No wonder people are confused. Most official COVID vaccine advice is way too complex


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Danielle Marie Muscat, University of Sydney; Julie Ayre, University of Sydney; Kirsten McCaffery, University of Sydney, and Olivia Mac, University of SydneyAs Sydney’s COVID-19 outbreak continues to grow, the message has shifted to urgently “get the jab”. And people’s motivation to get vaccinated is increasing.

But with ever-changing advice, many people are confused about which vaccine they’re eligible for and where to get an appointment.

Our recent review, which has been accepted for publication in the Medical Journal of Australia, shows information for the public about COVID vaccines is too complex to read, understand and act upon. It’s even more complex than other COVID public health advice, such as for physical distancing or masks.

Then there’s the results of our recent survey, which has yet to be peer reviewed, of where people from culturally and linguistically diverse (CALD) communities get their COVID information from. This finds a huge diversity of sources, beyond official government websites. So we need to tailor communications to these communities via channels people actually use.

Taken together, our research shows we are still missing clear and consistent communication about COVID vaccines all Australians can understand and act on.

No wonder people are confused

We looked at publically available COVID-19 information from government websites from Australia (federal and three states), the United Kingdom, New Zealand, and three international public health agencies (including the World Health Organization).

Most public information was above the recommended reading level for the general population (8th grade).

In Australia, information was commonly written at postgraduate level. This means it is too difficult for people with average reading ability to understand. It’s likely even harder for the 9 million Australians who have lower health literacy.

Vaccination information from the federal government website was the only Australian material to adequately outline the action or steps readers needed to take to get vaccinated. Websites from all three states (New South Wales, Queensland, Victoria) we reviewed did not.

This means there has been little progress nationally or internationally in terms of improving the readability of written COVID-19 information since April 2020.




Read more:
Yes, adult literacy should be improved. But governments can make their messages easier to read right now


Culturally and linguistically diverse Australians

Our review does not begin to capture the additional limitations of COVID-19 communications for CALD communities.

People from CALD backgrounds form a significant and growing share of Australia’s population. For instance, 43% of the population of southwest Sydney (one of the focuses of the current COVID-19 outbreak) was born overseas; up to 71% in certain local government areas speak a language other than English at home.

Yet, translated information and communications about COVID-19 have been sparse, intermittent and not all has been appropriate. The original source materials in English are too complex, official translators are not used, and/or translations are not reviewed to make sure the information makes sense.

There has been some progress

We’ve had some progress this week. Press briefings, crucially important for keeping up-to-date about new rules and regulations, have only in the past few days been made available in any other language than English.

Similarly, the online vaccination eligibility checker has only just been translated into 15 other languages. However, the online vaccine clinic finder, which you reach at end of the vaccine eligibility checker, remains only in English.

More positively, a COVID-19 vaccination glossary (with clear descriptions of complex vaccine terms) is now available in 29 languages.

But more work is needed

However, more work is needed to ensure COVID information is “distributed widely” to CALD communities via the most appropriate channels, as recommended in the Australian government’s own plan.

Our recent survey of over 700 CALD community members in Greater Western Sydney showed just over half (about 54%) of participants used official government sources to find out about COVID-19. However, this varied greatly between language groups, reaching as low as 29% for some.

Social media (52%), family and friends (33%), and community sources (26%) were also common pathways for seeking out information about COVID. Many sought in-language communication from overseas. For some of these groups, official sources appear less accessible or useful.

So work is clearly needed to distribute tailored communications via channels people actually use.




Read more:
Multilingual Australia is missing out on vital COVID-19 information. No wonder local councils and businesses are stepping in


What actually works?

We know how to communicate public health messages clearly for diverse communities. We can:

We know it is possible to successfully implement these strategies. Our review identified 12 “easy-to-read” materials written at a lower reading grade that were easier to understand.

However, these were rare, difficult to find on official websites and often poorly signposted. For instance, some were on pages labelled for “people with disability”.

We need concerted action to ensure materials such as these become the “rule” rather than the exception. Plain language and in-language information simply cannot be an afterthought or “optional extra” if we are to achieve the 80% or higher vaccination rates needed to end lockdowns and return to some semblance of normal.




