaccine rollouts for the people they serve. </p>
<p>For example, urban Indigenous health service providers sought <a href="https://doi.org/10.1503/cmaj.212147">to improve the accessibility</a> of culturally appropriate care for First Nations, Métis and Inuit communities, including people without shelter. However, some still noted lower uptake than in non-Indigenous populations. </p>
<p><a href="https://nafc.ca/programs/covid-19/task-group?lang=en">Across Canada</a>, <a href="https://www.millbrookband.com/new-events/2022/2/2/covid-19-vaccine-clinic">First Nations</a>, <a href="https://doi.org/10.17269/s41997-021-00603-7">Métis</a>, <a href="https://covid19.tunngavik.com/initiatives/covid-19-walk-in-vaccination-clinic/">Inuit</a> and <a href="https://bcaafc.com/help/covid-19/">Indigenous-led</a> initiatives provided culturally and linguistically appropriate <a href="https://www.mmf.mb.ca/covid-19-news/mmf-finally-able-to-offer-covid-19-vaccine-rollout-for-metis-citizens-12-and-up">clinics</a>, <a href="https://metisnationsk.com/2020/03/13/metis-nation-saskatchewan-updates-on-response-to-covid-19/">information</a> and wellness support. </p>
<p>Similarly, local organizations worked to improve vaccine accessibility for diverse peoples, including <a href="https://calgaryherald.com/news/local-news/how-calgarys-upper-northeast-achieved-canadas-best-covid-19-vaccine-rates">newcomers</a>, <a href="https://www.ctvnews.ca/health/coronavirus/good-public-health-policy-the-success-of-vaccine-clinics-for-black-racialized-canadians-1.5416822">racialized populations</a> and <a href="https://www.abilitiesmanitoba.org/news/article/4/abilities-manitoba-partners-with-community-to-provide-mobile-vaccination-options">people with disabilities</a>. </p>
<p>Provincial health authorities also worked to <a href="https://www.thestar.com/politics/provincial/2021/07/08/ontario-shifting-focus-to-better-target-those-not-vaccinated-against-covid-19.html?source=newsletter&utm_content=a01&utm_source=ts_sa&utm_medium=email&utm_email=D96C98BF127F325914880BBB38F86FF0&utm_campaign=vaccine_rollout_61599">diversify vaccination services</a>, providing <a href="https://novascotia.ca/news/release/?id=20210316006">mobile</a>, <a href="https://cisss-outaouais.gouv.qc.ca/language/en/covid19-en/covid-19-vaccination/">walk-in</a>, <a href="https://globalnews.ca/video/8461358/cars-line-up-for-drive-through-vaccine-clinic-in-kingston-ont">drive-through</a> and <a href="https://www.pvnccdsb.on.ca/durham-health-department-offering-pop-up-vaccination-clinics-in-local-schools/">pop-up</a> clinics. Federal, provincial and territorial governments also provided pandemic and vaccine information in <a href="https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/awareness-resources.html">multiple languages</a> to improve accessibility. </p>
<p>However, many of these efforts were initiated after mass vaccine clinics opened to the general public. This made it harder for populations that were recommended for vaccination early in rollouts to access the first available doses of COVID-19 vaccines. </p>
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<img alt="People walk past a blue storefront with a yellow Vaccine Clinic sign" src="https://images.theconversation.com/files/500130/original/file-20221209-25181-1qhnxv.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/500130/original/file-20221209-25181-1qhnxv.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=411&fit=crop&dpr=1 600w, https://images.theconversation.com/files/500130/original/file-20221209-25181-1qhnxv.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=411&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/500130/original/file-20221209-25181-1qhnxv.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=411&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/500130/original/file-20221209-25181-1qhnxv.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=516&fit=crop&dpr=1 754w, https://images.theconversation.com/files/500130/original/file-20221209-25181-1qhnxv.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=516&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/500130/original/file-20221209-25181-1qhnxv.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=516&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">People walk past a vaccine clinic during the COVID-19 pandemic in Mississauga, Ont. in April 2022.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Nathan Denette</span></span>
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<p>Although these initiatives improved vaccination accessibility for some underserved communities later in the rollout, <a href="https://doi.org/10.1080/21645515.2022.2129827">barriers to vaccination</a> remained high for many throughout the initial rollout, even for people who <a href="https://doi.org/10.1016/j.socscimed.2022.115400">wanted to be vaccinated</a>. </p>
<h2>Addressing barriers</h2>
<p>The overemphasis of research and public discussion on vaccine hesitancy makes systemic barriers to getting vaccinated invisible to the public. Instead, individuals are blamed for not getting vaccinated, even when access to vaccines is not equitable.</p>
<p>Without resolving barriers to vaccine access and acceptability, efforts solely focused on reducing vaccine hesitancy will not optimize vaccine uptake. Vaccine programs must be intentionally designed for those with the greatest barriers, starting with the initial rollout. </p>
<p>To improve vaccine access and trust, rollouts must occur in a contextualized way and in partnership with organizations that have community trust and experience working to improve access to health care and social justice. As modelled by local non-profit, community and Indigenous organizations, vaccine programs must be embedded in wider efforts to improve social equality and access to health care.</p><img src="https://counter.theconversation.com/content/193610/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Terra Manca currently receives funding from the Social Sciences and Humanities Research Council in the form of an Insight Development Grant for a study into how responsibility for risk mitigation, parenting, and family caregiving was assigned during the pandemic. She has previously received funding from IWK Health and the Canadian Immunization Research Network for research into how emotions and gender shape understandings of vaccination in pregnancy. </span></em></p><p class="fine-print"><em><span>Shannon MacDonald has received research operating funds from the Canadian Institutes of Health Research (CIHR), the Canadian Immunization Research Network (CIRN), and the Alberta Ministry of Health. All funds are directed toward research activities, with Dr. MacDonald receiving no financial remuneration.</span></em></p><p class="fine-print"><em><span>S. Michelle Driedger receives funding from the Canadian Institutes of Health Research for two COVID-19 projects. One project focuses on public understanding of the pandemic through public health communication concerning the virus, and protective behaviours that people can adopt to stay safe, including attitudes toward COVID-19 vaccines. The other project focuses specifically on Red River Métis experiences with the pandemic, including policies in Manitoba that excluded early access to COVID-19 vaccines in the first few months of the rollout and how this may have influenced vaccine uptake in that population group. She also received funding from the Canadian Immunization Research Network to conduct an evaluation of public health web-based communication with citizens in British Columbia, Manitoba and Ontario.</span></em></p><p class="fine-print"><em><span>Emmanuel Akwasi Marfo and Laura Aylsworth do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Systemic social issues affect vaccine access and acceptability. Yet, the term ‘vaccine hesitancy’ overlooks this, reducing the multiple factors that affect vaccine uptake to individual-level choices.Terra Manca, Research Associate, Faculty of Nursing, University of Alberta, Dalhousie UniversityEmmanuel Akwasi Marfo, Assistant researcher, Faculty of Nursing, University of AlbertaLaura Aylsworth, Research Assistant, Faculty of Nursing, University of AlbertaShannon E. MacDonald, Associate Professor, Faculty of Nursing, University of AlbertaS. Michelle Driedger, Professor, Department of Community Health Sciences, University of ManitobaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1722382021-12-12T19:10:44Z2021-12-12T19:10:44ZFarewell to 2021 in federal politics, the year of living in disappointment<figure><img src="https://images.theconversation.com/files/437037/original/file-20211212-142574-qccngn.png?ixlib=rb-1.1.0&rect=137%2C0%2C3706%2C2000&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Wes Mountain/The Conversation</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>Some will recall it as 2021. For more, it will be Year 2 of COVID. Either way, it will have been a time of disappointment for many. And the nation’s politicians need to bear a large share of the responsibility for that feeling.</p>
<p>It’s easy to imagine a different scenario. As 2020 ended, there were disappointments, too, with parts of Sydney in lockdown. But most imagined that, with vaccines on the way, our future would be brighter.</p>
<p>While there had been a tragic second wave of infections in Victoria that reflected poorly on its Labor government, the country’s decision-makers had taken advantage of Australia being an island nation, imposed external and internal border controls, and established an effective tracing system. </p>
<p>There had been some failures, and several hundred fatalities, and many Australians abroad were treated harshly. But governments succeeded in their primary duty of preserving our safety, and they seemed to have done well in propping up the economy in tough circumstances.</p>
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<img alt="" src="https://images.theconversation.com/files/436060/original/file-20211207-19-1h4xd5f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436060/original/file-20211207-19-1h4xd5f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436060/original/file-20211207-19-1h4xd5f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436060/original/file-20211207-19-1h4xd5f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436060/original/file-20211207-19-1h4xd5f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436060/original/file-20211207-19-1h4xd5f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436060/original/file-20211207-19-1h4xd5f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">By the end of 2020, mistakes had been made – particularly in Victoria – but by and large governments had protected Australians from the worst of the pandemic.</span>
<span class="attribution"><span class="source">James Ross/AAP</span></span>
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<p>What an opportunity this scenario offered! </p>
<p>An efficient vaccination program delivered rapidly in the first half of 2021, targeting vulnerable groups first, then extending quickly to the rest, would have provided substantial protection from COVID’s Delta strain when it arrived. The construction of quarantine facilities could have allowed the safe return of Australians stranded overseas.</p>
<p>Instead, the federal government mismanaged vaccine procurement, muddled its messaging, did nothing much about quarantine and stuffed up the “rollout” – both of Australia’s national dictionaries <a href="https://www.abc.net.au/news/2021-11-17/australian-word-of-the-year-is-strollout-referencing-vaccines/100626698">embraced “strollout”</a> as their Word of the Year. </p>
<p>Millions unnecessarily spent much of 2021 locked down. Some paid with their lives, and others with their health, jobs and businesses. The economy has suffered another multi-billion-dollar shock.</p>
<p>It would be easy to blame the Morrison government. After all, its indolence and squalor became increasingly plain during 2021.</p>
<p>But there is something more alarming at the heart of these failures: a basic frailty in national government. So energetic when chasing down “welfare cheats” and in persecuting whistleblowers, Australia’s federal government is just no longer very good at the hands-on delivery of anything of serious complexity.</p>
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Read more:
<a href="https://theconversation.com/as-australias-vaccination-bungle-becomes-clear-morrisons-political-pain-is-only-just-beginning-158704">As Australia's vaccination bungle becomes clear, Morrison's political pain is only just beginning</a>
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<p>The JobKeeper scheme acclaimed as a national saviour in 2020 was revealed this year as an <a href="https://www.smh.com.au/politics/federal/australians-want-jobkeeper-overpayments-given-back-to-taxpayers-20210827-p58mff.html">efficient scheme</a> whereby the already filthy rich could become even filthier and richer.</p>
<p>Unleashed in haste, it lacked basic mechanisms for checking whether those claiming its benefits had actually suffered their anticipated losses. The result has been an unprecedented looting of the country’s treasury, all within the law.</p>
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<img alt="" src="https://images.theconversation.com/files/436061/original/file-20211207-25-361n9w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436061/original/file-20211207-25-361n9w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436061/original/file-20211207-25-361n9w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436061/original/file-20211207-25-361n9w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436061/original/file-20211207-25-361n9w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436061/original/file-20211207-25-361n9w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436061/original/file-20211207-25-361n9w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Hailed in 2020 as a national saviour, JobKeeper was soon revealed to be a way for the already rich to become even richer.</span>
<span class="attribution"><span class="source">Mick Tsikas/AAP</span></span>
</figcaption>
</figure>
<p>JobKeeper contributed to a larger narrative that has gathered a hold: that the Morrison government lacks honesty and integrity. Its resistance to creating a proper anti-corruption commission is widely seen as prima facie evidence of its own fear of what one would find. </p>
<p>Scott Morrison instead raises <a href="https://www.theguardian.com/australia-news/2021/dec/07/legal-experts-condemn-scott-morrisons-continuing-attacks-on-icac-as-disgraceful-and-stupid">the furphy of ICAC’s treatment</a> of the former New South Wales premier, Gladys Berejiklian, as an objection to a federal body on anything like that model.</p>
<p>Australian conservatives and some on the Labor side, too, have long resolutely opposed the concept of a bill of rights, yet now we find just one right being elevated above others – religious freedom – which in the hands of the government amounts to an enhanced right to discriminate against sexual minorities.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/new-religious-discrimination-bill-will-cause-damage-to-australian-society-that-will-be-difficult-to-heal-172303">New religious discrimination bill will cause damage to Australian society that will be difficult to heal</a>
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</em>
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<hr>
<p>Predictably, its effort has done little more than draw adverse attention to the expansive right that already exists to do just that in the Sex Discrimination Act, the result of lobbying of the Hawke Labor government by the churches.</p>
<p>The Morrison government is certainly interested in accountability, but not in the accountability of politicians to voters. Its preferred version is the accountability of the people to their political masters. So, far from protecting whistleblowers against government illegality and wrongdoing, it prosecutes them with vigour. It sought to impose US Republican-inspired <a href="https://theconversation.com/voter-id-is-a-bad-idea-heres-why-170777">voter ID laws</a> to deal with a problem that only it seems to believe exists. </p>
<p>And it wants to <a href="https://theconversation.com/the-governments-planned-anti-troll-laws-wont-help-most-victims-of-online-trolling-172743">make it easier</a> for politicians to sue members of the public who say objectionable things about them on social media.</p>
<p>The same politicians who tell you that they believe resolutely in protecting women’s right to be free of sexual harassment maintain a workplace in Canberra, with its adjuncts in their electorate offices, that would disgrace the most rancid feudal regime.</p>
<p>Women have been harassed and even assaulted with impunity. Ministers have slept with staffers. Staffers have filmed themselves masturbating on desks. There is no recourse for the victims of this regime unless, like former Liberal staffers Brittany Higgins and Rachelle Miller, they go to the media.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/436069/original/file-20211207-140267-y338zb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436069/original/file-20211207-140267-y338zb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436069/original/file-20211207-140267-y338zb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436069/original/file-20211207-140267-y338zb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436069/original/file-20211207-140267-y338zb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436069/original/file-20211207-140267-y338zb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436069/original/file-20211207-140267-y338zb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Women have been treated disgracefully within Parliament House. This year some brave women, such as Brittany Higgins, called it out.</span>
<span class="attribution"><span class="source">Lukas Coch/AAP</span></span>
</figcaption>
</figure>
<p>The reckoning in these matters has arrived, but the prime minister repeatedly displayed his inability to understand what is at stake. On one occasion, he began a media conference expressing his sympathies with the plight of women but ended up issuing a thinly veiled threat to the female journalist most prominent in reporting of the issue.</p>
<p>Which brings us to Morrison himself. </p>
<p>The idea that he routinely lies now clings to him like a politician to a freebie. The <a href="https://theconversation.com/view-from-the-hill-scott-morrison-caught-in-catch-22-over-the-issue-of-his-integrity-171750">extraordinary attack</a> on him by French President Emmanuel Macron, over the mismanagement of the submarine contract and the AUKUS agreement, confirmed a sense of Morrison as a small-time Sydney politician morally and intellectually out of his depth, and lacking in the necessary gravitas or judgment to deal with complex international affairs and major world leaders.</p>
<p>It seemed odd, at the beginning of 2021, that we still didn’t have a single book about him. Was he too uninteresting to bother? </p>
<p>Now we have several, but the turn in Morrison’s fortunes was so rapid that it defeated the efforts of authors to keep up. When Wayne Errington and Peter Van Onselen’s How Good is Scott Morrison? went off to the printers, the authors were convinced he was a shoo-in for the next election. By the time it appeared in the bookshops, the edited extract that appeared in The Australian suggested they were <a href="https://insidestory.org.au/once-a-winner/">rather less sure</a>.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/is-morrison-gaining-a-reputation-for-untrustworthiness-the-answer-could-have-serious-implications-for-the-election-171816">Is Morrison gaining a reputation for untrustworthiness? The answer could have serious implications for the election</a>
</strong>
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</p>
<hr>
<p>The year saw a remarkable leaching of Morrison’s standing and authority, not least in relation to state and territory leaders. </p>
<p>But they too had their problems: Berejiklian lost her job when ICAC announced it had launched an investigation into her conduct. Daniel Andrews in Victoria suffered a serious back injury at the beginning of the year and faced large “freedom” protesters waving the Eureka Flag at the end of it. Mark McGowan seems a little less shiny than a year ago, as Western Australia’s severe border restrictions extend into 2022.</p>
<p>And we have a federal election to come. </p>
<p>Labor leader Anthony Albanese, having kept his powder dry for years, is beginning to drip-release policies, seeking just enough distance over issues such as climate policy for product differentiation without frightening the horses. He seems to wish to slip quietly into office rather as numerous Labor state and territory opposition leaders have done over the past 25 years. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/436070/original/file-20211207-141178-hxpgi7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/436070/original/file-20211207-141178-hxpgi7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/436070/original/file-20211207-141178-hxpgi7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/436070/original/file-20211207-141178-hxpgi7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/436070/original/file-20211207-141178-hxpgi7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/436070/original/file-20211207-141178-hxpgi7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/436070/original/file-20211207-141178-hxpgi7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Labor’s Anthony Albanese: hoping to slip quietly into office?</span>
<span class="attribution"><span class="source">Dean Lewins/AAP</span></span>
</figcaption>
</figure>
<p>Morrison is now transformed from goofy Scomo into biblical Moses, leading his people out of the COVID desert into the Promised Land of “Freedom”. </p>
<p>But he still must try keeping the increasingly wild right flank of his Coalition government solid while attending to the threat that independent and Labor candidates pose to metropolitan Liberal seats.</p>
<p>His government ended the year by losing two ministers to scandals, with another announcing his retirement at the next election. Morrison’s grip on the Coalition party room was now so loose that it called into question his grip on the House of Representatives itself. </p>
<p>The election result seems less certain than in the months before the 2019 election when it was all rather obvious that Labor and Bill Shorten were heading for a famous victory. </p>
<p>Readers will understand if I refrain from offering a prediction.</p><img src="https://counter.theconversation.com/content/172238/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Frank Bongiorno does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Whether it’s been the vaccine rollout, a federal ICAC, political scandals or the treatment of women, the Morrison government has had a shocking year. But will it pay for it in 2022?Frank Bongiorno, Professor of History, ANU College of Arts and Social Sciences, Australian National UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1727592021-11-30T03:49:00Z2021-11-30T03:49:00Z‘Strollout’ has gathered pace, romping home as the Macquarie word of the year. I’d have gone for ‘vax’ if on the list<figure><img src="https://images.theconversation.com/files/434584/original/file-20211129-14-c2rg6p.jpg?ixlib=rb-1.1.0&rect=5%2C5%2C3507%2C2071&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>In a break from the usual tradition, <a href="https://www.macquariedictionary.com.au/resources/view/word/of/the/year/">Macquarie</a> asked the public to choose their word of the year in advance of the committee’s decision. The pundits were betting on a COVID-19 inspired word and the shortlist certainly contained possibilities related to the pandemic: “Delta”, “shadow pandemic”, and “strollout”. And they were right!</p>
<p>Macquarie’s other 16 possibilities included more obscure choices such as “humane washing” to describe “the misleading marketing of a product sourced from animals, deceptively giving the impression that the animals have been treated humanely” and “dry scooping” to describe the “practice of ingesting powdered pre-workout supplements or protein powder without mixing with water or milk as directed”.</p>
<p>Many of the wordsmiths I shared the list with had not heard of most of them. Neither had I. For example, “brain tickler” instead of nose swab.</p>
<p>Nor could we see ourselves using such terms as “hate-follow” (of sites whose content we disagreed with) or “front-stab” (as opposed to back-stab). We were offended by “menty-b” for mental breakdown and not that curious about “sober curious”. </p>
<p>And I’m too fond of proper baking to prepare a “dump cake” by combining the ingredients directly in the cake tin in which the cake is to be baked. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/434632/original/file-20211130-20-gj10jv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/434632/original/file-20211130-20-gj10jv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/434632/original/file-20211130-20-gj10jv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/434632/original/file-20211130-20-gj10jv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/434632/original/file-20211130-20-gj10jv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/434632/original/file-20211130-20-gj10jv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/434632/original/file-20211130-20-gj10jv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/434632/original/file-20211130-20-gj10jv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">The term ‘menty-b’ gained popularity online as a shorthand for a pandemic induced ‘mental breakdown’.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>Macquarie has just announced the result of the committee’s AND the people’s choice: both chose “strollout”. <a href="https://www.abc.net.au/news/2021-11-30/covid-vaccine-strollout-macquarie-dictionary-word-year-australia/100659388">Defined as a “blend of rollout and stroll”</a>, the word refers to the “perceived lack of speed” in Australia’s vaccine rollout.</p>
<p>Strollout was <a href="https://www.theguardian.com/australia-news/2021/jul/22/im-sorry-scott-morrison-apologises-for-slow-pace-of-australias-vaccine-rollout">mostly used in media coverage to criticise the government</a> for Australia’s initially slow rollout of the vaccination program over the past year.</p>
<p>The Australian National Dictionary Centre had <a href="https://www.abc.net.au/news/2021-11-17/australian-word-of-the-year-is-strollout-referencing-vaccines/100626698">already chosen “strollout”</a>, which originated here and later featured on American media. </p>
<p>Oxford Dictionaries had chosen “vax”, which would have been my choice, had it been on Macquarie’s list. Was “strollout” as ubiquitous as “vax”?</p>
<p>Avoiding the COVID-19 direct expressions such as “Delta”, Cambridge had also gone for a subtler but still pandemic-inspired word of the year with “perseverance”, which we can all relate to. </p>
<h2>Other words of the year</h2>
<p><a href="https://www.theguardian.com/books/2021/nov/24/nft-is-collins-dictionary-word-of-the-year">Collins Dictionary chose the non-COVID “NFT”</a> (non-fungible token), which WAS on Macquarie’s list. An NFT is an ownership certificate for a chunk of digital data such as an image, a domain name, a tweet, or a video. It’s a one-off, not fungible or replaceable by any other piece of data. Christies sold a digital artwork for £50 million earlier this year.
