80% vaccination is the goal. What do we need to do to get there?

The recent four-phase national cabinet plan to get a vaccinated Australia back to normal is just a skeleton. We all want the details — flesh on the bones. How might the plan be more useful? Will a particular uptake figure for vaccination really be the ticket to freedom from lockdowns, to attend work and schools, the liberty to travel?

Today, national cabinet will for the first time look at the Doherty Institute’s modelling on the vaccination rates required to move the country out of lockdowns and tough restrictions. But are four phases enough? 

Getting to herd immunity

We need a range of targets starting at about 60% to minimise lockdowns. But much more is needed to get herd immunity and the freedom we ache for — at least 80% of the adult population vaccinated. Intensive mathematical modelling is anxiously awaited.  

We already have targets for herd immunity against other infections. Herd immunity for measles is set at 95% in Australia. Vaccination rates in Australia for children is very high, with 95% routinely achieved. 

Getting 80% of the population vaccinated for COVID-19 is possible. The general public and health workers pulled together in 2020 to get huge numbers vaccinated for influenza — 18 million people in a few months, a record high. 

Critical issues

There are ongoing critical issues that have to be addressed before herd immunity can be achieved, including vaccine supply, logistics of ramping up vaccination delivery, and addressing public hesitancy. 

Other organisations have addressed what needs to be done prior to the government announcing its four-phase plan. A seven-point plan for better vaccination of adults generally was launched in July by Dr Rod Pearce, chairman of Immunisation Coalition, while the Collaboration on Social Science and Immunisation (COSSI) outlined a six-point plan last Christmas to promote COVID-19 vaccination rates. 

The Immunisation Coalitions plan goes to priorities, calling especially to strengthen the monitoring of vaccination and accountability for rollouts, to improving access to vaccination, and enhance public understanding through clear and accurate messaging. These were all based on an extensive review of both local and international evidence. 

To its credit, the government has just introduced mandatory reporting of adult vaccination, and targets for COVID vaccine uptake are being mathematically modelled. But the public health communication campaigns in place have yet to achieve traction.

What can we do? 

We advocate that at-risk groups need focused communications: those of different ages and ethnicity, Indigenous Australians, the medically unwell. 

Communication with healthcare providers (GPs, nurses, and pharmacists) needs a major overhaul. It must be much more timely. GPs need to be able to give their patients digestible advice that is coherent and consistent. Policy changes by the government will be far better supported if explanations arrive to GPs before the public.

Vaccination really is a gift that goes on giving. And we can all maximise the protection of people, especially the vulnerable elderly and their carers, in Australia and abroad.

Our neighbours, near and far, need our help — everyone has a role to play in getting vaccinated, observing public health measures and, crucially, in giving back. The very large outbreaks in PNG and Indonesia are fanning the fires of viral mutation and enhancing the emergence of a new variant that is even more transmissible and difficult to control.

UNICEF is accepting pay-it-forward donations to support the COVAX facility delivering vaccination to low-income countries.

Professor Robert Booy is chair and director of the Immunisation Coalition Scientific Advisory Committee and developed the pay-it-forward COVID-19 jab initiative.