Read more:
Australia shouldn’t ‘open up’ before we vaccinate at least 80% of the population. Here’s why


The Conversation


Danielle Marie Muscat, Post-Doctoral Research Fellow, University of Sydney; Julie Ayre, Post Doctoral Research Fellow, University of Sydney; Kirsten McCaffery, NHMRC Principal Research Fellow, University of Sydney, and Olivia Mac, Research fellow, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Yes, there’s confusion about ATAGI’s AstraZeneca advice. But it’s in an extremely difficult position


Daniel Pockett/AAP

Hassan Vally, La Trobe UniversityOne can totally understand the frustration around where the AstraZeneca vaccine fits in our vaccine rollout in Australia.

At a time when we’re grappling with so much uncertainty, we need unambiguous information from the federal government about who should have this vaccine.

Instead, it feels very much like we’re swirling in a murky sea of information that is confusing and, at times, seems to be contradictory.




Read more:
Morrison government orders Pfizer ‘boosters’, while hoping new ATAGI advice will warm people to AstraZeneca


The confusion is compounded by the changing advice from ATAGI. ATAGI, the Australian Technical Advisory Group on Immunisation, is the group of vaccine experts which advises the government.

There is no doubt that for many people, some of its language has been difficult to make sense of, including the use of vague terms like “preferred”. As in, the Pfizer vaccine is the “preferred vaccine” for those under 60 years of age.

How exactly this should be interpreted by someone trying to make the important decision about whether to get the vaccine is unclear, and raises more questions than it answers.

The public commentary from a number of political leaders, including the prime minister, that ATAGI has been too conservative and too risk averse hasn’t helped either, with the implication ATAGI cannot be fully trusted to provide sensible advice.

The reality is, ATAGI is in an extremely difficult position and is grappling with competing concerns, considerable uncertainty, and a constantly changing landscape.

What is ATAGI’s role?

ATAGI can only give general advice to the government for the whole population.

Its task is to think about the whole population as if it were merged into a single person, or in the case of AstraZeneca, a series of people of different age ranges. It then has to formulate advice based on population-based averages of the benefits and risks of getting the AstraZeneca vaccine, which has a number of limitations.

It’s important to understand context plays a key role in formulating this advice to the government. The risk of the blood clotting and bleeding condition, called thrombosis with thrombocytopenia, from the AstraZeneca vaccine is slightly higher for younger people.

This is only part of what’s driven the advice for Pfizer to be the preferred vaccine for those under 60.

In fact, the risk of dying from this condition is incredibly rare whatever your age.




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Concerned about the latest AstraZeneca news? These 3 graphics help you make sense of the risk


What has been the bigger driver of the advice is the fact you’re less likely to develop severe disease from COVID if you’re younger, which means the corresponding benefits of vaccination are much lower if you take a narrow view of the benefits of the vaccine being solely the prevention of severe disease.

How did ATAGI draw its conclusions on AstraZeneca?

ATAGI initially said Pfizer was the preferred vaccine for under-50s in April, and then changed this to under-60s in June.

There are several assumptions in ATAGI’s advice which need to be understood.

Firstly, it calculated the risks and benefits of AstraZeneca across three scenarios — low, medium and high exposure risk. ATAGI has presented its advice assuming a low amount COVID circulating in the community, which has been the case until Sydney’s latest outbreak.

A low amount of COVID in the community means there’s a low chance of severe COVID, which is even smaller for younger people. This means there’s less of a benefit of being vaccinated for younger people, which is what has driven the advice for the Pfizer vaccine to be preferred for younger people.

However, the problem with this low prevalence assumption is we’re vaccinating to protect us not just right now, but also against the future risk of COVID, and future lockdowns, like the situation we’re seeing in Sydney now.

Once you’re in this situation, even if ATAGI changes its recommendations in response to more COVID circulating, which it did on Saturday, in some sense the horse has already bolted.

Another assumption implicit in ATAGI’s advice that it prefers under-60s get Pfizer, is that Pfizer is available and you have the option to get it now.