Merriam-Webster hasn’t announced its choice yet. Nor has the American Dialect Society, the first body to launch a Word of the Year competition in 1990. It announces its choice after the end of the year. </p>
<p>You may be surprised that Cambridge has chosen the abstract word “perseverance”. Doesn’t the Word of the Year have to be a neologism like “strollout”? </p>
<p>Well, no! Macquarie usually chooses newly coined words like the whimsical <a href="https://theconversation.com/when-we-needed-a-new-word-twitter-gave-us-milkshake-duck-90223">“milkshake duck”</a>, and “mansplain”, <a href="https://theconversation.com/mansplaining-the-word-of-the-year-and-why-it-matters-37091">which was chosen</a> as Macquarie’s word of the decade. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/cancel-culture-cleanskin-hedonometer-im-not-sure-i-like-any-of-macquarie-dictionarys-words-of-the-year-128109">Cancel culture, cleanskin, hedonometer ... I'm not sure I like any of Macquarie Dictionary's words of the year</a>
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<h2>What criteria do the authorities base their choice on?</h2>
<p>As Rose Wild asks in <a href="https://www.thetimes.co.uk/article/2ea0b184-4973-11ec-9969-911e63457092?shareToken=99dc4eb38fe144b6b95184a02656737c">The Times</a>, does a word of the year mean: </p>
<blockquote>
<p>a word we perceive to be most used, abused or overused? Or is it one that encapsulates something unique to this year’s mood or events — or can it be both? What’s the point of it? </p>
</blockquote>
<h2>How is the decision made? Who gets to choose?</h2>
<p>Merriam-Webster bases its decision on the frequency of words that are “looked up” in their online dictionary. As does Cambridge. Collins tracks word usage in its corpus database that covers social media and print publications such as newspapers, and uses its team of editors, lexicographers, and marketing and publicity staff. </p>
<p>The American Dialect Society’s choice is determined by a vote of independent linguists. The Australian National Dictionary Centre’s editorial staff chooses words that have been prominent in the Australian social and cultural landscape during the year, though the word is not always one that has originated in Australia. </p>
<p>Macquarie lists on its website a committee of language experts to make the choice. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/when-we-needed-a-new-word-twitter-gave-us-milkshake-duck-90223">When we needed a new word, Twitter gave us 'milkshake duck'</a>
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<h2>Beyond the Word of the Year</h2>
<p>The American Dialect Society takes its mission seriously. It goes beyond Word of the Year to Word of the Decade; for the 2010s, it was the singular “they”. Its Word of the 20th Century was “Jazz” (Yay!), and its word of the past millennium was “she”. </p>
<p>The American Dialect Society also chooses words in several intriguing sub-categories. Some previous choices include most useful “they” (as a gender-neutral pronoun); most unnecessary “manbun”; most outrageous “gate rape” (airport patdown); most euphemistic “scooping technician” (a person whose job it is to pick up dog pooh); most productive “shaming” (as in “fat-shaming”); most likely to succeed “binge-watch” (many of us can confess to that), and most unlikely to succeed “sitbit” (a device that rewards a sedentary lifestyle), which is, of course, a pun on Fitbit. Some of us may be guilty of “sitbit”.</p>
<p>My favourite category is the most creative word. Apparently, the Milwaukee Mitchell International Airport provides a “recombobulation area” for passengers who have passed through security screening, so that they can get their clothes and belongings back in order. </p>
<p>Having been prevented from international travel by COVID-closed borders for nearly two years, oh, how I long to be recombobulated again, though not necessarily at the Milwaukee Mitchell International Airport.</p><img src="https://counter.theconversation.com/content/172759/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Roslyn Petelin does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Criticism of the Morrison government’s slow vaccine rollout has taken out the Macquarie Dictionary’s Word of the Year.Roslyn Petelin, Course coordinator, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1716562021-11-17T19:03:59Z2021-11-17T19:03:59ZUS vaccine rollout was close to optimal at reducing deaths and infections, according to a model comparing 17.5 million alternative approaches<figure><img src="https://images.theconversation.com/files/432253/original/file-20211116-19-opv49.jpg?ixlib=rb-1.1.0&rect=0%2C83%2C5054%2C3094&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In the U.S., people were placed into four groups for vaccine access.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/VirusOutbreakFlorida/4458ecb3aa344896a73bac36a61cc7aa/photo?Query=vaccination%20eligible&mediaType=photo&sortBy=&dateRange=Anytime&totalCount=328&currentItemNo=172">AP Photo/Lynne Sladky</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em></p>
<h2>The big idea</h2>
<p>The Centers for Disease Control and Prevention’s plan for who gets vaccines and in what order <a href="https://doi.org/10.1371/journal.pone.0259700">saved nearly as many lives and prevented nearly as many infections</a> as a theoretically perfect rollout, according to a new mathematical model we developed to assess the rollout of COVID–19 inoculations in the U.S.</p>
<p>In December 2020, with a limited number of vaccines available, the CDC had to make a hard decision: Who gets the COVID-19 vaccines first? It decided to <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm695152e2.htm">divide the U.S. population into four groups</a> for vaccine prioritization based on age, occupation, living condition and known COVID-19 risk factors.</p>
<p>Using a new model and an Iowa State University supercomputer, we compared the real–world CDC recommendations with 17.5 million possible strategies that also staggered the rollout in up to four phases. To calculate how well a vaccine allocation strategy performed, our model measured total deaths, cases, infections and years of life lost.</p>
<p>We found that the CDC allocation strategy performed exceptionally well – <a href="https://doi.org/10.1371/journal.pone.0259700">within 4% of perfect</a> – in all four measures.</p>
<p>According to our model, the <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm695152e2.htm">CDC’s decisions</a> to not vaccinate children initially and prioritize health care and other essential workers over nonessential workers were both correct. But our model also showed that giving individuals with known risk factors earlier access to vaccines would have led to slightly better outcomes.</p>
<p>No single rollout was able to simultaneously minimize deaths, cases, infections and years of life lost. For example, the strategy that minimized deaths led to a higher number of cases. Given these limitations, the CDC plan did a good job of balancing the four goals of vaccination and was particularly good at reducing deaths.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1362071405668499456"}"></div></p>
<h2>Why it matters</h2>
<p><a href="https://doi.org/10.1126/sciadv.abf1374">Many other studies</a> have looked at <a href="https://doi.org/10.1126/science.abe6959">a small number of alternative COVID-19 vaccine rollouts</a>. Our project incorporated more characteristics of the current pandemic and considered 17.5 million possible strategies. We believe this gives our results more authority.</p>
<p>Our model includes <a href="https://doi.org/10.1038/s41591-020-0962-9">differences in disease severity and susceptibility</a> to the coronavirus due to age. It also incorporates social distancing levels that change over time, as well as <a href="https://doi.org/10.1016/j.lanepe.2021.100252">variable infectivity rates</a> to account for more contagious virus strains such as the delta variant.</p>
<p>All this gave us the ability to accurately assess the CDC’s past decisions. But the greater value of our modeling approach lies in how it could help guide future policy.</p>
<p>By changing model inputs, we were able to show how optimal rollout strategies should change given different <a href="https://doi.org/10.1038/s41598-021-00794-6">vaccine hesitancy rates</a> and for different vaccines that can <a href="https://doi.org/10.1038/s41591-021-01410-w">protect in different ways against infection or death</a>. For countries that are <a href="https://graphics.reuters.com/world-coronavirus-tracker-and-maps/vaccination-rollout-and-access/">currently planning COVID-19 vaccination strategies</a>, our model could help decision-makers develop the most effective strategies given their local resources and specifics. And even in the U.S., our modeling technique can inform allocation strategies for booster shots and future vaccine rollouts so health care administrators can make the best use of limited resources.</p>
<h2>What still isn’t known</h2>
<p>Any model is a simplification of reality. Our model did not account for <a href="https://doi.org/10.1136/bmj.n99">re-infections</a> or <a href="https://dx.doi.org/10.1016%2Fj.socscimed.2020.113638">varying levels of vaccine hesitancy</a> based on socio-economic status, political ideology or race. We also assumed that the level of hesitancy was constant over time.</p>
<p>Additionally, some important factors for how the coronavirus spreads – like <a href="https://doi.org/10.1371/journal.pmed.0050074">contact rates between individuals of different age and demographic groups</a> and <a href="https://www.cdc.gov/coronavirus/2019-ncov/hcp/planning-scenarios.html">the contagiousness of asymptomatic</a> and vaccinated individuals – are still unknown. Better data on these parameters would improve the accuracy of our results.</p>
<h2>What’s next</h2>
<p>Now that we have the model built, we can extend it. For example, we can study how <a href="https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/vaccine-induced-immunity.html">waning immunity</a> and booster shots might affect the spread of the disease. Our computer code is <a href="https://github.com/ckadelka/COVID19-CDC-allocation-evaluation">available to the public</a>, and we hope it will guide health care policymakers in the U.S. and around the world.</p><img src="https://counter.theconversation.com/content/171656/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>With limited vaccines available in early 2021, the CDC had to decide which people received vaccines first. With the help of a supercomputer, researchers have shown that the CDC did an excellent job.Audrey L. McCombs, PhD. Candidate in Ecology and Statistics, Iowa State UniversityClaus Kadelka, Assistant Professor of Mathematics, Iowa State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1677422021-10-05T19:45:08Z2021-10-05T19:45:08ZHow Canada compares to welfare states in COVID-19 cases and deaths<figure><img src="https://images.theconversation.com/files/424565/original/file-20211004-12717-1uhrujs.jpg?ixlib=rb-1.1.0&rect=17%2C35%2C5846%2C3868&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Canadian Minister of Health Patty Hajdu speaks during a press conference in Ottawa.
