A woman takes part in an anti-vaccination protest in Parliament Square, London. Photo / Getty Images
How Australians live in the future will likely depend on whether people get vaccinated. So how does Australia ensure everyone gets the jab, asks Charis Chang.
Vaccinating against Covid-19 is the easiest way for Australians to get their normal lives back, but millions are hesitant to get the jab.
News.com.au's Our Best Shot campaign answers questions about the Covid-19 vaccine roll out.
We'll debunk myths about vaccines, answer your concerns about the jab and tell Australians when you can get the Covid-19 vaccine.
While it's tempting to dismiss people's concerns as uninformed or silly, immunisation expert Associate Professor Margie Danchin of the University of Melbourne believes this is the worst thing people can do.
Prof Danchin runs a weekly clinic at The Royal Children's Hospital in Melbourne where she provides information to people who are vaccine hesitant.
"It's critical that you don't battle with people who have vaccination concerns," she told news.com.au.
"If there is trust and there's rapport, hearing and listening, then you are in a much better position to communicate information and a chance to change their minds," she said.
She said if someone was in a heightened state of "fight or flight" they would have their defences up and would not be receptive to receiving factual information.
If they feel open and listened to, they can relax and absorb the information.
There is also a lot of "noise" that confuses people on the internet and people often didn't know which sources to trust.
Prof Danchin believes doctors in particular will play a crucial role in helping people who are vaccine hesitant to feel more comfortable about getting the jab.
"Engagement with their health care provider (such as their GP) is the most likely point of contact where a hesitant person may change their mind," she said.
"That's going to be critical for the Covid vaccine, that people can discuss this with a trusted health care provider, that there's information and that there's transparency."
News.com.au understands that government research from October and November last year, found about 80 per cent of Australians would be somewhat or very likely to get vaccinated if it was available to them at no cost.
Those least likely to be vaccinated were Queenslanders with 75 per cent saying they would, compared to South Australians, who were the most likely to get the jab, with 83 per cent willing to do so.
Overall, this leaves around 20 per cent of Australians who may resist getting the jab and it's unclear whether this will be enough to achieve herd immunity.
Achieving herd immunity provides Australia's best chance at returning to normal life, but it requires a substantial amount of the population to be vaccinated, especially in a place like Australia where there has not been many coronavirus cases and not many people have natural immunity.
The exact percentage depends on factors including how effective vaccines are.
Based on current estimates of the infectiousness of Covid-19, a vaccine with efficacy of 90 per cent, would require about 70 per cent of the population to be vaccinated, to achieve herd immunity, infectious diseases expert Professor Raina MacIntyre told news.com.au.
The AstraZeneca vaccine, which Australia will be relying on for most of its vaccination programme, only has an efficacy of around 60 per cent so may require a much higher uptake.
However, Prof Danchin said other research showed that generally a higher number of people were willing to take vaccinations than the government research indicated.
She said about 90 to 94 per cent of people were vaccinated in Australia, even if they still held concerns. Research has shown that people who are willing to get other vaccinations, were also more likely to get the Covid-19 jab.
Generally, Prof Danchin said only about 6-8 per cent of Australians are unvaccinated and the reasons for this vary.
Prof Danchin said an estimated 3 per cent were vaccine refusers or deniers, who tended to have the most extreme views, including about government or pharmaceutical conspiracies, or religious views that object to the use of aborted foetuses used to produce some vaccines in the 1960s.
While it can be hard to change their minds, Prof Danchin said it was still important to show them respect and openness.
This leaves about 3-5 per cent of the population who may be vaccine hesitant for other reasons.
"Vaccine hesitancy exists on a spectrum," Prof Danchin said.
"You have 'fence sitters' who are still vaccinating despite having concerns and 'cherry pickers' who might get some vaccines but not others."
She said 'cherry pickers' in particular were open to getting vaccinated if trust was developed and if they felt heard and had their questions answered.
Prof Danchin said some people's concerns were vaccine specific but others could have different fears depending on what period of life they were in and what vaccine they were receiving.
"It varies among pregnant women, parents of adolescents, elderly and young children," she said.
Prof Danchin said one of the top concerns among parents for example, was that they thought there were too many vaccinations in the first two years of their child's life. The second top concern was that vaccination ingredients were toxic.
Government research found the main barriers to vaccination when it comes to Covid-19 relate to the potential long-term side effects of the vaccine, with 23 per cent concerned about this. People were also worried they did not know enough about it (22 per cent), while 18 per cent felt there had been inadequate testing or research, and 17 per cent felt the process was rushed.
In particular women aged 30 to 39 had concerns about the safety of the vaccine, with 42 per cent of this age group saying they were worried.
Prof Danchin said this may be because they are potentially more engaged with organising vaccines for their children.
"I think it's something that needs to be further explored and it's probably related to being engaged about giving vaccinations to young children. Whereas older people and other adults don't even think about vaccination," she said.
Pregnant women are also often not included in trials and this has been the case for the Covid vaccines. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) have recommended pregnant women do not get Covid vaccines because not enough information is known about the impacts.
Vaccines are often tested mainly on men, and the lack of testing on women and in particular pregnant women, has meant much less is known about women's bodies, making them more likely to have negative experiences with the healthcare system.
"We know from previous research that women are less likely to be believed by doctors about pain and chronic conditions," Dr Naomi Smith told The Guardian. "Women are under-diagnosed or treated for psychological problems instead of their physical symptoms.
"In a system that can often be hostile to women and their health needs, women do often have lower levels of trust in the medical establishment, because they are not taken seriously."
In contrast, Australians aged over 60 years were the group most likely to get the jab, with 66 per cent saying they would do so compared to 45 per cent among other age groups.
There are also practical barriers to some people getting vaccinated.
"Maybe they can't get time off work, struggle to get an appointment at their GP or need reminder letters," Prof Danchin said.
Concerns may also vary among different geographical groups.
"The most critical thing is the importance of trust and rapport," she said.
"People need to feel they are getting trusted, clear information and their concerns have been addressed.
"This will be critical for Covid and there is a need for transparency.
"If there isn't an answer to their questions, we should say so, but most times we can address people's concerns."
Health Minister Greg Hunt said the Federal Government had committed A$23.9 million for a national public education campaign to be rolled out about Australia's Covid-19 vaccination programme.
"The campaign will help ensure confidence in the rigour of Australia's approval process and encourage uptake of the vaccine when the time comes, across a number of channels," he said.
Resources are being made available online with information on Australia's vaccine candidates, national rollout strategy, the Therapeutic Goods Administration's (TGA) assessment and approval process, Australia's priority population groups and more.
There will also be information specifically for priority groups, culturally and linguistically diverse (CALD) groups and Aboriginal and Torres Strait Islander people.
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