However, given the limited supply of Pfizer vaccine, the decision to hold off on the AstraZeneca vaccine is not one to get Pfizer, it is one to hold off on getting vaccinated at all. This leaves you exposed and vulnerable to COVID. This is an important distinction to make, which of course will change as we get more Pfizer vaccine.

Another major limitation in the ATAGI advice is the panel, in dealing with population-level data, takes a very narrow view of the benefits of vaccination: the prevention of severe disease.

It doesn’t take into account other benefits that may be relevant to many people. It doesn’t take into account the prevention of long COVID; the benefits of being vaccinated allowing travel and other freedoms; and, most glaringly, the importance many people place on getting vaccinated to protect their loved ones and the community.

These may weigh heavily on individuals but aren’t taken into account when you look at the risk-benefit calculation from a narrow perspective.

So what’s the bottom line on AstraZeneca?

We must remember the AstraZeneca vaccine is a fantastic vaccine.

It’s safe and effective, and two doses offer almost complete protection against severe disease and death from COVID, including the Delta variant.

It does carry a small risk of the blood clotting and bleeding condition, but this risk is incredibly small. COVID is much more of a threat to your health than the vaccine, as we are seeing in NSW right now.

If you’re under 60 years of age, the decision to have the AstraZeneca vaccine is one only you can make. But if you do make it, you should understand the benefits go beyond just preventing severe disease.The Conversation

Hassan Vally, Associate Professor, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Morrison government orders Pfizer ‘boosters’, while hoping new ATAGI advice will warm people to AstraZeneca


Michelle Grattan, University of CanberraWhile still struggling with a current shortage of Pfizer, the Morrison government announced it has secured 85 million doses of that vaccine for future “booster” shots.

This will be made up of 60 million doses in 2022, and 25 million doses in 2023. Delivery will start in the first quarter of next year.

Scott Morrison said on Sunday this was “prudent future proofing”, although there is still not definitive advice on when boosters will be needed.

Meanwhile the Australian Technical Advisory Group on Immunisation (ATAGI) has liberalised its advice on AstraZeneca.

It said in a statement on Saturday all people aged 18 and over in greater Sydney, including those under 60, “should strongly consider getting vaccinated with any available vaccine including COVID-19 Vaccine AstraZeneca”.

This was on the basis of the increasing risk of COVID and “ongoing constraints” of Pfizer, the advice said.

Last week Scott Morrison said the government was constantly appealing to ATAGI to review its advice on AZ according to the balance of risk. Many people have shied away from AZ, supplies of which are plentiful, after ATAGI’s caution about it for younger people because of rare blood clots.

Asked about some general practioners being reluctant to give AZ to people under 40, Morrison said he certainly hoped GPs “would be very mindful of the ATAGI advice”.

ATAGI is presently considering whether children between 12 and 15 years old should be vaccinated against COVID, with the government expecting advice in mid-August.

As the crisis continues in Sydney, on Sunday NSW reported 141 new locally acquired cases and two deaths, including a woman in her 30s. This followed Saturday’s report of 163 new cases in the previous 24 hours.

Victoria on Sunday reported 11 new local cases, and is on track to end its lockdown soon, as is South Australia.

Morrison again stressed the lockdown was the primary weapon in fighting the Sydney outbreak.

“There’s not an easy way to bring these cases down. And it’s the lockdown that does that work. The vaccines can provide some assistance, but they are not going to end this lockdown. What’s going to end this lockdown is it being effective.”

But NSW Premier Gladys Berejiklian, who tried unsuccessfully to get the vaccination program refocused on south west Sydney, the centre of the outbreak, has a different emphasis. “Please know that what will get us through this outbreak is a combination of our restrictions, but also of more people being vaccinated”.

Morrison has refused to alter the focus, saying this would “interrupt the rhythm of the national vaccine program”.

The federal government has found 50,000 extra Pfizer doses for NSW. Asked where these came from, Morrison said: “There are small variations in supply and delivery, which from time to time may ensure that there’s tens of thousands of doses that might be free at any given time.”