</span> <span class="attribution"><span class="source">THE CANADIAN PRESS/Sean Kilpatrick</span></span></figcaption></figure><p>Almost two years into the pandemic, it is clear that the impact of COVID-19 has not been uniform. It is difficult to adopt a one-size-fits-all interpretation as to why certain states experienced a higher number of infections while others kept theirs in check. </p>
<p>In July 2020, at the end of the first wave of the pandemic, we looked at <a href="https://theconversation.com/how-canada-compares-to-other-countries-on-covid-19-cases-and-deaths-142632">how Canada’s COVID-19 cases and mortality</a> compared against three types of <a href="https://press.princeton.edu/books/paperback/9780691028576/the-three-worlds-of-welfare-capitalism">welfare states</a>: liberal, social democratic and conservative.</p>
<p>We found no differences between the three groups, but there was high variation among the liberal state group. The United Kingdom, the United States and Ireland had seen an explosion in numbers and mortality rates, while New Zealand, Australia, South Korea and Japan had fared significantly better. Canada, a liberal state, was sitting somewhere in the middle.</p>
<h2>State approaches</h2>
<p>In the year since, most countries were hit by a second wave of COVID-19 in the fall of 2020 and a third wave in the spring of 2021. We expanded our analysis to include COVID-19 cases and deaths per 100,000 population from the subsequent infection waves. </p>
<p>It is important to note that how we categorize countries does not represent their electoral leanings, as in liberal, conservative and social democratic partisan platforms. Our classification refers to the <a href="https://press.princeton.edu/books/paperback/9780691028576/the-three-worlds-of-welfare-capitalism">welfare regime of a state</a>, meaning its relation to redistributive income measures (like tax collection and allocation), employment, wages and other macro-economic variables.</p>
<p>The liberal welfare systems — which loosely correspond to the Anglo-Saxon regimes such as Canada, the U.S., Ireland, the U.K., Australia and New Zealand, but also Japan and South Korea — are characterized by minimalist governmental intervention, modest benefit plans and a strong support of the market. </p>
<p>The social democratic regimes — situated mainly in Northern Europe, such as Sweden, Norway, Denmark, Finland, Iceland and the Netherlands — are generally invested in providing universal benefit coverage and rely on strong governmental intervention.</p>
<p>The conservative states — Italy, Greece, France, Germany, Austria, Switzerland and Belgium — tend to be characterized by a minimum level of welfare provision, usually negligible in impacting class differences in society.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/dhsOV6gmfms?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">NBC News takes a look at the coronavirus pandemic in Italy, which was hit particularly hard.</span></figcaption>
</figure>
<h2>Public services</h2>
<p>Welfare regimes have <a href="https://doi.org/10.5324/nje.v17i1.165">proved effective in targeting health-related outcomes</a>, particularly by levelling socio-economic conditions and decreasing social marginalization in society. <a href="https://www.ippr.org/research/publications/state-of-the-north-2019">Unequal societies</a> — where the state has failed to equitably redistribute wealth and to invest in public systems of service provision — have been found to have much higher mortality rates than those with strong public sectors, public medical coverage and generous benefits provision.</p>
<p>Trickling down through health policy, welfare provision determines the type of care provided to the vulnerable and the sick and tends to materialize into national disease statistics, from routine mortality rates to infectious disease numbers.</p>
<p>Our analysis shows that one year into the pandemic, Canada seems to have fared better with COVID-19 cases than some of its sister Anglo-American states, such as the U.S. and the U.K. Yet Canada fared much worse than Australia and New Zealand, two other liberal, Commonwealth countries. It also fared worse than South Korea and Japan.</p>
<p>As of Sept. 10, the number of COVID-19 cases per 100,000 people in Canada (4,051) was three times lower than in the U.S. (12,184), two-and-a-half times lower than in the U.K. (10,505), and one-and-a-half times lower than in Ireland (7,335). However, the COVID-19 figures for Canada were 56 times higher than those in New Zealand (73), 15 times higher than those in Australia (267), seven times higher than those in South Korea (525), and three times higher than those in Japan (1,276). </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/421971/original/file-20210918-48840-hx5kcs.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="graph showing confirmed COVID-19 cases per 100,000 people based on the type of welfare state" src="https://images.theconversation.com/files/421971/original/file-20210918-48840-hx5kcs.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/421971/original/file-20210918-48840-hx5kcs.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=431&fit=crop&dpr=1 600w, https://images.theconversation.com/files/421971/original/file-20210918-48840-hx5kcs.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=431&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/421971/original/file-20210918-48840-hx5kcs.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=431&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/421971/original/file-20210918-48840-hx5kcs.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=542&fit=crop&dpr=1 754w, https://images.theconversation.com/files/421971/original/file-20210918-48840-hx5kcs.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=542&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/421971/original/file-20210918-48840-hx5kcs.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=542&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Confirmed COVID-19 cases per 100,000 people based on the type of welfare state.</span>
<span class="attribution"><span class="source">(Bejan/Nikolova)</span></span>
</figcaption>
</figure>
<p>When it comes to COVID-19 mortality rates, Canada fares much better than the U.K., the U.S. and Ireland, yet not as well as the Antipodean states of Australia and New Zealand, nor South Korea or Japan. The number of COVID-19 deaths per 100,000 people in Canada (72) was almost one-third of those in the U.K. (197) and the U.S. (196) and one-and-a-half times lower than in Ireland (104). COVID-19 deaths in Canada were, however, 142 times higher than in New Zealand (0.5), 17 times higher than in Australia (4.2), 15 times higher than in South Korea (4.6) and five time higher than in Japan (13.1). </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/421973/original/file-20210918-23-1i2by0a.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="graph showing confirmed COVID-19 deaths per 100,000 people by the type of welfare state" src="https://images.theconversation.com/files/421973/original/file-20210918-23-1i2by0a.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/421973/original/file-20210918-23-1i2by0a.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=382&fit=crop&dpr=1 600w, https://images.theconversation.com/files/421973/original/file-20210918-23-1i2by0a.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=382&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/421973/original/file-20210918-23-1i2by0a.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=382&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/421973/original/file-20210918-23-1i2by0a.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=479&fit=crop&dpr=1 754w, https://images.theconversation.com/files/421973/original/file-20210918-23-1i2by0a.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=479&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/421973/original/file-20210918-23-1i2by0a.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=479&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Confirmed COVID-19 deaths per 100,000 people by the type of welfare state.</span>
<span class="attribution"><span class="source">(Bejan/Nikolova)</span></span>
</figcaption>
</figure>
<h2>Differences over time</h2>
<p>The U.K. had a lower number of cases at the end of the first wave, however, it reached the high levels of infections seen in the U.S. by the end of the third wave. The U.K.’s high number of cases during the third wave is most plausibly explained through the <a href="https://www.cnbc.com/2021/06/28/how-the-uk-with-the-delta-variant-is-a-blueprint-for-the-us.html">“explosion” of the Delta variant</a>. </p>
<p>Ireland’s high number of cases was trailed upwards by high infection rates during the winter. Holiday get-togethers overlaid on what was then the new Alpha variant were <a href="https://www.ctvnews.ca/health/coronavirus/ireland-has-the-world-s-highest-covid-19-rate-how-did-it-go-so-wrong-1.5263405">primarily blamed for the Irish COVID-19 incidence rates</a>. </p>
<p>While the U.K. and the U.S. are statistically at par in terms of the number of deaths at the end of all three waves, the U.K. shows lower mortality than the U.S., despite the Delta surge. This could be explained by the effectiveness of available vaccines and the success of national vaccination campaigns, with the number of unresolved cases attributed to the consequences of vaccine hesitancy. </p>
<p>The U.K. government recently reported that <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandwellbeing/articles/coronavirusvaccinehesitancyfallingacrosstheregionsandcountriesofgreatbritain/2021-08-09">vaccine hesitancy had fallen significantly</a>. </p>
<p>In the U.S., however, <a href="https://news.gallup.com/opinion/polling-matters/352976/vaccine-hesitancy-public-opinion.aspx">public opinion polls</a> have been suggesting that the 20-25 per cent of unvaccinated people are unlikely to ever get vaccinated due to low public trust in state institutions and health authorities. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/421964/original/file-20210918-17-1oaei8t.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="timeline of COVID-19 deaths per 100,000 people within the liberal welfare states" src="https://images.theconversation.com/files/421964/original/file-20210918-17-1oaei8t.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/421964/original/file-20210918-17-1oaei8t.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=336&fit=crop&dpr=1 600w, https://images.theconversation.com/files/421964/original/file-20210918-17-1oaei8t.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=336&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/421964/original/file-20210918-17-1oaei8t.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=336&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/421964/original/file-20210918-17-1oaei8t.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=422&fit=crop&dpr=1 754w, https://images.theconversation.com/files/421964/original/file-20210918-17-1oaei8t.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=422&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/421964/original/file-20210918-17-1oaei8t.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=422&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Timeline of COVID-19 deaths per 100,000 people within the liberal welfare states.</span>
<span class="attribution"><span class="source">(Bejan/Nikolova)</span></span>
</figcaption>
</figure>
<h2>Canada’s high vaccination rates</h2>
<p>Vaccines work to reduce the number of COVID-19 cases and deaths. Canada had higher COVID-19 figures during the first and the second waves of the pandemic, when the public rollout of the vaccines was still in its preliminary stages. After an initial setback of <a href="https://www.canada.ca/en/public-services-procurement/services/procuring-vaccines-covid19.html">supply shortages and unreliable shipments</a>, Canada quickly became <a href="https://www.theguardian.com/world/2021/aug/13/canada-anita-anand-covid-vaccine">one of the countries with the highest vaccination rates</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/421975/original/file-20210918-48840-1b9me2b.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="graph showing percentage of fully vaccinated people by the type of welfare state." src="https://images.theconversation.com/files/421975/original/file-20210918-48840-1b9me2b.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/421975/original/file-20210918-48840-1b9me2b.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=368&fit=crop&dpr=1 600w, https://images.theconversation.com/files/421975/original/file-20210918-48840-1b9me2b.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=368&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/421975/original/file-20210918-48840-1b9me2b.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=368&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/421975/original/file-20210918-48840-1b9me2b.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=463&fit=crop&dpr=1 754w, https://images.theconversation.com/files/421975/original/file-20210918-48840-1b9me2b.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=463&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/421975/original/file-20210918-48840-1b9me2b.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=463&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Percentage of fully vaccinated people by the type of welfare state.</span>
<span class="attribution"><span class="source">(Bejan/Nikolova)</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>The rollout of vaccines over the summer, coupled with strong trust in public health institutions, put Canada ahead of the curve. </p>
<p>What has raised the number of COVID-19 infections and mortality rates in Canada during the first and the second wave of the pandemic were the <a href="https://ltccovid.org/wp-content/uploads/2020/05/Mortality-associated-with-COVID-3-May-final-5.pdf">outbreaks in long-term care facilities</a> and infection flare-ups across the <a href="https://www.cbc.ca/news/canada/london/85-migrant-workers-norfolk-county-coronavirus-1.5592482">agri-food industry</a>. </p>
<p>Better health and safety conditions in <a href="https://www.facetsjournal.com/doi/10.1139/facets-2020-0056">long-term care homes</a> and better occupational and living conditions for <a href="https://www.cbc.ca/news/canada/prince-edward-island/pei-migrant-worker-report-unsafe-at-home-1.6047995">migrant workers within the agri-food industry</a> could have further improved Canada’s performance amongst comparable welfare states.</p><img src="https://counter.theconversation.com/content/167742/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Raluca Bejan receives funding from the Social Sciences and Humanities Research Council of Canada. </span></em></p><p class="fine-print"><em><span>Kristina Nikolova does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>When it came to managing the spread of COVID-19, Canada fared better than the United States and the United Kingdom, but worse than other welfare states like New Zealand and Japan.Raluca Bejan, Assistant Professor of Social Work, Dalhousie UniversityKristina Nikolova, Research assistant professor, Wayne State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1679072021-09-14T10:12:59Z2021-09-14T10:12:59ZPodcast with Michelle Grattan: Christian Porter’s anonymous money pot<figure><img src="https://images.theconversation.com/files/421045/original/file-20210914-21-a5tkxv.png?ixlib=rb-1.1.0&rect=11%2C0%2C3982%2C1994&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> </figcaption></figure><p>As well as her interviews with politicians and experts, Politics with Michelle Grattan now includes “Word from The Hill”, where she discusses the news with members of The Conversation politics team.</p>
<p>In this episode, politics + society editor Amanda Dunn and Michelle discuss Christian Porter’s extraordinary “blind trust” – where generous benefactors (assuming there’s more than one) are helping out with his legal bills in his now discontinued ABC defamation case. Porter, it seems, doesn’t know who he should be thanking because the donors are anonymous.</p>
<p>Amanda and Michelle also canvass Gladys Berejiklian’s on-again-off-again media appearances, and Scott Morrison’s trip to the US next week, which is likely to include some interesting exchanges with President Biden on climate policy. </p>
<p><a href="https://itunes.apple.com/au/podcast/politics-with-michelle-grattan/id703425900?mt=2"><img src="https://images.theconversation.com/files/233721/original/file-20180827-75984-1gfuvlr.png" alt="Listen on Apple Podcasts" width="268" height="68"></a> <a href="https://www.google.com/podcasts?feed=aHR0cHM6Ly90aGVjb252ZXJzYXRpb24uY29tL2F1L3BvZGNhc3RzL3BvbGl0aWNzLXdpdGgtbWljaGVsbGUtZ3JhdHRhbi5yc3M"><img src="https://images.theconversation.com/files/233720/original/file-20180827-75978-3mdxcf.png" alt="" width="268" height="68"></a></p>
<p><a href="https://www.stitcher.com/podcast/the-conversation-4/politics-with-michelle-grattan"><img src="https://images.theconversation.com/files/233716/original/file-20180827-75981-pdp50i.png" alt="Stitcher" width="300" height="88"></a> <a href="https://tunein.com/podcasts/News--Politics-Podcasts/Politics-with-Michelle-Grattan-p227852/"><img src="https://images.theconversation.com/files/233723/original/file-20180827-75984-f0y2gb.png" alt="Listen on TuneIn" width="318" height="125"></a></p>
<p><a href="https://radiopublic.com/politics-with-michelle-grattan-WRElBZ"><img class="alignnone size-medium wp-image-152" src="https://images.theconversation.com/files/233717/original/file-20180827-75990-86y5tg.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" alt="Listen on RadioPublic" width="268" height="87"></a> <a href="https://open.spotify.com/show/5NkaSQoUERalaLBQAqUOcC"><img src="https://images.theconversation.com/files/237984/original/file-20180925-149976-1ks72uy.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" width="268" height="82"></a> </p>
<h2>Additional audio</h2>
<p><a href="https://freemusicarchive.org/music/Blue_Dot_Sessions/Azalai/Gaena">Gaena</a>, Blue Dot Sessions, from Free Music Archive.</p><img src="https://counter.theconversation.com/content/167907/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Michelle Grattan discusses politics with politics + society editor, Amanda DunnMichelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1676962021-09-10T03:06:21Z2021-09-10T03:06:21ZVIDEO: Michelle Grattan on the ‘roadmap to freedom’<p>Michelle Grattan discusses the week in politics with University of Canberra Associate Professor Caroline Fisher.</p>
<p>This week the pair discuss the National Summit on Women’s Safety, focusing on the prime minister’s opening address and the criticism it attracted. This criticism came at the same time that Scott Morrison attracted significant flack for travelling to Sydney from Canberra and back again over the weekend, to see his family on Father’s Day.</p>
<p>They also discuss the New South Wales roadmap to freedom, and revelations that Greg Hunt possibly could have secured more Pfizer in June of last year.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/lbn6bdmxjJw?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure><img src="https://counter.theconversation.com/content/167696/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>University of Canberra Professorial Fellow Michelle Grattan and University of Canberra Associate Professor Caroline Fisher discuss the week in politics.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1675572021-09-08T11:27:21Z2021-09-08T11:27:21ZHealth Minister Hunt failed to take up Pfizer’s June 2020 invitation to meet<p>Documents show Pfizer reached out in June 2020 for a meeting with federal Health Minister Greg Hunt, but he did not take up the invitation. </p>
<p>Labor obtained the documents under freedom of information and the opposition health spokesman Mark Butler said they showed the government “took a deliberate ‘wait and see’ approach to vaccine deals”, a claim Hunt rejected in a statement late Wednesday.</p>
<p>Inadequate supplies of Pfizer slowed the rollout, becoming an increasing problem after AstraZeneca was set back by health warnings for some age groups and resultant hesitancy among many people.</p>
