We have all been inundated with messages over the last year about the importance of getting vaccinated for COVID-19. Vaccination information can often be confusing, which has been exacerbated by the introduction of a new vaccine during a pandemic with recommendations changing over time. Recent research from the University of Sydney has found that information provided to the public about COVID-19 vaccination is too complex, with clear and consistent communication lacking.
As an infectious disease epidemiologist, I get asked a lot of questions about vaccination by my friends and family. After I explain, my mum usually tells me that it makes perfect sense to her now, but she finds all the other information sources hard to follow. What happens when you don’t have an expert on hand to answer these questions and why is it important for each of us to understand this information?
As the research shows, when you don’t have an expert on hand, information can be confusing and overwhelming which can lead to individuals becoming vaccine hesitant. Whilst the majority of Australians are supportive of COVID-19 vaccinations, a small proportion of the population are hesitant or resistant to getting the vaccine.
Why is this important for Australia’s response to the pandemic?
As we enter a new phase of the response to COVID-19, with lockdowns ending and border restrictions easing in many states, the future is likely to involve Australians ‘living with COVID’. In this phase vaccination against the virus is one of our most important measures for control. This is particularly true in terms of protecting children from infection, as they are not currently eligible for vaccination. Without a vaccine, children are predicted to experience the highest case numbers which is likely to disproportionately affect women who are most often primary carers. High vaccination coverage in the rest of the population will provide some protection for those who can’t currently be vaccinated.
The good news for Australians is that our vaccination rates are continuing to increase. Recent data shows that 88.2% of people aged over 16 years have had a least one dose of COVID vaccine, with 77.2% fully vaccinated. However, whilst overall rates are high, coverage is not currently equitably spread with vaccination rates of less than 65% in Queensland, the Northern Territory, Western Australia and South Australia. There are also disparities within states, with some regional and remote areas reporting levels of full vaccination below 60%. It is likely that lower rates in some areas are being affected by both complacency, due to the fact that people have not seen many cases of COVID near them, and vaccine hesitancy.
What are the pros and cons of COVID-19 vaccination?
As we have heard many times by now, high vaccination rates are key to re-opening Australia. But why is this the case when there appear to be some downsides to vaccination. Firstly, whilst no vaccine is 100% effective, the COVID-19 vaccine does provide a significant level of protection for individuals against infection from COVID-19. But more importantly the vaccine is very good at preventing severe disease, hospitalisation and death. This is even more important for women who are pregnant who are at higher risk of serious outcomes if infected.
Additionally, the more people vaccinated, the less opportunities provided in the population for the virus to spread. This is referred to as herd immunity. This is particularly important at a population level as some people, such as children and those that have experienced an allergic reaction following a previous dose of a COVID vaccine, aren’t able to be vaccinated.
But as widely reported, there are possible side effects and risks associated with vaccination such as a specific type of blood clots. It is very important for us all to realise that these types of serious reactions to the vaccine are extremely rare and the Australian Technical Advisory Group on Immunisation, who advise the government on vaccinations, have reviewed and considered all of the safety data.
When we think about the risks as an individual, we often aren’t weighing these up with the benefits.
But there are very real benefits to receiving the COVID-19 vaccine, in addition to the extra freedoms provided to those in Australia fully vaccinated. A new risk tool from the Immunisation Coalition, which allows people to input data specific to their situation, shows that generally individuals are significantly more likely to be infected with COVID than to experience a serious adverse event. And if you aren’t vaccinated, your risk of contracting COVID-19 is greatly increased.
How does all this information impact us?
As you can hopefully see from the description above, the facts about vaccination are nuanced which can make clear communication a challenge. Especially with a new vaccine like COVID-19 where evidence is accumulating over time resulting in changes to recommendations.
This can cause problems when it leads to vaccine hesitancy which impacts on overall levels of vaccination coverage. COVID-19 vaccine hesitancy in Australia has shown to fluctuate over time. The highest rates of vaccine hesitancy were reported in Australia in May 2021 at 33% but have fallen to 12% in October. Only WA has reported a slight increase in hesitancy since May from 13.6% to 15.6%.
What is the role of information in vaccination hesitancy?
There are issues with misinformation online, where incorrect information about COVID-19 vaccination is spread by those with very strong anti-vaccination views. This has been exacerbated during the pandemic with anti-vaxxers attempting to use the confusion around vaccine messaging to increase their scope of influence. This has worked to some extent with social media followers for these types of accounts increasing during the pandemic.
And whilst safety data is still being collected, it is highly likely that in the near future recommendations for vaccinations will be extended to children. This will again require women to make sense of the COVID-19 vaccination information available to ensure they can make a decision for their children, with research showing that in approximately 70% of cases mothers are responsible for following up on recommended care for their children.
And finally, what can we do about it?
As individuals, the best action we can take to assist with the Australian response to the pandemic is to get vaccinated. If you have questions or concerns about getting vaccinated, talk with your local GP about these concerns. If you have friends or family who are vaccine hesitant, make sure to listen to their concerns to ensure they don’t feel dismissed. It’s important to understand why someone is hesitant about receiving the vaccine, which is understandable as we have established that information to date hasn’t always been clear. You could offer to look into the information together using official health department websites or offer to attend the doctor or pharmacist to discuss together.
From a population level, the most important part of any vaccine messaging is that it is clear and simple. Unfortunately, this has not always been the case in Australia’s pandemic response to date. Let’s hope we can learn from these mistakes moving forward as the vaccine rollout continues.