Why Australia's two largest states are behind in the vaccination race

© 2021 Matt Jelonek

In Western Australia’s remote Pilbara, where mining drives the state economy co-ordinated from 1000 kilometres south in Perth, people are itching to get the jab. But more than 200 days into the national rollout, many still have not.

“There’s a lot of young families who live in the mining towns and that’s why they haven’t been done,” Shire of Ashburton president Kerry White said from the heart of WA’s powerhouse region. “But now that Pfizer is available they’ve got the opportunity to go and get it done.”

“They’re all very keen, we have to be because with all these mines, if the virus got into one it would shut the Pilbara down.”

Hosting some of the lowest COVID-19 vaccination rates in Australia – at about 14 per cent double-dosed among the 16-plus population, compared to the 50.1 per cent national average – White said supply has been a big issue to date. There, mining giants are joining forces with the McGowan government and local councils to get faster access to the jabs.

About 3300 kilometres due east, in Queensland’s own regional mining heartland, low vaccination rates have also raised eyebrows. Among the local government area of Isaac, only 17.8 per cent have received a second dose.

Mayor Anne Barker says the council had been disappointed by the figures and was working with Queensland Health to boost access. Though until increasing supply meant the broader population under 40 could begin to get Pfizer, not just priority groups, more than half the population was not eligible. A lack of both supply and clinics “definitely slowed” the uptake.

Now that new hubs were opening in the region, she remains hopeful the numbers will climb. “Vaccination is, without doubt, our greatest weapon to fight this virus,” Cr Barker said.

Both regions are among the lowest ranking in those there is consistent data for nationwide. While there are promising stories around uptake in some remote Indigenous communities, of which both states have many, there are also fears for others after what has been seen in western NSW.

Both WA and Queensland make up more than half the country’s landmass, but host only 30 per cent of the population. In Queensland, unlike all other Australian jurisdictions barring the small island state of Tasmania, less than half live in the capital.

Both have also drawn much of the Commonwealth ire for their last-place duel in the race to protect their populations from all-but-inevitable Delta variant outbreaks, as the country angles to begin reopening this year at targets of 70 and 80 per cent of the eligible population fully vaccinated under the national plan.

In NSW, Victoria and the ACT, weeks and months into their toughest outbreaks of the pandemic, the pace of vaccination has upped gears.

All three are well ahead of the national average on both first and second dose figures and are now looking to vaccinate their way out of lockdowns, having given up on suppressing or eliminating the virus. The ACT is much smaller and largely metropolitan, too. Tasmania also sits slightly further ahead of the pack.

At the bottom, there are Queensland and WA. But they are among the remaining essentially COVID-free jurisdictions within about six percentage points of each other on second doses – between 43.9 per cent and 50 per cent. On first doses, the field narrows to 2.7 percentage points.

Based on the current speed, all are widely tipped to reach 80 per cent by mid December at the latest.

The two Labor premiers’ hesitancy to open borders to hotspot states once vaccination targets are reached has also been a point of significant contention, and vocal criticism, among elements of the Coalition and business community. Though officials in the NT and Tasmania have also, more quietly, flagged closed borders at Christmas and an aim to stay closed until 90 per cent is double-dosed.

Queensland’s Annastacia Palaszczuk declared on Thursday the freedoms being aimed for in NSW and Victoria at 80 per cent would be a “backwards” step from those already available in her state, and has consistently heaped blame on the federal government’s for lacking supply.

Western Australia’s Mark McGowan has blamed an unfair vaccine share from the Commonwealth, as the reason vaccine uptake is low, despite nearly 20,000 unbooked Pfizer appointments being available at state-run clinics at the time he made the comments.

Both of the largest states have now opened Pfizer doses to over-60s, in an effort to encourage remaining people only previously eligible for the much misaligned AstraZeneca to get the jab. NSW and Victoria are among the few remaining jurisdictions to have not.

The stated population-share basis of the national rollout has swayed slightly to states facing outbreaks, along with greater portions of priority groups.

Experts say lifting vaccination rates boils down motivation and access. The latter has largely been an issue Australia-wide until recent weeks. The former is also a more uphill push for largely COVID-free jurisdictions already home to the freedoms others are now trying to vaccinate their way to.

Immunologist and Laureate Professor Peter Doherty, patron of the Doherty Institute, believed this had been a driving factor behind the national progress.

Former Queensland chief health officer and emergency medicine expert Gerard FitzGerald, now at Queensland University of Technology, said distribution across the two largest and most decentralised states also played a part when mass hubs in capital cities could theoretically manage more than three-quarters of some other state populations.

But the relatively small coverage gaps among most states was largely moot, Professor FitzGerald said. And it was better to think of targets in behavioural terms rather than freedom-day trigger points: once enough supply had arrived and time had passed for every eligible person who wanted the jab to have had a “reasonable” chance to access their two doses.

After this, there needed to be a shift in approach nationwide. “We can’t continue to hold back the rest of the community,” he said.

Hermione Parsons, director of Deakin University’s Centre for Supply Chain and Logistics, believes the fundamental issue was an early Commonwealth failure to procure enough vaccine doses fast enough – from enough types and sources – for the entire population, pointing to early approaches from Pfizer to federal Health Minister Greg Hunt.

She said “glib” early messaging from the federal government that it was not a race and – as concerns around the extremely rare AstraZeneca clotting side effect – that there would be enough mRNA vaccines for everyone later in the year, also did not help. (Others, including Ms Palaszczuk, have also been criticised for muddying the waters on the safe and effective jab).

“Did they have the urgency in the procurement of, and the purchasing of vaccines, did they have the volumes worked out, and did they mitigate risk?” Dr Parsons said. “I would say no.”

A federal Health Department spokeswoman said the Commonwealth was working with all parties, including the Royal Flying Doctors Service and Defence Force in remote settings, to ensure all Australians had access to a COVID-19 vaccine. Targeted work was also being done with states and territories in local government areas falling behind.

With more than 21 million mRNA vaccines arriving in September and October, she said this meant “every Australian over the age of 16, in every state and territory, will have the opportunity to be fully vaccinated” before November.

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