<p>The government announced in November last year it had an agreement to obtain ten million Pfizer doses. More were subsequently purchased, but the supply timetable left persistent shortages.</p>
<p>The government scrambled to bring forward some of the Pfizer doses and recently Scott Morrison intervened with some vaccine diplomacy to get extra doses from Poland, Singapore and Britain. Efforts to get doses from the US failed.</p>
<p>The documents include a letter from the managing director of Pfizer Australia to Hunt dated June 30 2020 requesting “a meeting with you to open discussions regarding your planning for potential COVID-19 vaccination programs”.</p>
<p>“I would welcome an opportunity to discuss our candidate vaccine development in more detail, and open discussions on how we might work together to support planning for potential COVID-19 vaccinations in Australia and continue to build a strong partnership for the future.” </p>
<p>The letter said Pfizer would “be in touch to schedule a meeting. I look forward to meeting you and working with you into the future.”</p>
<p>It canvassed progress on developing a mRNA-based vaccine that, if approved, “could be deployed at unprecedented speed for the prevention of COVID-19 infection”.</p>
<p>The letter foreshadowed Pfizer had the potential to supply millions of vaccine doses by the end of 2020, subject to technical success and regulatory approvals and hundred of millions in 2021.</p>
<p>A covering email from a Pfizer representative noted a request for a formal engagement opportunity with members of the Vaccines Taskforce.</p>
<p>Senior members of Pfizer’s global leadership team would be available for this “particularly if the Minister and/or Departmental leadership can be involved,” it said.</p>
<p>“As the vaccine development landscape is moving swiftly, including through engagements with other nations, I am requesting this meeting occur at the earliest opportunity,” the email said.</p>
<p>On July 3 Lisa Schofield, first assistant secretary, health economics and research division, in the health department, wrote to say she was managing the whole of government work on COVID vaccine and would appreciate an opportunity to talk about Pfizer’s plans.</p>
<p>Pfizer wanted a confidentiality agreement for any detailed talks, which would include several senior global representatives. The alternative it put up was a more general exploratory session, with local Pfizer representatives, including the MD of Pfizer Australia.</p>
<p>Schofield said the confidentiality agreement was being considered, although it was not the government’s usual practice to sign such documents. She proposed the more general session adding “we can always line up subsequent ones as needed”.</p>
<p>On July 23 Pfizer drew Schofield’s attention to “recent news of Pfizer’s agreements with the UK and US on vaccine supply”.</p>
<p>Hunt said in a statement that “both Pfizer and the Health Department have consistently confirmed, including on the public record at Senate Estimates, that the Australian government entered into formal discussions on the purchase of vaccines, as soon as the company was in a position to do so, and were in discussions prior to this”.</p>
<p>“When formal discussions began, no country had a contract with Pfizer.”</p>
<p>Hunt said there had been regular discussions with the minister’s office and Pfizer, including a meeting on 26 June 2020, initiated by his office. This was referenced in an email in the documents, and was followed by the June 30 letter, he said. </p>
<p>“The Australian government moved immediately to formal negotiations with the first step being to agree and negotiate a Confidentiality Disclosure Agreement.”</p>
<p>Hunt said the reference to millions of doses was about global capacity, not to what was on offer to Australia.</p><img src="https://counter.theconversation.com/content/167557/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Documents show Pfizer reached out in June 2020 for a personal meeting with federal Health Minister Greg Hunt, but instead the contact was left to a senior health department official.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1674522021-09-07T08:32:42Z2021-09-07T08:32:42ZPodcast with Michelle Grattan: A Father’s Day backlash hits Scott Morrison<figure><img src="https://images.theconversation.com/files/419728/original/file-20210907-27-nhjzcz.png?ixlib=rb-1.1.0&rect=17%2C5%2C3976%2C1988&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> </figcaption></figure><p>As well as her interviews with politicians and experts, Politics with Michelle Grattan now includes “Word from The Hill”, where she discusses the news with members of The Conversation politics team.</p>
<p>In this episode, politics + society editor Amanda Dunn and Michelle discuss the criticism Scott Morrison has already faced this week. </p>
<p>Firstly, his trip to Sydney to visit his family for Father’s Day, which required a special exemption to return to Canberra, brought a sharp backlash when so many families couldn’t reunite for the weekend. The PM didn’t breach the rules – but did fail the pub test.</p>
<p>Secondly, while his address to the National Summit on Women’s Safety acknowledged that “Australia has a problem” when it comes to ensuring women feel safe, critics including Australian of the Year Grace Tame are scathing of his and his government’s performance.</p>
<p><a href="https://itunes.apple.com/au/podcast/politics-with-michelle-grattan/id703425900?mt=2"><img src="https://images.theconversation.com/files/233721/original/file-20180827-75984-1gfuvlr.png" alt="Listen on Apple Podcasts" width="268" height="68"></a> <a href="https://www.google.com/podcasts?feed=aHR0cHM6Ly90aGVjb252ZXJzYXRpb24uY29tL2F1L3BvZGNhc3RzL3BvbGl0aWNzLXdpdGgtbWljaGVsbGUtZ3JhdHRhbi5yc3M"><img src="https://images.theconversation.com/files/233720/original/file-20180827-75978-3mdxcf.png" alt="" width="268" height="68"></a></p>
<p><a href="https://www.stitcher.com/podcast/the-conversation-4/politics-with-michelle-grattan"><img src="https://images.theconversation.com/files/233716/original/file-20180827-75981-pdp50i.png" alt="Stitcher" width="300" height="88"></a> <a href="https://tunein.com/podcasts/News--Politics-Podcasts/Politics-with-Michelle-Grattan-p227852/"><img src="https://images.theconversation.com/files/233723/original/file-20180827-75984-f0y2gb.png" alt="Listen on TuneIn" width="318" height="125"></a></p>
<p><a href="https://radiopublic.com/politics-with-michelle-grattan-WRElBZ"><img class="alignnone size-medium wp-image-152" src="https://images.theconversation.com/files/233717/original/file-20180827-75990-86y5tg.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" alt="Listen on RadioPublic" width="268" height="87"></a> <a href="https://open.spotify.com/show/5NkaSQoUERalaLBQAqUOcC"><img src="https://images.theconversation.com/files/237984/original/file-20180925-149976-1ks72uy.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" width="268" height="82"></a> </p>
<h2>Additional audio</h2>
<p><a href="https://freemusicarchive.org/music/Blue_Dot_Sessions/Azalai/Gaena">Gaena</a>, Blue Dot Sessions, from Free Music Archive.</p><img src="https://counter.theconversation.com/content/167452/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Michelle Grattan discusses politics with politics + society editor, Amanda DunnMichelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1672182021-09-02T12:02:35Z2021-09-02T12:02:35ZGrattan on Friday: The transition to living with ‘endemic’ COVID could be rough<p>In the Orwellian world of the pandemic, Victoria Premier Daniel Andrews’s raising of the white flag on “COVID zero” was greeted positively by the Morrison government and with relief by many among the public who are at the end of their tether.</p>
<p>We’ve now officially moved into a new stage. As federal Health Minister Greg Hunt said on Thursday, “the pandemic has become endemic”.</p>
<p>In accepting Victoria couldn’t get back near zero, Andrews was following NSW Premier Gladys Berejiklian, who lost control of the virus, with daily new cases in that state now running well above a thousand and rising.</p>
<p>Only weeks ago there were hopes of suppressing the outbreaks in both states. When it was becoming obvious NSW was failing, Berejiklian was criticised for not locking down early and hard enough. Andrews went hard immediately – and failed too.</p>
<p>“Living with COVID is a reality – it’s not an option,” Berejiklian said on Thursday, sending the blunt message to premiers still set on COVID-minimalism that they’d have to accept the Delta world.</p>
<p>As they will. But not for some time, if they can help it.</p>
<p>Watching Australia’s third wave escalate, the Labor states of Western Australia and Queensland are dug in, trenchantly and vociferously, behind their efforts to keep cases out. The brawling between them and the Morrison government took on an even sharper edge this week.</p>
<p>In contrast, Morrison praised the Liberal premiers of South Australia and Tasmania, who are also pursuing COVID zero, but keeping their heads down.</p>
<p>Australia’s federation is now more fractured than at any time during this crisis, in a toxic mix of policy differences and politics, exacerbated by the approaching federal election.</p>
<p>WA’s Mark McGowan must be concerned as to how he’ll eventually reintegrate his state into the rest of the country, which he accepts must happen at some point. With WA vaccination levels lagging, he’s not tying himself down but says he’ll set a date when “the time is right” (assuming he’s not mugged by a runaway outbreak). He wants to ensure vulnerable sections of the population are fully protected. The state’s isolation and insulation help him.</p>
<p>Economic imperatives for WA’s opening will strengthen, but McGowan can usually outplay the federal government on the politics.</p>
<p>Last year Scott Morrison had to make an embarrassing withdrawal from the Clive Palmer challenge (subsequently lost) to the WA border closure, after it became clear local public opinion was strongly on the state government’s side.</p>
<p>This week federal Attorney-General Michaelia Cash, who’s from WA, mused about how an action could be more successful in the changed circumstances of a vaccinated population (not that the federal government is planning to launch a case).</p>
<p>McGowan seized the baseball bat. “West Australians don’t want me to bring [the border] down now, to give in to this sort of crazy bullying by the federal government, and infect our population, lose jobs and shut down part of our economy, including the mining industry,” he said.</p>
<p>This highlights, incidentally, a point often overlooked in the heated political rows. Talk about “opening” WA and Queensland refers to opening borders. Internally, these states are “open” – unlike the shuttered NSW and Victoria.</p>
<p>McGowan is usually careful to avoid overreach. In contrast, Queensland Premier Annastacia Palaszczuk went over the top when she defended her closed border with an emotive claim about the danger to young children.</p>
<p>“You open up this state and you let the virus in here, and every child under 12 is vulnerable, every single child,” she told state parliament on Wednesday. These children were “vulnerable because they are the unvaccinated”.</p>
<p>The federal government, and other critics, retorted that while young children caught the virus, very few got a severe illness, and they’ve not so far been vaccinated in other countries (although vaccination is being trialled in the US).</p>
<p>In the border wars, it’s worth remembering the big border decisions – about reopening Australia to the world – rest with the federal government.</p>
<p>There are multiple fronts – not just Australians travelling abroad and returning home, but also the admission of foreign tourists, students, workers to fill serious skill shortages, and migrants. The relaxation won’t be done all at once; even so it will be challenging – for example, needing home quarantine arrangements as well as vaccination requirements.</p>
<p>The government’s COVID strategy is built around the national cabinet “plan”, underpinned by the Doherty Institute’s modelling, and buttressed with the catchword “hope” and the promise of a great Christmas.</p>
<p>But grim realities will accompany the transition.</p>
<p>NSW is likely to reach 3,000-4,000 daily new cases this month, while Victoria is expected to rise above 1,000 daily. In NSW, the state government is bracing for the month of October to be very bad, in hospitalisations and deaths.</p>
<p>More generally, the Australian Medical Association wrote to Morrison this week warning of a looming crisis in the public hospital system.</p>
<p>“As it stands, our hospital system is not ready to cope with an easing of restrictions, even with increased vaccination rates,” the letter from AMA president Omar Khorshid said. “To prepare we must develop a detailed understanding of our current hospital capacity and model the impact of ‘living with COVID-19’, with the associated caseload increase.”</p>
<p>The AMA suggested a vaccination rate of higher than 80% of the adult population was likely to be required, “given the existing constraints on hospital capacity and staffing”.</p>
<p>With Friday’s national cabinet receiving a report on the health system and its workforce, the government appears inclined to regard the AMA pitch as part of its periodic appeal for more hospital funding.</p>
<p>But from what we’ve seen in NSW, with some hospitals coming under acute pressure, and evidence the WA system is already inadequate, hospitals are clearly a potential weak point in our defences as COVID cases rise quickly after restrictions are eased in coming months.</p>
<p>We know the Morrison government is now totally focused on getting life back to some normality. It stresses this will be done “safely”.</p>
<p>In fact, it is less a matter of opening “safely” than minimising the risks inevitable in opening. That goes beyond the state of the health system to include issues such as sub-groups in the population who might not be adequately vaccinated when the general community levels of 70% and 80% are reached. Dealing with the risks will demand more nuance than “the plan” seems to provide.</p>
<p>The government is banking on the attention of people – who are now deeply frustrated if they live in NSW or Victoria – shifting decisively off the health issues once life is freer. That, however, will depend on effective management of an unpredictable transition.</p><img src="https://counter.theconversation.com/content/167218/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Victoria Premier Daniel Andrews’s raising of the white flag on “COVID zero” was greeted positively by the Morrison government and with relief by many among the public who are at the end of their tether.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1671312021-09-01T10:09:10Z2021-09-01T10:09:10ZPodcast with Michelle Grattan: Learning to live with COVID<figure><img src="https://images.theconversation.com/files/418853/original/file-20210901-26-1qswb64.png?ixlib=rb-1.1.0&rect=5%2C0%2C3988%2C2000&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> </figcaption></figure><p>As well as her interviews with politicians and experts, Politics with Michelle Grattan now includes “Word from The Hill”, where she discusses the news with members of The Conversation politics team.</p>
<p>In this episode, politics + society editor Amanda Dunn and Michelle discuss the June quarter national accounts, released on Wednesday. While this quarter was better than expected, the September quarter is certain to be negative as a result of the prolonged lockdowns.</p>
<p>They also mark the change this week in the national COVID debate, as the Victorian government, following NSW, admits defeat in the battle to get to COVID zero.</p>
<p><a href="https://itunes.apple.com/au/podcast/politics-with-michelle-grattan/id703425900?mt=2"><img src="https://images.theconversation.com/files/233721/original/file-20180827-75984-1gfuvlr.png" alt="Listen on Apple Podcasts" width="268" height="68"></a> <a href="https://www.google.com/podcasts?feed=aHR0cHM6Ly90aGVjb252ZXJzYXRpb24uY29tL2F1L3BvZGNhc3RzL3BvbGl0aWNzLXdpdGgtbWljaGVsbGUtZ3JhdHRhbi5yc3M"><img src="https://images.theconversation.com/files/233720/original/file-20180827-75978-3mdxcf.png" alt="" width="268" height="68"></a></p>
<p><a href="https://www.stitcher.com/podcast/the-conversation-4/politics-with-michelle-grattan"><img src="https://images.theconversation.com/files/233716/original/file-20180827-75981-pdp50i.png" alt="Stitcher" width="300" height="88"></a> <a href="https://tunein.com/podcasts/News--Politics-Podcasts/Politics-with-Michelle-Grattan-p227852/"><img src="https://images.theconversation.com/files/233723/original/file-20180827-75984-f0y2gb.png" alt="Listen on TuneIn" width="318" height="125"></a></p>
<p><a href="https://radiopublic.com/politics-with-michelle-grattan-WRElBZ"><img class="alignnone size-medium wp-image-152" src="https://images.theconversation.com/files/233717/original/file-20180827-75990-86y5tg.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" alt="Listen on RadioPublic" width="268" height="87"></a> <a href="https://open.spotify.com/show/5NkaSQoUERalaLBQAqUOcC"><img src="https://images.theconversation.com/files/237984/original/file-20180925-149976-1ks72uy.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" width="268" height="82"></a> </p>
<h2>Additional audio</h2>
<p><a href="https://freemusicarchive.org/music/Blue_Dot_Sessions/Azalai/Gaena">Gaena</a>, Blue Dot Sessions, from Free Music Archive.</p><img src="https://counter.theconversation.com/content/167131/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Michelle Grattan discusses politics with politics + society editor, Amanda DunnMichelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1671152021-09-01T09:26:47Z2021-09-01T09:26:47ZPolitics with Michelle Grattan: Pat Turner on COVID – and god botherers – stalking Indigenous communities<p>COVID has been spreading quickly in western NSW Indigenous communities where low vaccination rates and poor conditions make for a toxic mix. The first Indigenous death occurred in Dubbo this week.</p>
<p>As efforts intensify to deal with the NSW outbreak Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisations (NACCHO) joins the podcast. As well as discussing the NSW situation, she warns of the vulnerability of communities in Western Australia, attacks religious figures promoting dangerous misinformation, and says Indigenous communities can’t safely open at 70% or 80% vaccination rates. </p>
<p>On western NSW, where there are hundreds of cases, Turner says crowded and bad housing make it “almost impossible to isolate and quarantine”. People in Wilcannia are “having to isolate in tents – in Australia in 2021”. </p>
<p>In WA First Nations communities, the low vaccine coverage “is a very significant concern to all of us”. </p>
<p>“It has by far the lowest uptake, with less than 10% of its population 12 years and over fully vaccinated”.</p>
<p>“I would think that the first death for Aboriginal and Torres Strait Islander people […] has been a wake up call for some, especially those who didn’t think that COVID would affect them. The reality is sinking in for many of those.”</p>
<p>One obstacle is the spread of false claims by god botherers. </p>
<p>“[Aboriginal] Pastor Geoffrey Stokes called out a circular that had been sent around by [a] so-called Indigenous prayer group in the goldfields of Western Australia. And it happened that it was a white bloke from Brisbane who had circulated the misinformation. So that was soon put to bed. </p>
<p>"But there are people and communities, Aboriginal communities that belong to groups like the Assemblies of God and, you know, other such religions that strongly believe that God will protect them.”</p>
<p>“God will not stop COVID killing our people. I’m sorry to the religious leaders who believe that, but I’m telling them that will not happen.”</p>
<p>While the national cabinet’s plan provides for easing restrictions for the general community at 70% and 80% vaccination levels of those 16 and over, Turner insists that can’t apply in Indigenous communities. </p>
<p>“No, no, no, 70 to 80% will not be good enough for our communities. We are aiming for 100% vaccination of Aboriginal and Torres Strait Islander people 12 years and over by the end of this year.”</p>
