A person holds their hand up to an injection

Hesitant about COVID-19 vaccines? You’re not alone

The latest data from the COVID-19 vaccine preparedness study see Australians’ intention to get a COVID-19 vaccine, population-wide, sitting around 66%.

But since the report’s release at the beginning of April, more recent surveys indicate that the national willingness to get vaccinated has declined across all population subgroups, according to Professor Margie Danchin, an immunisation expert and group leader of the vaccine uptake group at the Murdoch Children’s Research Institute, Melbourne.

“People have every right to have questions about these vaccines, and they should have questions,” says Danchin, who says there is a lot of judgment around the word “hesitant”.

She believes that, instead, the discussion should be “about supporting health providers who are having these conversations on the ground, with the right resources and the right information to be able to reassure people”.

Danchin says people are mainly worried about vaccine safety – about possible severe side effects, such as the rare blood clots that occurred in people who have received the AstraZeneca jab, and also more common side effects, such as local injection-site reactions and systemic symptoms.

People are also concerned about long-term unknown effects that might reveal some years down the track.

But probably the most common doubt, says Danchin, is whether vaccines developed in such an extraordinarily short time can be trusted: “There is a lot of concern out there.”

“Those questions are normal and expected,” she says. “But now we need to roll up our sleeves and really trying to address people’s questions.”

Danchin is also the vaccine risk communication and community engagement consultant for ATAGI (the Australian Technical Advisory Group on Immunisation), in which capacity, she emphasises, “all we can do is advise the government and then it’s up to the government [to decide] what they do”.

“I’m one of the people responsible for advising on that communication approach,” she says. “And the advice that we’ve provided to the Commonwealth and to the state governments and different jurisdictions is around community engagement and risk communications.

“So community engagement is what we have managed to progress here in Victoria – we have funding from the Victorian Government.

“We have approached the Commonwealth…to do that work nationally, but they did not want to take that up.”

“The only way that we can really get back to normal is getting vaccinated,” says Professor Fiona Russell, a paediatrician at the Murdoch Children’s Research Institute, Melbourne, and public health and epidemiology expert.

The rapid spreading of the disease in neighbouring countries is a constant concern. Our hotel quarantine system provides a layer of protection, but it has flaws, and the rapid emergence of more variants means that a quarantine breach could lead to the virus getting out of control quickly.

Protection from vaccines is not immediate. The first doses of any of the approved vaccines give some protection, but full cover can take weeks with Pfizer’s vaccine or months with AstraZeneca’s.

Underlying this is the understanding that we can’t keep our borders shut forever, and eventually, the virus will break into the country. When that happens, the level of vaccination in the population will determine the severity of the outbreak.

“People don’t see the urgency in it,” says Russell. “But we know that we could go down the gurgler really quickly.”

“The benefits of vaccination to prevent severe disease – in other words, admission to hospital or ICU and death – is not really resonating with the public at the moment because they don’t see disease in the community,” agrees Danchin.

But if staying out of ICU, or reducing the risk of living with long COVID for months, or – in the most extreme case – avoiding a spot at the mortuary aren’t reasons enough to convince people of the benefits of getting a vaccine, says Danchin, there are many others: “Freedom from lockdowns, school closures, ability to travel, move around in society… Basically, [the opportunity to] move out of the social restrictions.”

“The best way for people to have their concerns addressed is to speak with their healthcare provider to discuss their eligibility and get a clear recommendation,” she says.

Russell says there’s an immediate need to invest in an evidence-based communication approach that targets different population groups. “At the moment, it’s pathetic,” she says. “It really needs to step up.”

“It’s really important to get the social scientists to come up with messaging that actually gives a sense of urgency around the need to get vaccinated. It’s an investment for the future.”


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