<p><a href="https://itunes.apple.com/au/podcast/politics-with-michelle-grattan/id703425900?mt=2"><img src="https://images.theconversation.com/files/233721/original/file-20180827-75984-1gfuvlr.png" alt="Listen on Apple Podcasts" width="268" height="68"></a> <a href="https://www.google.com/podcasts?feed=aHR0cHM6Ly90aGVjb252ZXJzYXRpb24uY29tL2F1L3BvZGNhc3RzL3BvbGl0aWNzLXdpdGgtbWljaGVsbGUtZ3JhdHRhbi5yc3M"><img src="https://images.theconversation.com/files/233720/original/file-20180827-75978-3mdxcf.png" alt="" width="268" height="68"></a></p>
<p><a href="https://www.stitcher.com/podcast/the-conversation-4/politics-with-michelle-grattan"><img src="https://images.theconversation.com/files/233716/original/file-20180827-75981-pdp50i.png" alt="Stitcher" width="300" height="88"></a> <a href="https://tunein.com/podcasts/News--Politics-Podcasts/Politics-with-Michelle-Grattan-p227852/"><img src="https://images.theconversation.com/files/233723/original/file-20180827-75984-f0y2gb.png" alt="Listen on TuneIn" width="318" height="125"></a></p>
<p><a href="https://radiopublic.com/politics-with-michelle-grattan-WRElBZ"><img class="alignnone size-medium wp-image-152" src="https://images.theconversation.com/files/233717/original/file-20180827-75990-86y5tg.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" alt="Listen on RadioPublic" width="268" height="87"></a> <a href="https://open.spotify.com/show/5NkaSQoUERalaLBQAqUOcC"><img src="https://images.theconversation.com/files/237984/original/file-20180925-149976-1ks72uy.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" width="268" height="82"></a> </p>
<h2>Additional audio</h2>
<p><a href="http://freemusicarchive.org/music/Lee_Rosevere/The_Big_Loop_-_FML_original_podcast_score/Lee_Rosevere_-_The_Big_Loop_-_FML_original_podcast_score_-_10_A_List_of_Ways_to_Die">A List of Ways to Die</a>, Lee Rosevere, from Free Music Archive.</p><img src="https://counter.theconversation.com/content/167115/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Michelle Grattan discusses the vulnerability of First Nation communities with Indigenous Advocate Pat TurnerMichelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1668872021-08-28T04:21:40Z2021-08-28T04:21:40ZNational Cabinet leaves us in the dark about reopening the nation, so we’re left joining the dots<p>National Cabinet <a href="https://www.pm.gov.au/media/national-cabinet-statement-53">met on Friday</a> after a week of intensifying debate about the vaccination thresholds in the <a href="https://www.pm.gov.au/sites/default/files/media/national-plan-to-transition-australias-national-covid-19-response-30-july-2021.pdf">national plan for reopening</a> the nation. </p>
<p>While expectations for the meeting were high, there was no showdown — at least as far as we know. </p>
<p>The current plan is <a href="https://theconversation.com/opening-with-70-of-adults-vaccinated-the-doherty-report-predicts-1-5k-deaths-in-6-months-we-need-a-revised-plan-166659">vague</a>, with words such as “may occur” and only subject to “in principle” agreement. </p>
<p>And the <a href="https://www.doherty.edu.au/uploads/content_doc/DohertyModelling_NationalPlan_and_Addendum_20210810.pdf">Doherty Institute modelling</a>, which underpins the plan, acts as a fig leaf for the Commonwealth government to hide behind. So the plan has survived to live another day. </p>
<p>Deferring the day of reckoning has papered over the cracks. National Cabinet is holding tight for another week and awaiting further modelling. </p>
<p>A decision to hold tight is likely a compromise between the three factions in the virtual meeting room. But it leaves many questions unanswered.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/opening-with-70-of-adults-vaccinated-the-doherty-report-predicts-1-5k-deaths-in-6-months-we-need-a-revised-plan-166659">Opening with 70% of adults vaccinated, the Doherty report predicts 1.5K deaths in 6 months. We need a revised plan</a>
</strong>
</em>
</p>
<hr>
<h2>We have three factions</h2>
<p><strong>1. Commonwealth and NSW</strong></p>
<p>In one faction, you have the Commonwealth and New South Wales, both committed to easing restrictions according to the vaccination thresholds set out in the Doherty report: 70% and 80% of the population aged 16 and over. </p>
<p>Prime Minister Scott Morrison probably wanted to hold firm. After repeated <a href="https://theconversation.com/is-the-covid-vaccine-rollout-the-greatest-public-policy-failure-in-recent-australian-history-164396">failures to hit his vaccine rollout targets</a>, he cannot afford another change in the plan.</p>
<p>At the same time, NSW Premier Gladys Berejiklian has probably recognised she has lost the fight to control COVID in her state and wants political cover to claim victory. She has already announced the <a href="https://www.theguardian.com/australia-news/2021/aug/26/more-than-1000-covid-cases-a-day-in-nsw-and-we-are-told-we-can-have-a-picnic-welcome-to-the-future">easing of some minor restrictions</a> for fully vaccinated people.</p>
<p><strong>2. Other states handling NSW leaks</strong></p>
<p>In the second faction, you have states such as Queensland and Victoria affected by leaks of COVID cases from NSW. </p>
<p>These states would have wanted the modelling to reassure them their health systems would not be overwhelmed if they started to ease strong public health measures at low vaccination thresholds. </p>
<p><strong>3. COVID-zero states</strong></p>
<p>The third faction comprises the COVID-zero states, such as Western Australia, which would be concerned about any heightened risk of COVID leakage from other states. </p>
<p>These states only see <a href="https://thewest.com.au/news/coronavirus/wa-premier-unmoved-on-borders-lockdowns-c-3695364">downsides</a> from easing restrictions too early, when not enough people are vaccinated. They do not want to throw away the benefits of their hard-won COVID-zero status.</p>
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<h2>How to broker peace?</h2>
<p>To reconcile these conflicting positions, the leaders found peace in process: they decided to seek more information. </p>
<p>They agreed to establish a cross-jurisdictional working group, led by the heads of health departments, to investigate health and hospital system capacity and workforce needs in the next phases of the national plan.</p>
<p>This work will draw on the Doherty modelling, which shows many deaths will occur months after lockdowns end. </p>
<p>The group is due to report back by next week, presumably taking into account rapid advances in <a href="https://theconversation.com/were-seeing-more-covid-patients-in-icu-as-case-numbers-rise-that-affects-the-whole-hospital-165966">our understanding</a> of how <a href="https://ad996812-f908-4f9a-ae29-44e0df5347d5.filesusr.com/ugd/4e5c71_cc113a0bc7e54713a4d5443140234dd5.pdf">Delta might impact our health systems</a>. </p>
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<p>The other states will not want to replicate the makeshift responses NSW was forced into — <a href="https://www.smh.com.au/politics/nsw/hotspot-hospitals-to-triage-covid-19-patients-in-makeshift-units-to-manage-surge-20210825-p58lum.html">such as triage tents to assess patients</a> — because of escalating hospital admissions.</p>
<p>This process may provide a way out for the Commonwealth. At the moment, states are highlighting the impacts of the Commonwealth’s failures on slow vaccination rollouts. But they could be brought around by a big-enough payment to compensate for the increased pressure reopening could put on their hospital systems.</p>
<p>As former Prime Minister Paul Keating <a href="https://www.dailytelegraph.com.au/news/opinion/all-riled-up-over-an-empty-bucket/news-story/93c0bff6a075170852189ba9a7480365">said</a>, “never get between a premier and a bucket of money”.</p>
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<p>States will also need more Pfizer doses. At the moment, the lion’s share of the available Pfizer doses is going to NSW, leaving GPs in other states — especially Victoria — <a href="https://www.theage.com.au/national/victoria/victoria-in-talks-over-extra-shots-mulls-gp-payments-to-boost-rollout-20210826-p58m8o.html">scrambling to find doses</a> to meet demand. </p>
<p>Although these side-deals will not mean the states come out ahead, at least, financially, they will not be so far in the red.</p>
<h2>How about the Doherty modelling?</h2>
<p>As the National Cabinet’s behind-the-scenes negotiations were going on, the Doherty Institute <a href="https://www.pm.gov.au/media/national-cabinet-statement-53">reconfirmed its recommendation</a> of the 70% and 80% (adult population) vaccination thresholds. It continues to undertake further modelling, including specification of public health measures in areas of low vaccination coverage. </p>
<p>While the thresholds may not have changed, further modelling is yet to show how Australia’s rapidly rising COVID-19 case numbers impact the phasing, and the substance, of the plan.</p>
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<p>For instance, specific policy measures, such as exempting vaccinated people from restrictions, must be incorporated into the modelling, since vaccinated people can still spread the virus. </p>
<p>What privileges are extended to fully vaccinated people — holders of a <a href="https://www.abc.net.au/news/science/2021-08-23/covid-19-vaccine-certificates-forged-in-10-minutes/100390578">validated</a> vaccine passport — will be one of the next big challenges for the states, both politically and in terms of implementation and monitoring.</p>
<h2>How does vaccinating 12 to 15-year-olds fit in?</h2>
<p>National Cabinet’s meeting took place the same day the Australian Technical Advisory Group on Immunisation (ATAGI) <a href="https://www.health.gov.au/news/atagi-statement-on-the-use-of-covid-19-vaccines-in-all-young-adolescents-in-australia">recommended vaccination for 12 to 15-year-olds</a>, to begin on September 13.</p>
<p>But there were no updates to the national plan to include this age group as part of the total population vaccinated. The plan’s targets are still expressed as a proportion of the population aged 16 and over, rather than of the population soon eligible to be vaccinated, those aged 12 and over.</p>
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Read more:
<a href="https://theconversation.com/should-we-vaccinate-children-against-covid-19-we-asked-5-experts-165316">Should we vaccinate children against COVID-19? We asked 5 experts</a>
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<p>This means 12 to 15-year-olds are completely missing from the plan. It makes no sense for the nation to track progress towards vaccination targets without including this group.</p>
<p>Any plan to ease restrictions must also consider the <a href="https://www.theaustralian.com.au/nation/covid19-we-owe-it-to-ourkids-to-get-theschools-open/news-story/c98fc39019db2728cb2685fb21481da7">impact on children and their education</a>, especially for those under 12, who are not expected to be vaccinated this year.</p>
<h2>What next?</h2>
<p>While National Cabinet might be holding tight, there is still much work to be done to fill the many gaps in the current plan. We still need a robust national plan all states can sign up to, without hedging or caveats.</p><img src="https://counter.theconversation.com/content/166887/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Grattan Institute began with contributions to its endowment from each of the Federal and Victorian Governments, BHP Billiton, and NAB. In order to safeguard its independence, Grattan Institute’s board controls this endowment. Grattan Institute also receives funding from corporates, foundations, and individuals to support its general activities as disclosed on its website. Grattan Institute has published three Reports on COVID issues, and has developed models which simulate the pandemic and the impacts of opening up at various population vaccination rates.</span></em></p><p class="fine-print"><em><span>Anika Stobart does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Brokering peace among the factions appearing in National Cabinet will be key to a successful transition to reopening Australia. But there are many gaps in the plan.Stephen Duckett, Director, Health and Aged Care Program, Grattan InstituteAnika Stobart, Associate, Grattan InstituteLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1668422021-08-26T12:16:31Z2021-08-26T12:16:31ZGrattan on Friday: As COVID’s third wave worsens, Scott Morrison pivots to the future<p>Josh Frydenberg is Scott Morrison’s house guest at The Lodge – sharing, in Canberra’s lockdown, microwaved meals and watching “Yes, Prime Minister”.</p>
<p>As he recounted domestic life with Scott, the treasurer was inevitably asked whether he’d measured up the curtains.</p>
<p>Among the ministers, Frydenberg and Health Minister Greg Hunt have carried the frontline burdens during the pandemic. For Frydenberg – the biggest-spending federal treasurer in the nation’s history – the experience can be viewed as a test for future leadership.</p>
<p>Although there’ve been mistakes – JobKeeper had design flaws which led to serious waste – he has come through creditably in extraordinary circumstances.</p>
<p>Frydenberg, who is also deputy Liberal leader, has never hidden his ambition and is hungry for the top job. But he is also loyal. Morrison knows that, unlike prime ministerial predecessors Tony Abbott and Malcolm Turnbull, he doesn’t have to look over his shoulder, even in the bad times. Morrison marked three years as PM this week, and there has been no white-anting.</p>
<p>There’s more than one path to the prime ministership for Frydenberg. If Morrison loses the election, Frydenberg would be favourite to become leader of the opposition. But that’s the start of a very rocky road; hard work and high hopes can be dashed, as Bill Shorten found.</p>
<p>An alternative path is to be well placed vis-a-vis your internal competitors and inherit the post when it becomes available, one way or another.</p>
<p>If the Coalition is re-elected next year, would Morrison serve a full term, or is it possible he might leave triumphant after a couple of years, not risking the gamble on a third election “miracle”? Frydenberg knows Morrison’s moving on in a smooth transition would be his best prospect. </p>
<p>The prime minister this week was in full campaign mode for the March or May election and we had a glimpse of the formidable fighter we saw in 2019.</p>
<p>In a week when the NSW government lost control of COVID, the state’s daily new cases rising above 1,000 and hospitals under severe strain, and with Victoria on the brink, Morrison made a dramatic pivot to focus on opening the country.</p>
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Read more:
<a href="https://theconversation.com/view-from-the-hill-achieving-vaccine-targets-could-be-followed-by-a-pre-election-health-pinch-point-166678">View from The Hill: Achieving vaccine targets could be followed by a (pre-election) health 'pinch point'</a>
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<p>Embattled NSW Premier Gladys Berejiklian was firmly in step, making it clear she’s determined to move when the 70% vaccine target is reached (meanwhile announcing some minor easings).</p>
<p>It seemed incongruous that as the third wave deepened and with only a third of eligible people fully vaccinated, Morrison simply left the bad news behind and headed for the ground on which he wants to stand. In his Thursday news conference, for example, he began by hailing “another day of hope”, based on the latest vaccination numbers. </p>
<p>Morrison, backed by research, judges most voters have had enough of lockdowns and blocked internal travel.</p>
<p><a href="https://www.smh.com.au/politics/federal/voters-back-national-vaccination-targets-to-ease-restrictions-20210824-p58lk5.html">A poll published by Nine this week</a> showed 54% believed Australia could not completely suppress COVID, and more than six in ten favoured opening up once the target vaccination thresholds were reached. In the second year of the pandemic, public opinion appears to have swung from preoccupation with the health response to a strong desire to return to more freedom.</p>
<p>While Morrison pivots when in political trouble, Anthony Albanese this week looked to be lumbering. With the PM accusing the opposition leader of undermining the national cabinet’s exit plan, Albanese knew he had to get himself out of that corner. He stressed support for the plan, but his demeanour was that of a man on the back foot.</p>
<p>The defiant premiers of Queensland and Western Australia are in an easier short-term position. WA’s Mark McGowan, in particular, with his stratospheric popularity, can tell Morrison to go jump, as in effect he did this week. After the PM invoked “The Croods” film to say we must emerge from the cave, McGowan played heavily to West Australians’ parochialism and angst towards the east.</p>
<p>“This morning the prime minister made a comment implying Western Australians were like cave people from a recent kids’ movie. It was an odd thing to say,” McGowan wrote on Facebook. “I think everyone would rather just see the Commonwealth look beyond New South Wales and actually appreciate what life is like here in WA.</p>
<p>"We currently have no restrictions within our State, a great quality of life, and a remarkably strong economy, which is funding the relief efforts in other parts of the country.</p>
<p>"West Aussies just want decisions that consider the circumstances of all States and Territories, not just Sydney.”</p>
<p>Regardless of the national plan to which they agreed, McGowan and Annastacia Pałaszczuk have the constitutional and political authority to handle their states’ transitions as they see fit. But they can’t get away from the fact they’ll have to make the journey, relaxing border restrictions, at some stage.</p>
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Read more:
<a href="https://theconversation.com/coalition-gains-in-federal-resolve-poll-but-labor-increases-lead-in-victoria-166649">Coalition gains in federal Resolve poll, but Labor increases lead in Victoria</a>
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<p>As New Zealand is now finding, a zero-COVID position, however assiduously pursued, seems an impossible dream over the longer term.</p>
<p>Without the sharp motivators of big outbreaks, WA and Queensland have vaccination rates lower than the national average, and health systems that haven’t been stress-tested under maximum COVID pressure. WA, self-sheltered for so long, would be especially vulnerable if there were a big outbreak.</p>
<p>At the national level, one political unknown is what the public reaction will be in the difficult transition period ahead. Will sentiment change again when there are more hospitalisations and deaths as we reopen, albeit with some continuing safeguards?</p>
<p>With the length of the current extensive lockdowns unknown, it is not clear whether by election time we’ll have had, or have escaped, another recession. We know this September quarter will be negative but the December quarter could go either way.</p>
<p>Two consecutive quarters of negative economic growth (the economy shrinking) is taken in technical terms to be a recession. AMP economist Shane Oliver says there is a 45% chance of negative growth in the June-quarter figures, which will be released next Wednesday. If that happened a recession would be certain.</p>
<p>At the election the economy and fiscal policy will be central issues. If we are as “open” as the prime minister foreshadows, the government will need to have plans for when and how it would start fiscal repair.</p>
<p>For Morrison and Frydenberg, this will be another pivot point. Many will be watching carefully how much agility the treasurer can show.</p>
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Read more:
<a href="https://theconversation.com/politics-with-michelle-grattan-dohertys-sharon-lewin-on-pivoting-from-chasing-covid-zero-166740">Politics with Michelle Grattan: Doherty's Sharon Lewin on pivoting from chasing COVID zero</a>
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<img src="https://counter.theconversation.com/content/166842/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Despite being the week that the NSW government lost control of COVID, Prime Minister Scott Morrison was in full campaign mode – a glimpse of the formidable fighter we saw in 2019.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1667402021-08-25T03:51:58Z2021-08-25T03:51:58ZPolitics with Michelle Grattan: Doherty’s Sharon Lewin on pivoting from chasing COVID zero<p>The Doherty modelling is the government’s underpinning for a proposed easing of COVID restrictions once we reach targets of 70% and 80% of the adult population vaccinated.</p>
<p>But the exit path has put Scott Morrison at odds with Western Australia and Queensland, states which would inevitably have to give up their present status of having little or no COVID.</p>
<p>The model’s priority is pivoting from reaching zero cases, to limiting COVID by vaccination, minimising serious illness, hospitalisation, and deaths.</p>
<p>This week, Professor Sharon Lewin, Director of the Peter Doherty Institute for Infection and Immunity joins the podcast to explain into the much-discussed modelling and its policy implications.</p>
<p>In the event things open up, our “first line of defence” will be the public health capacity, says Lewin. The ability to trace, test, isolate, and quarantine limits the explosion of cases and keeps the transmission potential “less than one”.</p>
<p>Some critics have said the 70-80% target won’t sufficiently protect the entire population from COVID. Lewin notes that amongst the varying models there is agreement we cannot open up on vaccine uptake alone.</p>
<p>“You can’t just open up a 70% with nothing else in place. There is no ‘Freedom Day’. You do need these additional public health measures.”</p>
<p>In particular, while “tremendous advances have been made in capabilities[…] it’s not universal across the country. In particular, First Nation communities, which have been prepared and boasted an "effective community lead response” earlier in the pandemic, will require a strengthening of their public health facilities.</p>
<p><a href="https://itunes.apple.com/au/podcast/politics-with-michelle-grattan/id703425900?mt=2"><img src="https://images.theconversation.com/files/233721/original/file-20180827-75984-1gfuvlr.png" alt="Listen on Apple Podcasts" width="268" height="68"></a> <a href="https://www.google.com/podcasts?feed=aHR0cHM6Ly90aGVjb252ZXJzYXRpb24uY29tL2F1L3BvZGNhc3RzL3BvbGl0aWNzLXdpdGgtbWljaGVsbGUtZ3JhdHRhbi5yc3M"><img src="https://images.theconversation.com/files/233720/original/file-20180827-75978-3mdxcf.png" alt="" width="268" height="68"></a></p>
<p><a href="https://www.stitcher.com/podcast/the-conversation-4/politics-with-michelle-grattan"><img src="https://images.theconversation.com/files/233716/original/file-20180827-75981-pdp50i.png" alt="Stitcher" width="300" height="88"></a> <a href="https://tunein.com/podcasts/News--Politics-Podcasts/Politics-with-Michelle-Grattan-p227852/"><img src="https://images.theconversation.com/files/233723/original/file-20180827-75984-f0y2gb.png" alt="Listen on TuneIn" width="318" height="125"></a></p>
<p><a href="https://radiopublic.com/politics-with-michelle-grattan-WRElBZ"><img class="alignnone size-medium wp-image-152" src="https://images.theconversation.com/files/233717/original/file-20180827-75990-86y5tg.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" alt="Listen on RadioPublic" width="268" height="87"></a> <a href="https://open.spotify.com/show/5NkaSQoUERalaLBQAqUOcC"><img src="https://images.theconversation.com/files/237984/original/file-20180925-149976-1ks72uy.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" width="268" height="82"></a> </p>
<h2>Additional audio</h2>
<p><a href="http://freemusicarchive.org/music/Lee_Rosevere/The_Big_Loop_-_FML_original_podcast_score/Lee_Rosevere_-_The_Big_Loop_-_FML_original_podcast_score_-_10_A_List_of_Ways_to_Die">A List of Ways to Die</a>, Lee Rosevere, from Free Music Archive.</p><img src="https://counter.theconversation.com/content/166740/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Michelle Grattan discusses the Doherty Modelling with director of the Doherty Institute Professor Sharon LewinMichelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1659482021-08-24T20:07:26Z2021-08-24T20:07:26ZUnder-12s are increasingly catching COVID-19. How sick are they getting and when will we be able to vaccinate them?<figure><img src="https://images.theconversation.com/files/417339/original/file-20210823-13-18t8e0x.jpg?ixlib=rb-1.1.0&rect=8%2C0%2C5551%2C3709&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>In July Australia’s Therapeutic Goods Administration (TGA) <a href="https://www.tga.gov.au/covid-19-vaccine-provisional-registrations">provisionally approved</a> the Pfizer COVID-19 vaccine for kids aged 12-15.</p>
<p>The Australian Technical Advisory group on Immunisation (ATAGI) <a href="https://www.health.gov.au/news/atagi-statement-regarding-vaccination-of-adolescents-aged-12-15-years">subsequently recommended</a> kids in this age group with underlying chronic medical conditions, Aboriginal and Torres Strait Islander children and kids living in remote communities should be prioritised. </p>
<p>We’re expecting advice from ATAGI as to whether the rollout should be extended to all 12 to 15-year-olds, as countries like <a href="https://covid.cdc.gov/covid-data-tracker/#vaccination-demographic">the United States</a> and <a href="https://health-infobase.canada.ca/covid-19/vaccination-coverage/">Canada</a> have done.</p>
<p>But where does that leave children under 12? We know they’re making up <a href="https://www.smh.com.au/politics/nsw/as-more-than-200-primary-kids-get-a-covid-diagnosis-in-one-weekend-hazzard-says-it-s-too-early-to-talk-about-school-20210822-p58kwt.html">a large proportion</a> of new infections in Australia’s current outbreaks, which was not the case last year.</p>
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<p>Do they need to be vaccinated? What are the benefits of vaccinating children, both for the child and the community? And how will we know the vaccines are safe and effective for young children?</p>
<h2>COVID in kids</h2>
<p>Throughout the pandemic, fortunately, we’ve seen children are very unlikely to get severely unwell or die from COVID-19. </p>
<p>Australian data from January 1 to August 1 this year show <a href="https://www1.health.gov.au/internet/main/publishing.nsf/Content/C50CAE02452A48A7CA2587320081F7BF/$File/covid_19_australia_epidemiology_report_47_reporting_period_ending_1_august_2021.pdf">2.5% of children</a> aged up to nine and 2.9% children and teenagers aged 10-19 who contracted COVID were hospitalised. This is compared to 7.7% of young adults aged 20-29, with the rates continuing to increase with age.</p>
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<p>Cases are on the rise among children <a href="https://data.nsw.gov.au/search/dataset/ds-nsw-ckan-3dc5dc39-40b4-4ee9-8ec6-2d862a916dcf/details?">in New South Wales</a>, but to date this hasn’t been accompanied by a large increase in paediatric hospitalisations.</p>
<p>Recent data show <a href="https://covid.cdc.gov/covid-data-tracker/#new-hospital-admissions">increased rates of hospitalisation</a> among children in the US with COVID-19 compared to last year, alongside <a href="https://www.wsj.com/articles/more-kids-are-hospitalized-with-covid-19-and-doctors-fear-it-will-get-worse-11629624602">rising infections with the Delta variant</a>.</p>
<p>But even though the rate has gone up, it remains low. In children and adolescents aged 17 and under the rate is 0.38 per 100,000 people, well below the rate in adults aged 60 to 69 (5.63 per 100,000) and those over 70 (8.07 per 100,000).</p>
<p>However, some kids who have <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780706">chronic medical conditions</a> are at a higher risk of getting really sick from COVID, which is why ATAGI has listed them as a priority group.</p>
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Read more:
<a href="https://theconversation.com/should-we-vaccinate-children-against-covid-19-we-asked-5-experts-165316">Should we vaccinate children against COVID-19? We asked 5 experts</a>
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<p>One of the complications of COVID-19 is <a href="https://www.england.nhs.uk/coronavirus/post-covid-syndrome-long-covid/">long COVID</a> where a person experiences lasting symptoms such as breathlessness, anxiety and “brain fog” (reductions in attention and concentration).</p>
<p>Reassuringly, <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(21)00198-X/fulltext">a recent study</a> found only a small proportion of children had symptoms beyond four weeks after their initial COVID infection, and almost all children had recovered by eight weeks.</p>
<h2>So what are the benefits of vaccinating kids?</h2>
<p>While the Delta variant is <a href="https://theconversation.com/why-is-delta-such-a-worry-its-more-infectious-probably-causes-more-severe-disease-and-challenges-our-vaccines-163579">more infectious</a> than other strains of the coronavirus, and more kids are becoming infected, there’s not a scientific consensus at this stage that it’s causing more severe disease in children.</p>
<p>That said, a small minority will get sicker than others and need hospital care. </p>
<p>If vaccines are found to be safe and effective for younger children <a href="https://www.bmj.com/content/bmj/374/bmj.n2030.full.pdf">there would be benefit</a> in protecting the individual child.</p>
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<img alt="A teenage boy with a mask on and a band-aid on his arm." src="https://images.theconversation.com/files/417525/original/file-20210824-13-10prd1g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/417525/original/file-20210824-13-10prd1g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/417525/original/file-20210824-13-10prd1g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/417525/original/file-20210824-13-10prd1g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/417525/original/file-20210824-13-10prd1g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/417525/original/file-20210824-13-10prd1g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/417525/original/file-20210824-13-10prd1g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The TGA has approved the Pfizer vaccine for ages 12 and up. But we don’t yet have a COVID vaccine for younger children.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>What about collective benefits? Will vaccinating young children reduce transmission in the community and improve our herd protection? </p>
<p>Recent modelling from the <a href="https://www.doherty.edu.au/uploads/content_doc/DohertyModelling_NationalPlan_and_Addendum_20210810.pdf">Doherty Institute</a> doesn’t appear to consider whether vaccinating children under 12 would or wouldn’t contribute to reducing community transmission.</p>
<p>Other modelling has suggested <a href="https://theconversation.com/we-may-need-to-vaccinate-children-as-young-as-5-to-reach-herd-immunity-with-delta-our-modelling-shows-164942">vaccinating younger children</a> and adolescents will be important if Australia is to reach the elusive “herd immunity”.</p>
<h2>Trials are under way</h2>
<p>Clinical trials of the mRNA vaccines from <a href="https://www.nejm.org/doi/10.1056/NEJMoa2107456?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">Pfizer</a> and <a href="https://www.nejm.org/doi/10.1056/NEJMoa2109522?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed">Moderna</a> in children aged 12 and up have shown good results (though at this stage <a href="https://www.tga.gov.au/covid-19-vaccine-spikevax-elasomeran">Moderna</a> is only approved in Australia for adults).</p>
<p>Before we move to vaccinating children under 12 we’ll need safety and efficacy data from trials in this age group.</p>
<p>It’s important to conduct clinical trials specifically <a href="https://www.chop.edu/news/feature-article-covid-19-vaccines-clinical-trials-children">in children</a> because their immune systems are different. For example, children may experience different side effects following vaccination, and may need a smaller dose.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-prepare-your-child-for-a-covid-test-165248">How to prepare your child for a COVID test</a>
</strong>
</em>
</p>
<hr>
<p>Trials of the COVID-19 mRNA vaccines in younger children are under way. The <a href="https://trials.modernatx.com/study/?id=mRNA-1273-P204">Moderna trial</a> KidCOVE is currently recruiting in the US. So far close to 7,000 kids are enrolled. </p>
<p>Meanwhile, Pfizer is aiming to enrol <a href="https://www.pfizer.com/science/coronavirus/vaccine/additional-population-studies">4,500 children under 12</a> across the US and other countries.</p>
<p>The studies are divided into children aged six to 11, aged two to five, and six months to less than two years old. They are aiming to assess safety and immune responses after two vaccinations with <a href="https://clinicaltrials.gov/ct2/show/NCT04796896?term=moderna+pediatric&cond=Covid19&draw=2&rank=1">three different dose sizes</a>.</p>
<p>For <a href="https://clinicaltrials.gov/ct2/show/NCT04816643?term=pfizer+pediatric&cond=Covid19&draw=2&rank=1">Pfizer</a>, the three doses being trialled are 10 micrograms, 20 micrograms, and 30 micrograms (the latter is the dose given to older teens and adults).</p>
<p>A trial of AstraZeneca’s COVID-19 vaccine <a href="https://covid19vaccinetrial.co.uk/volunteer">in children</a> aged 6-17 commenced in March 2021 in the United Kingdom. However this trial was paused as a precautionary measure following reports of blood clots in adults who received this vaccine.</p>
<figure class="align-center ">
<img alt="A young girl in a mask with a teddy bear." src="https://images.theconversation.com/files/417526/original/file-20210824-19-gvlb96.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/417526/original/file-20210824-19-gvlb96.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/417526/original/file-20210824-19-gvlb96.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/417526/original/file-20210824-19-gvlb96.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/417526/original/file-20210824-19-gvlb96.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/417526/original/file-20210824-19-gvlb96.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/417526/original/file-20210824-19-gvlb96.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Children who contract COVID-19 don’t usually need hospital care.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>What now?</h2>
<p>You may be wondering when children under 12 will be able to be vaccinated. The short answer is we don’t know for sure. </p>
<p>We need strong safety and efficacy data from the clinical trials before considering vaccinating young children. Currently, it’s anticipated the first data on children younger than 12 may be available for review <a href="https://www.chop.edu/news/feature-article-covid-19-vaccines-clinical-trials-children">later this year</a>.</p>
<p>For now though, it’s reassuring to know children still appear less likely to end up in hospital with COVID compared to adults.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/is-it-more-infectious-is-it-spreading-in-schools-this-is-what-we-know-about-the-delta-variant-and-kids-163724">Is it more infectious? Is it spreading in schools? This is what we know about the Delta variant and kids</a>
</strong>
</em>
</p>
<hr>
<p>Further, it seems many of the cases we’re seeing in children are due to <a href="https://www.smh.com.au/politics/nsw/household-transmissions-account-for-70-per-cent-of-sydney-s-covid-cases-20210817-p58ji7.html">transmission in the household</a>, often from an infected adult to the child.</p>
<p>So the best way to protect younger kids for now is to ensure as many adults as possible are fully vaccinated.</p>
<p>High vaccine coverage in the community will also benefit children by reducing the need for lockdowns and school closures, which we know can have <a href="https://www.who.int/pmnch/covid-19/toolkits/child/mental-health/en/">negative effects</a> on their education, socialisation and <a href="https://psyarxiv.com/369ey/">mental health</a>.</p><img src="https://counter.theconversation.com/content/165948/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicholas Wood receives funding from the NHMRC for a Career Development Fellowship. He holds a Churchill Fellowship</span></em></p>Trials are under way to ascertain whether COVID vaccines are safe and effective for children under 12. In the meantime, it’s reassuring to note that generally, young kids cope OK with the virus.Nicholas Wood, Associate Professor, Discipline of Childhood and Adolescent Health, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1666032021-08-23T12:56:28Z2021-08-23T12:56:28ZMorrison battles to get hardline premiers to accept the inevitable spread of COVID<p>Australia’s road out of the pandemic has descended into political acrimony and confusion, as Scott Morrison pushes back against the reluctance of some states to accept they will have to live with COVID in their populations.</p>
<p>Morrison on Monday again insisted the nation must open – start “coming out of the cave” – once vaccination levels reached 70% and 80% of the eligible population.</p>
<p>This would mean accepting a large number of COVID cases in the community but minimising hospitalisations and deaths.</p>
<p>“If not at 70% and 80%, then when?” Morrison said. “We must make that move and … we must prepare the country to make that move. The lockdowns now being endured are taking an extremely heavy toll.”</p>
<p>“We must adjust our mindset. Cases will not be the issue once we get above 70%. Dealing with serious illness, hospitalisation, ICU capabilities, our ability to respond in those circumstances, that will be our goal. And we will live with this virus as we live with other infectious diseases. That’s what the national plan is all about.” </p>
<p>NSW Premier Gladys Berejiklian, whose state has new cases running at more than 800 a day, said it was “completely unrealistic” to believe zero COVID could be sustained with the Delta variant.</p>
<p>But Western Australia’s Mark McGowan said: “Queensland has no cases. Northern Territory has no cases. Western Australia has no case. South Australia and Tasmania have no cases. That’s 40% of the national population. And we’re actually quite happy with that. </p>
<p>"So I think there’s a lot of self-serving justification going on by the New South Wales government because of their performance.”</p>
<p>Morrison is trying to hold states to national cabinet’s plan, agreed by all governments, which provides that when vaccination reached 80% (nationally and in the state or territory) lockdowns would be extremely rare and specific.</p>
<p>But WA and Queensland have made it clear they will make their own decisions about opening to other parts of the country even when high vaccination levels are reached.</p>
<p>The Prime Minister told parliament the Doherty Institute had confirmed over the weekend that its modelling on the vaccination levels held regardless of the case numbers in the community at the start.</p>
<p><a href="https://www.doherty.edu.au/uploads/content_doc/DohertyModelling_NationalPlan_and_Addendum_20210810.pdf">The Doherty modelling</a> assumed a very few COVID numbers as its starting point.</p>
<p>The institute’s director, Sharon Lewin, on Monday said opening up with more than the small number of cases didn’t change the trajectory of the modelling, although it would affect the timing.</p>
<p>“The most important message from the modelling, is that once we move to Phase B, when we have 70% vaccination and then to Phase C with 80% vaccination, we no longer have zero COVID as a goal,” she said. </p>
<p>“If you open up with more cases, you reach that peak [of cases] quicker and you have a greater load on your public health system. …The outcome is the same. The load on the public health system is higher when you open up with hundreds of cases.”</p>
<p>In a Monday night statement the institute said: “Once we reach 70% vaccine coverage, opening up at tens or hundreds of cases nationally per day is possible, however, we will need vigilant public health interventions with higher case loads”.</p>
<p>It said that while it might seem the “test, trace, isolate and quarantine” measures were not currently working in NSW or Victoria, in fact they were. “They are stopping transmissions and reducing the effective reproduction rate.</p>
<p>"These measures will become more effective with more people vaccinated as vaccines also contribute to stopping transmission.</p>
<p>"We need to keep suppressing COVID-19 through public health measures while we work towards 70%-80% vaccination across the country. This will ensure we continue to keep the level of hospitalisations and deaths as low as possible to protect the community and prevent our healthcare system from becoming overrun.”</p>
<p>The institute said the team of modellers from across Australia which it was leading was “now working through the implementation issues specific to the states and territories, specific populations and high risk settings”.</p>
<p>Drawing on its modelling the institute said: “In an average year of influenza, we would roughly have 600 deaths and 200,000 cases in Australia. </p>
<p>"In the COVID-19 modelling, opening up at 70% vaccine coverage of the adult population with partial public health measures, we predict 385,983 symptomatic cases and 1,457 deaths over six months. With optimal public health measures (and no lockdowns), this can be significantly reduced to 2,737 infections and 13 deaths.”</p>
<p>McGowan said the national cabinet plan allowed for lockdowns at 70% and 80% two-dose vaccination levels. “It’s in black and white. People should read the plan.” </p>
<p>“My view is we should do everything we can to stay in the state we are currently in, and at the same time vaccinate like hell.</p>
<p>"I think that’s the majority view here and in the states without Covid cases. And in Victoria and the ACT, which are trying to eliminate it as we speak,” McGowan said.</p>
<p>National cabinet on Friday is due to consider the health advice on vaccinating young people 12-15, with the federal government’s aiming for that to be done this year.</p><img src="https://counter.theconversation.com/content/166603/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Australia’s road out of the pandemic has descended into political acrimony and confusion, as Scott Morrison pushes back against the attempt by some states to stay largely COVID-free.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1664252021-08-23T05:46:53Z2021-08-23T05:46:53ZHigh priority: why we must vaccinate children aged 12 and over now<figure><img src="https://images.theconversation.com/files/417324/original/file-20210823-23-1j404lh.jpg?ixlib=rb-1.1.0&rect=0%2C20%2C6709%2C4446&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>People <a href="https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/getting-vaccinated-for-covid-19/covid-19-vaccination-program-for-16-to-39-year-olds">aged 16 and above</a> will soon be able to get a COVID vaccine in Australia, but this begs the question: what about children in younger age groups?</p>
<p>Currently, only 12-15 year olds with underlying medical conditions, Aboriginal and Torres Strait Islander children, and those living in remote communities are <a href="https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/pfizer-covid-19-vaccine-approved-for-at-risk-children-aged-12-15-years">eligible</a>. </p>
<p><a href="https://www.doherty.edu.au/uploads/content_doc/DohertyModelling_NationalPlan_and_Addendum_20210810.pdf">Modelling</a> by the Doherty Institute has suggested vaccinating 12-15 year olds would not make a material difference to the COVID epidemic.</p>
<p>However, as a researcher with expertise on modelling infectious diseases, it’s my view children aged 12 and over must be vaccinated with high priority.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-may-need-to-vaccinate-children-as-young-as-5-to-reach-herd-immunity-with-delta-our-modelling-shows-164942">We may need to vaccinate children as young as 5 to reach herd immunity with Delta, our modelling shows</a>
</strong>
</em>
</p>
<hr>
<h2>Children and transmission</h2>
<p>A key concept you might have heard about is the reproduction number — the number of new cases per infectious case. For the Delta strain, this number could be <a href="https://www.theguardian.com/commentisfree/2021/aug/20/it-might-not-feel-like-it-as-cases-rise-but-nsw-is-controlling-delta">as high as nine</a>. In other words, if there were no lockdowns or other controls in place, each Delta infection could theoretically lead to as many as nine new infections.</p>
<p>The “effective reproduction number” is how many new cases you get per infectious case <em>after</em> public health measures such as lockdowns have been applied. </p>
<p>The Doherty modelling used a baseline effective reproduction number of 3.6 but acknowledges the effective reproduction number will be different from state to state. It can also change over time.</p>
<p>The effective reproduction numbers in NSW and Victoria are currently under two — but this figure could rise when lockdowns lift.</p>
<p><a href="https://theconversation.com/we-may-need-to-vaccinate-children-as-young-as-5-to-reach-herd-immunity-with-delta-our-modelling-shows-164942">Modelling</a> by colleagues and I shows that once the value of the effective reproduction number creeps up above four, all else being equal, children including those younger than 16 start to feature highly in transmission.</p>
<p>In other words, we need to vaccinate children aged 12 and above now, in preparation for a scenario when the effective reproduction number is much higher than it has been under lockdowns.</p>
<h2>A reality check</h2>
<p>In a scenario where children aged 12 and above are returning to school and moving around the community unvaccinated, could masks and social distancing be enough? </p>
<p>Well, perhaps in an ideal world. But many simply assume children will be able to socially distance and wear masks just like adults do. Parents may wish to reflect on that. </p>
<p>We also need to compare old assumptions about COVID and children with what we are now seeing in reality. </p>
<p>The original strain of COVID-19 appeared to spare children; they were less likely than older people to be infected in the first place. The Delta strain seems to have <a href="https://theconversation.com/should-we-vaccinate-children-against-covid-19-we-asked-5-experts-165316">changed</a> all that.</p>
<p>According to <a href="https://www.nsw.gov.au/covid-19/find-the-facts-about-covid-19">NSW Health</a>’s factsheet on coronavirus disease in NSW, only one person under 20 has died due to COVID. However, people in this age group are showing up significantly in overall case numbers. </p>
<p>Since NSW began its current lockdown, <a href="https://data.nsw.gov.au/search/dataset/ds-nsw-ckan-3dc5dc39-40b4-4ee9-8ec6-2d862a916dcf/details?q=">about one third of new COVID</a> cases in NSW (around 3,000) have been in under 20 year olds.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/417319/original/file-20210823-21-1xe4fo0.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/417319/original/file-20210823-21-1xe4fo0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/417319/original/file-20210823-21-1xe4fo0.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=237&fit=crop&dpr=1 600w, https://images.theconversation.com/files/417319/original/file-20210823-21-1xe4fo0.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=237&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/417319/original/file-20210823-21-1xe4fo0.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=237&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/417319/original/file-20210823-21-1xe4fo0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=298&fit=crop&dpr=1 754w, https://images.theconversation.com/files/417319/original/file-20210823-21-1xe4fo0.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=298&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/417319/original/file-20210823-21-1xe4fo0.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=298&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">According to NSW Health, only one person under 20 has died due to COVID but people in this age group are showing up significantly in overall case numbers.</span>
<span class="attribution"><a class="source" href="https://www.nsw.gov.au/covid-19/find-the-facts-about-covid-19">NSW Health</a></span>
</figcaption>
</figure>
<p>Victoria’s chief health officer has also noted childcare centres and schools feature heavily <a href="https://www.dhhs.vic.gov.au/covid-19-chief-health-officer-update#update-outbreaks">among the hotspots in that state</a>.</p>
<p>If Delta does end up infecting children more than the original strain did, children may become the super-spreaders of the Delta variant — just as they are key transmitters of influenza, pertussis, measles, chicken pox and just about every respiratory virus.</p>
<p>Now, some expert groups — <a href="https://www.theaustralian.com.au/nation/politics/how-to-stop-spread-of-covid19-delta-variant-jab-all-teenagers/news-story/7287ea97986dcaff39125c4cb7b3ca55">including modellers</a> — are starting to call for younger children to be vaccinated with high priority. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1428814688154832897"}"></div></p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/should-we-vaccinate-children-against-covid-19-we-asked-5-experts-165316">Should we vaccinate children against COVID-19? We asked 5 experts</a>
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</em>
</p>
<hr>
<h2>Which vaccine? While Pfizer is scarce, we should direct it to younger people</h2>
<p>While Pfizer is scarce, we should be providing Pfizer to the younger population (who are <a href="https://www.doherty.edu.au/uploads/content_doc/DohertyModelling_NationalPlan_and_Addendum_20210810.pdf">more likely</a> to <a href="https://theconversation.com/we-may-need-to-vaccinate-children-as-young-as-5-to-reach-herd-immunity-with-delta-our-modelling-shows-164942">transmit COVID-19</a>), while giving AstraZeneca to older people. </p>
<p>While both vaccines are over 90% effective at reducing death and severe outcomes from COVID (including Delta), <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2108891">Pfizer is better than AstraZeneca at reducing transmission</a> of the virus.</p>
<p>In Australia, children 12-17 are approved to receive Pfizer but not AstraZeneca. </p>
<h2>What are the consequences of not vaccinating younger children?</h2>
<p>The risks of not vaccinating children in the 12+ age group include:</p>
<ul>
<li><p>more children becoming sick with COVID</p></li>
<li><p>denying children potential freedoms that may come with vaccination, such as returning to school, travel or avoiding strict lockdowns</p></li>
<li><p>not vaccinating children means living with the knowledge we haven’t done everything possible to ensure they don’t transmit COVID to more vulnerable people.</p></li>
</ul>
<p>It’s unlikely Australia will achieve herd immunity to COVID this year. </p>
<p>But even without herd immunity, every little bit helps — and the growing number of cases in younger children suggests we need to vaccinate this group sooner, rather than later.</p><img src="https://counter.theconversation.com/content/166425/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emma McBryde receives funding from the NHMRC and the MRFF. She previously worked for the Doherty Institute. </span></em></p>Not vaccinating children means living with the knowledge we haven’t done everything possible to ensure they don’t transmit COVID to more vulnerable people.Emma McBryde, Professor of Infectious Disease and Epidemiology, James Cook UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1664892021-08-20T03:55:43Z2021-08-20T03:55:43ZVIDEO: Michelle Grattan on the legacy of the Afghanistan War<p>Michelle Grattan discusses the week in politics with University of Canberra Associate Professor Caroline Fisher.</p>
<p>This week the pair discuss the evacuation from Afghanistan as the Taliban returns to power - in particular, the government’s moral obligation to Afghan translators who assisted the Australian Defence Force, and the government’s stance on Afghan refugees.</p>
<p>They also discuss recent COVID outbreaks in Indigenous communities, and the announcement that the vaccine will be mandatory for QANTAS employees.</p>
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</figure><img src="https://counter.theconversation.com/content/166489/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Michelle Grattan discusses the political week that was with Professor Paddy Nixon.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1663642021-08-18T09:06:02Z2021-08-18T09:06:02ZPodcast with Michelle Grattan: Was the Afghanistan War worth it?<figure><img src="https://images.theconversation.com/files/416729/original/file-20210818-25-1ow8dpb.png?ixlib=rb-1.1.0&rect=0%2C0%2C4000%2C1994&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> </figcaption></figure><p>As well as her interviews with politicians and experts, Politics with Michelle Grattan now includes “Word from The Hill”, where she discusses the news with members of The Conversation politics team.</p>
<p>In this episode, politics + society editor Amanda Dunn and Michelle discuss the lost war in Afghanistan, as Australia tries to secure the evacuation of its citizens and Afghans who assisted the Australian Defence Force. They also canvass the government’s hard line towards Afghans who came to Australia by boat and are on temporary protection visas.</p>
<p><a href="https://itunes.apple.com/au/podcast/politics-with-michelle-grattan/id703425900?mt=2"><img src="https://images.theconversation.com/files/233721/original/file-20180827-75984-1gfuvlr.png" alt="Listen on Apple Podcasts" width="268" height="68"></a> <a href="https://www.google.com/podcasts?feed=aHR0cHM6Ly90aGVjb252ZXJzYXRpb24uY29tL2F1L3BvZGNhc3RzL3BvbGl0aWNzLXdpdGgtbWljaGVsbGUtZ3JhdHRhbi5yc3M"><img src="https://images.theconversation.com/files/233720/original/file-20180827-75978-3mdxcf.png" alt="" width="268" height="68"></a></p>
<p><a href="https://www.stitcher.com/podcast/the-conversation-4/politics-with-michelle-grattan"><img src="https://images.theconversation.com/files/233716/original/file-20180827-75981-pdp50i.png" alt="Stitcher" width="300" height="88"></a> <a href="https://tunein.com/podcasts/News--Politics-Podcasts/Politics-with-Michelle-Grattan-p227852/"><img src="https://images.theconversation.com/files/233723/original/file-20180827-75984-f0y2gb.png" alt="Listen on TuneIn" width="318" height="125"></a></p>
<p><a href="https://radiopublic.com/politics-with-michelle-grattan-WRElBZ"><img class="alignnone size-medium wp-image-152" src="https://images.theconversation.com/files/233717/original/file-20180827-75990-86y5tg.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" alt="Listen on RadioPublic" width="268" height="87"></a> <a href="https://open.spotify.com/show/5NkaSQoUERalaLBQAqUOcC"><img src="https://images.theconversation.com/files/237984/original/file-20180925-149976-1ks72uy.png?ixlib=rb-1.1.0&q=45&auto=format&w=268&fit=clip" width="268" height="82"></a> </p>
<h2>Additional audio</h2>
<p><a href="https://freemusicarchive.org/music/Blue_Dot_Sessions/Azalai/Gaena">Gaena</a>, Blue Dot Sessions, from Free Music Archive.</p><img src="https://counter.theconversation.com/content/166364/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Michelle Grattan discusses politics with politics + society editor, Amanda DunnMichelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1662792021-08-17T11:52:21Z2021-08-17T11:52:21ZMedical dash as COVID spreads among Indigenous people in western NSW<p>Urgent medical resources are being dispatched to western NSW in a vaccination and support drive after the alarming spread of COVID into Aboriginal communities there.</p>
<p>Health Minister Greg Hunt said the first of five Australian Defence Force vaccination teams will arrive on Wednesday.</p>
<p>An initial Australian Medical Assistance Team (AUSMAT) – which is multidisciplinary health group – will also be sent within a couple of days. AUSMATs can help shore up local hospitals and health services where that might be needed.</p>
<p>COVID has now spread to areas including Bourke, Broken Hill, Brewarrina, Gilgandra, Walgett and Dubbo.</p>
<p>With a large Indigenous population in these areas and a low vaccination rate, COVID presents an especially serious threat. Aboriginal people are vulnerable because they often already have other health conditions.</p>
<p>Most of the about 117 cases in western NSW are among Indigenous people, particularly young people.</p>
<p>The Minister for Indigenous Australians, Ken Wyatt, said that nationally 169,000 Indigenous Australians had had their first vaccine (a rate of 30%), and 69,000 (15%) had had two doses.</p>
<p>The rates are much lower than for the general community, where more than a quarter of eligible Australians (26.9%) are now fully vaccinated.</p>
<p>Wyatt said Indigenous leaders were stepping up and “we’re seeing straight talking happening”. </p>
<p>He said some Indigenous people had been fearful of adverse effects of being vaccinated.</p>
<p>“People are now believing that it is time for them to take the proactive action. And the elders and the leaders are ensuring that the straight messages, straight talking is now part of what communities are hearing.”</p>
<p>Dharriwaa Elders Group at Walgett called for more resources and help in a statement last week. </p>
<p>“Many of our Elders and others in Walgett experience health and social issues that make them vulnerable to contracting COVID-19. The impact on our community could be devastating,” they said.</p>
<p>Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO), said the shortage of Pfizer and people’s reluctance to have AstraZeneca had been problems in the rollout in western NSW.</p>
<p>“People put their back up against getting AstraZeneca,” she said. They had also thought they were a long way from Sydney, where the NSW outbreak was centred.</p>
<p>With the spread of the virus people were now realising they needed to be vaccinated, Turner said. But she was still “very concerned” about the situation in western NSW.</p>
<p>She said one of the problems Aboriginal health centres had was a shortage of staff due to state border closures, as well as nurses not coming from New Zealand.</p>
<p>She welcomed the dispatch of the defence and AUSMAT teams and that increased supplies of Pfizer had been prioritised as well as more testing capacity and personal protective equipment.</p><img src="https://counter.theconversation.com/content/166279/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Urgent medical resources are being dispatched to western NSW in a vaccination and support drive after the alarming spread of COVID into Aboriginal communities.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1645512021-08-16T04:26:12Z2021-08-16T04:26:12Z‘Don’t leave the esky in the sun’: how to get cold vaccines to hot, remote Australia<figure><img src="https://images.theconversation.com/files/416139/original/file-20210814-27-iq6h8f.jpg?ixlib=rb-1.1.0&rect=1%2C4%2C997%2C658&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/off-road-track-outback-683939944">from www.shutterstock.com</a></span></figcaption></figure><p>There’s a <a href="https://www.9news.com.au/national/coronavirus-update-nsw-pfizer-covid-vaccine-shipment-for-walgett-and-other-regional-towns-in-lockdown/78193137-f185-420e-b6d1-88a3f18aa7a2">rush to vaccinate</a> vulnerable remote Aboriginal communities in New South Wales after spread of the coronavirus out of metropolitan areas has led to a state-wide lockdown.</p>
<p>So focus is turning to how quickly we can get COVID-19 vaccines over vast distances, far from vaccine warehouses in the cities, into remote Australians’ arms.</p>
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<p>But transporting vaccines to remote Australia isn’t new. Nor are the challenges that must be overcome to keep vaccines at the right temperature on the long and bumpy journey to remote clinics. </p>
<p>Here are some of the practical issues nurses, Aboriginal and Torres Strait Islander health practitioners, community health workers, pharmacists and others face when vaccines are transported vast distances by road, air or on water.</p>
<h2>It’s a long way</h2>
<p>The vast distances and isolated communities of remote Australia pose significant challenges to transporting vaccines. Then there are the environmental extremes, with freezing winter nights and scorching summer days, plus monsoonal rains and cyclones often interrupting transport services and making regions inaccessible for weeks. </p>
<p>Keeping vaccines at the right temperature over large distances, over days and weeks, can be challenging. But vaccines are temperature-sensitive products, and their effectiveness is dependent on correct storage. If a vaccine is too hot or too cold it may be damaged and not work as well.</p>
<p>So it’s critical to keep vaccines at the right temperature to ensure their safety and efficacy.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1403230641064497153"}"></div></p>
<p>For non-COVID vaccines and the <a href="https://www.health.nsw.gov.au/Infectious/covid-19/vaccine/Pages/az-refrigerator-to-administration.aspx">AstraZeneca COVID vaccine</a>, the recommended cold chain — between 2°C and 8°C — must be maintained from the place of manufacture to administration in the community.</p>
<p>However, transport and storage requirements for the Pfizer COVID vaccine are different. Unopened vials of the vaccine <a href="https://www.tga.gov.au/media-release/wider-storage-and-transportation-conditions-pfizer-covid-19-vaccine-now-approved">need to be stored</a> and transported at domestic freezer temperatures, between -25°C and -15°C, for up to two weeks. </p>
<p>Unopened vials may also be stored at domestic refrigerator temperatures, between 2°C to 8°C, for up to five days. Once a Pfizer vaccine has thawed it should not be re-frozen.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/cracking-the-cold-chain-challenge-is-key-to-making-vaccines-ubiquitous-99329">Cracking the cold chain challenge is key to making vaccines ubiquitous</a>
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<p>Keeping vaccines <a href="https://www.health.gov.au/resources/publications/national-vaccine-storage-guidelines-strive-for-5">in the recommended temperature range</a> over long distances often means styrofoam boxes and regular eskies are inadequate, particularly when the transit time is likely to be three to four days. Transporting vaccines to remote Australia requires special infrastructure, including dedicated <a href="https://www.health.gov.au/health-topics/immunisation/health-professionals/storing-handling-and-administering-vaccines">vaccine fridges and insulated containers</a>.</p>
<p>If there’s a cold-chain breach, when vaccines are exposed to temperatures outside the recommended range, the vaccines may become damaged and might need to be thrown away and replaced. </p>
<p>Such breaches are estimated to have cost the Australian health system <a href="https://www1.racgp.org.au/newsgp/clinical/tip-of-the-cold-chain-iceberg-vaccines-worth-26-mi">at least A$25.9 million</a> in replacement vaccines over a five-year period. This estimate is pre-COVID, so the figure is likely higher if we take into account any cold-chain breaches with COVID vaccines.</p>
<p>There is a significant risk <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-842X.1996.tb01084.x">of this happening</a> in remote Australia.</p>
<h2>All staff need to be aware</h2>
<p>All staff involved in the vaccination process, from manufacture to transport to administration, must understand the need to <a href="https://www.health.gov.au/resources/publications/national-vaccine-storage-guidelines-strive-for-5">maintain the cold chain</a> and the risks associated with cold chain breaches. </p>
<p>This includes knowing the correct way to pack the vaccines in an insulated container (such as a vaccine cold box, esky or styrofoam box), using temperature monitors, and what to do when there’s a cold-chain breach.</p>
<p>However, there are few training materials dealing with vaccine cold chain in remote Australia. And with high staff turnover, it’s difficult to know everyone in the chain has the right training.</p>
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<strong>
Read more:
<a href="https://theconversation.com/first-nations-people-urgently-need-to-get-vaccinated-but-are-not-being-consulted-on-the-rollout-strategy-164067">First Nations people urgently need to get vaccinated, but are not being consulted on the rollout strategy</a>
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<h2>We made a video</h2>
<p>A team at Flinders University collaborated with Irene Nangala — a Pintupi elder and director of Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation (<a href="https://www.purplehouse.org.au">Purple House</a>), an Aboriginal community controlled organisation in Alice Springs — to make a short educational video called Vaccine Story.</p>
<p>The video depicts the journey a vaccine takes from a supply centre to a remote Australian community in a culturally appropriate manner. </p>
<p>This freely available video is especially useful for non-clinical staff, who may not otherwise receive professional training or updates.</p>
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<figcaption><span class="caption">Vaccine Story follows an esky full of vaccines from the city to remote Australia.</span></figcaption>
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<h2>Transport is important</h2>
<p>The video also looks at the importance of transport in maintaining the cold chain, especially in the “last mile” of <a href="https://www.nejm.org/doi/full/10.1056/NEJMp2100574">vaccine logistics</a>. </p>
<p>For remote Australia, variable and unreliable transport add extra logistical challenges. Freight to remote communities is often limited with infrequent or non-existent services. </p>
<p>So local clinics and supply centres need to be adaptable and resourceful to ensure vaccine supply. The right transport option for one day might not be the best for another. Staff need to ask:</p>
<ul>
<li><p>is there a bus travelling to the community today?</p></li>
<li><p>can the visiting specialist team take the esky with them on the plane?</p></li>
<li><p>can the patient-transport driver pick up the vaccine from the pharmacy?</p></li>
<li><p>how are the roads today?</p></li>
</ul>
<p>Each of these options presents new challenges. Non-clinical staff may have to be trained in how to handle vaccines and the importance of maintaining the cold chain. </p>
<p>For example, the esky needs to be safely secured in the car. If it bounces around, the ice bricks may come into direct contact with the vaccines, which can cause them to freeze (the vaccines are generally separated from the ice with packing materials).</p>
<p>Staff will have to consider the temperature in a car, bus, the hull of a plane or on a barge. Vaccines will have to be handed over to the right person, not left on the runway or on the clinic doorstep in the sun.</p>
<p>There must be good lines of communication so everyone knows where the vaccines are.</p>
<h2>The electricity’s out</h2>
<p>Vaccines need to be stored in dedicated vaccine fridges when they reach the clinic in remote Australia.</p>
<p>However, challenges in maintaining the cold chain don’t stop there. It’s common in remote communities for <a href="https://www.theguardian.com/australia-news/2020/mar/04/power-outages-leave-aboriginal-people-on-nt-islands-with-no-food-fuel-or-phones-for-three-days">electricity outages</a> that mean vaccine fridges go off. Clinic staff <a href="https://www.remotephcmanuals.com.au/">need to be trained</a> in <a href="https://www.health.gov.au/sites/default/files/documents/2020/04/national-vaccine-storage-guidelines-strive-for-5.pdf">how to manage</a> these situations.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-manage-your-essential-medicines-in-a-bushfire-or-other-emergency-127516">How to manage your essential medicines in a bushfire or other emergency</a>
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<h2>It’s a long road</h2>
<p>Despite these significant logistical challenges, vaccines have been successfully shipped to remote Australia for years before COVID vaccines became urgently needed.</p>
<p>But with the latest COVID cases in remote NSW, we’re reminded just how different the vaccine cold chain is in the bush compared with the city.</p>
<p>So all eyes are on looking after this precious cargo, including maintaining the cold chain.</p><img src="https://counter.theconversation.com/content/164551/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tobias Speare received funding from Northern Territory PHN to create Vaccine Story video.</span></em></p><p class="fine-print"><em><span>Suzanne Belton is employed by CARPA to evaluate the Vaccine Story film. </span></em></p>Millions of dollars worth of vaccines are thrown out each year because they are not transported or stored at the right temperature. We made a video to help prevent that.Tobias Speare, Lecturer, Pharmacy Academic, Rural and Remote Health NT, Flinders UniversitySuzanne Belton, Associate professor, Menzies School of Health ResearchLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1661552021-08-15T08:51:41Z2021-08-15T08:51:41ZPfizer from Poland directed to young super spreaders<p>People aged 20-39, who were identified by the Doherty Institute modelling as super spreaders of COVID, will be targeted for the one million Pfizer doses the Morrison government has purchased from Poland.</p>
<p>Of these, 530,000 doses will be sent urgently to a dozen Sydney local government areas, where the outbreak remains out of control. They will start being administered in state clinics this week, Scott Morrison said.</p>
<p>He said the allocation to NSW “will give everyone aged 20 to 39 years in the 12 LGAs the opportunity to be vaccinated”.</p>
<p>The Doherty modelling said: “As supply allows, extending vaccinations for adults under 40 years offers the greatest potential to reduce transmission now that a high proportion of vulnerable Australians are vaccinated”.</p>
<p>When the modelling was recently released Professor Jodie McVernon, Director of Epidemiology at the Doherty Institute, said the 20 to 39 year olds were “the peak spreaders” of the virus.</p>
<p>“They will bring COVID home to their children, they will take it home to their own parents, and this is the group now where we’re proposing the reorientation of the strategy,” she said.</p>
<p>In the heartland of the Sydney outbreak many of this age group are necessarily mobile because they are in essential jobs and unable to work from home.</p>
<p>Sunday saw 415 new locally acquired NSW cases announced and four deaths. Late Saturday the state government locked down the whole of regional NSW. Victoria recorded 25 new cases and the ACT two, in Sunday’s announcements.</p>
<p>NSW Premier Gladys Berejiklian said:“The experience of Delta is that no other jurisdiction has been able to eliminate it. It’s not possible to eliminate it completely. We have to learn to live with it. But the best chance we have to live with it freely and safely is to get the case numbers down as low as possible.”</p>
<p>A particular concern is the spread of the disease into regional areas of NSW where there are vulnerable Indigenous populations.</p>
<p>The Pfizer doses from Poland were set to begin landing in Australia on Sunday night.</p>
<p>The rest of the vaccines will be distributed on a per capita basis to other parts of the country, to accelerate the vaccination of the under 40s and high risk groups.</p>
<p>“Within days of landing in Australia, these extra Pfizer doses will be available to go into the arms of young Australians in our hardest hit COVID hot-spots,” Morrison said.</p>
<p>“These young Australians are often the backbone of our essential workforce and these doses will not only protect them, but their loved ones, their state and our nation.” </p>
<p>He thanked Polish Prime Minister Mateusz Morawiecki and the Polish government “for their generous support of Australia’s COVID-19 response, during this challenging time”.</p>
<p>The vaccines were produced at Pfizer’s Belgium facility.</p>
<p>The federal government has been pulling out all stops internationally to try to get more Pfizer.</p><img src="https://counter.theconversation.com/content/166155/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>People aged 20-39, who were identified by the Doherty Institute modelling as super spreaders of COVID will be targeted for the one million Pfizer doses the Morrison government has purchased from Poland.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1660942021-08-13T01:57:49Z2021-08-13T01:57:49ZVIDEO: Michelle Grattan on mandatory vaccination and the IPCC report<p>Michelle Grattan discusses the week in politics with University of Canberra Associate Professor Caroline Fisher.</p>
<p>This week the pair discuss provisional approval of the Moderna vaccine, as well as the wider question of vaccine hesitancy - especially in light of George Christensen’s controversial speech before Question Time on Tuesday.</p>
<p>They also discuss the government’s response to the grim report out of the Intergovernmental Panel on Climate Change, which has called for immediate action to combat global warming.</p>
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</figure><img src="https://counter.theconversation.com/content/166094/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>University of Canberra Professorial Fellow Michelle Grattan and University of Canberra Associate Professor Caroline Fisher discuss the week in politics.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1660452021-08-12T12:12:01Z2021-08-12T12:12:01ZGrattan on Friday: Vaccine passports are a better tool than mandating jabs for all jobs<p>As the nation proceeds – but still at an agonisingly slow pace – towards the targets of having 70% and 80% of those 16 and over fully vaccinated, the next big debate is about making the jab compulsory in workplaces.</p>
<p>This would give the community greater protection and accelerate the lifting of restrictions and opening the economy.</p>
<p>Dig deeper, however, and it’s a fraught issue, full of political, legal, practical and ethical complexities.</p>
<p>From the start, Scott Morrison has insisted his government would not make taking the vaccine mandatory.</p>
<p>It’s not just a matter of the anti-vaxxers, who are only a small, albeit noisy, minority.</p>
<p>It’s that many in the Coalition’s ranks and, even more important, among its base would be totally against compulsion. A fair number of these have already been angered by the extent of restrictions, believing civil rights have been excessively compromised.</p>
<p>So when individual businesses, notably the food processor SPC, started down the road of requiring workers to be vaccinated, Morrison last week had the solicitor-general brief national cabinet on the confusing legalities. He also said neither the federal government nor any state or territory intended to legislate to give employers the legal safety they would like.</p>
<p>“We are not going to seek to impose a mandatory vaccination program by the government by stealth,” he said this week. </p>
<p>A very hot potato has been left firmly in the hands of individual businesses.</p>
<p>They are in an awkward position. The advantage of having their workplaces vaccinated is obvious. But the legal position is unclear. In the absence of a public health order, they would be relying on directions to employees being judged lawful and reasonable. Inevitably there would be court challenges.</p>
<p><a href="https://coronavirus.fairwork.gov.au/coronavirus-and-australian-workplace-laws/covid-19-vaccinations-and-the-workplace/covid-19-vaccinations-workplace-rights-and-obligations">In advice published on Thursday</a>, the Fair Work Ombudsman said: “In some cases, employers may be able to require their employees to be vaccinated against COVID-19. Employers should exercise caution if they’re considering making COVID-19 vaccinations mandatory in their workplace and get their own legal advice.”</p>
<p>ACTU secretary Sally McManus doubts the legality, short of public health orders, of employers forcing vaccinations and says support and encouragement for employees is the better way to go.</p>
<p>Even apart from any court challenge, some businesses would face division among their workers, and potential dismissals and voluntary departures. When Western Australia made vaccination compulsory for quarantine workers – surely a very reasonable requirement – it lost some of them.</p>
<p>Simon Longstaff, head of The Ethics Centre, points to the distinction between vaccination being compulsory or a condition for doing something.</p>
<p>Vaccination could be a condition for a person working in a company, just like donning safety equipment is for certain jobs, Longstaff says. “If they are not prepared to accept the condition, then they may choose not to work for an employer imposing such a condition.”</p>
<p>But “conditions” form a continuum. For example, having to be vaccinated to work in a hospital is very different to the jab being required to keep a job that involves minimal risk. </p>
<p>This takes us to the various ways of skinning the cat – and to vaccine “passports”. The government already has the beginnings of a vaccine passport scheme, although it won’t use that name – because its “base” doesn’t like the idea. It calls it a certificate.</p>
<p>The vaccine passport is the iron-fist-in-velvet-glove approach to imposing vaccinations.</p>
<p>Once we reach the 70% or 80%, and people are registered as being vaccinated, evidence of having had the jab will be the gateway to freedoms. Looked at the other way, lack of the passport would restrict what people could do.</p>
<p>A vaccine passport could be as necessary for international travel as a national passport. At a more mundane level, it could be required to eat at a restaurant just as, currently, people are told to sign in. Similarly, it could be needed to attend music or sporting events. Or to enter Parliament House.</p>
<p>Forcing people, directing or indirectly, to have a COVID vaccination involves sometimes competing rights – your right to choose whether to accept a vaccine, my right to be safe in the workplace and the community’s right to protection from a very serious and potentially fatal disease.</p>
<p>It is not as simple as “no jab no pay” for the vaccination of children, which only denies government benefits. In the COVID case we’re talking, in the extreme, about people’s access to jobs and livelihoods.</p>
<p>So where are we left?</p>
<p>When people are dealing with the vulnerable – most obviously in aged care – the rights of those being cared for clearly come ahead of the workers’ right to choose. National cabinet was correct in supporting the mandating of vaccinations of the aged care workforce. </p>
<p>Workers in quarantine, disability, and health care are, or should be, treated similarly by whoever employs them.</p>
<p>There are many other “frontline” workers, including those in supermarkets and hospitality. While this gets us back to the compulsion issue, it could be tackled, especially in occupations where there is high turnover, by giving preference in hiring to the vaccinated. This would be harsh, but less harsh than firing workers.</p>
<p>When everyone eligible has been offered the vaccine, we will have a better idea of the size of the minority of unvaccinated people we’re dealing with.</p>
<p>It’s important during the rollout to minimise this pool – to make sure as many as possible of the apathetic have been motivated and the hesitant persuaded.</p>
<p>The latest government “vaccine sentiment” survey, released on Thursday, had 79% of Australians intending to get vaccinated, or already done. According to rollout chief Lieutenant General J.J. Frewen, of the rest 14% were making up that their minds and only 7% were saying they won’t get vaccinated. </p>
<p>Incentives may be helpful, although they shouldn’t be as expensive or extensive as Anthony Albanese’s $300 for everyone vaccinated. Much better advertising is also needed, including niche campaigns where vaccination is below average.</p>
<p>The Australian community has proved remarkably compliant during COVID. Some hesitancy about AstraZeneca notwithstanding, we are lagging in our vaccination rate not primarily because of the public’s resistance or reluctance but because of the faults in the rollout. With improvements in that, and a combination of the positive and negative incentives of the vaccine passport, we can probably reach a vaccination level high enough to keep the community safe without having to go further down the road of compulsion.</p><img src="https://counter.theconversation.com/content/166045/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michelle Grattan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>As the nation proceeds towards the targets of having 70% and 80% fully vaccinated, we are lagging not because of the public’s reluctance but because of the faults in the rollout.Michelle Grattan, Professorial Fellow, University of CanberraLicensed as Creative Commons – attribution, no derivatives.