Morrison condemned Saturday’s Sydney anti-lockdown demonstration attended by thousands of people, which saw violence, dozens of people charged, and more being pursued where they can be identified.

He said it was not just selfish. “It was also self-defeating. It achieves no purpose. It will not end the lockdown sooner, it will only risk the lockdowns running further,” he said.

Asked about Queensland Nationals MP George Christensen, who attended a rally in Mackay, Morrison said: “As for other parts of the country that aren’t in lockdown, well, there is such a thing as free speech, and I’m not about to be imposing those sorts of restrictions on people’s free speech”.

Christensen said on Facebook, “Civil disobedience eventually becomes the only response to laws that restrict freedom. This is what we’ve seen in Melbourne today.”

Pressed on this, Morrison said: “The comments I made before related to an event that took place in Queensland where there are no lockdowns”.

The Prime Minister told the Liberal National Party state council in a virtual address on Sunday: “After a difficult start, the vaccine program is now making up lost ground, and quickly”.The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

AstraZeneca advice has just changed (again). Here’s what you need to know if you’re in lockdown


Nicholas Wood, University of SydneySydney’s COVID outbreak has just prompted official advice on the AstraZeneca vaccine to change to encourage more people to get fully vaccinated sooner.

Now, the Australian Technical Advisory Group on Immunisation (ATAGI) recommends people in outbreak areas have their booster shot at 4-8 weeks after their initial dose rather than wait for 12 weeks. ATAGI now also advises people in outbreak areas under 60 to “re-assess the benefits to them and their contacts” from getting an AstraZeneca vaccine now if the Pfizer vaccine is not available.

Advice for people outside outbreak areas remains unchanged.

Here’s how to make sense of the latest advice if you’re in an outbreak area.

The situation has changed

Getting vaccinated, like taking any medication, is a case of balancing the risks against the benefits. And clearly, when there’s a COVID outbreak such as Sydney’s, the potential benefit of vaccination just increased.

We know two doses of AstraZeneca vaccine (or the Pfizer vaccine) are really good at preventing you from serious disease and hospitalisation. There’s growing evidence COVID vaccines also reduce your chance of infecting others. And we know two doses are needed to improve your protection from the Delta variant, which is currently circulating in NSW.




Read more:
Should I get my second AstraZeneca dose? Yes, it almost doubles your protection against Delta


Now let’s turn to the AstraZeneca vaccine. In parts of Australia with low rates of (or no) community transmission, the advice remains to wait 12 weeks after your initial dose for your booster shot. This is the time needed for your body to mount the best immune response.

However, as case numbers in Sydney have climbed, we’ve had calls from Prime Minister Scott Morrison, NSW Chief Health Officer Kerry Chant and Australia’s Chief Medical Officer Paul Kelly for people in outbreak areas to bring forward their AstraZeneca booster shots. Now ATAGI joins them.

Will I be protected if I go early?

Leaving less than 12 weeks between your first and second doses of AstraZeneca is a trade-off. There is slightly lower vaccine effectiveness against serious disease compared to if you’d waited for the full 12 weeks, but you will have some protection. In an outbreak, some reasonable protection now may be better than remaining unprotected while hanging out for greater immunity later.

The difficulty is pinning down exactly how much the vaccine’s efficacy drops by going early. The only figures we have that chart the different lengths of time between AstraZeneca shots and the corresponding levels of vaccine efficacy come from earlier variants of the virus (before Delta). We don’t actually have the figures as they relate to the Delta variant, circulating in NSW right now.

With that caveat in mind, here’s the best data we have about how different gaps between first and second dose of AstraZeneca affect its efficacy. It’s the same data ATAGI has cited to explain its latest advice.



The Lancet, CC BY-ND

If you’ve decided to go early with your booster shot, don’t worry if you can’t book an earlier appointment than 12 weeks. Your first shot has already started you on the protective road.




Read more:
Should I have my AstraZeneca booster shot at 8 weeks rather than 12? Here’s the evidence so you can decide


What if I’m under 60?

Earlier advice was for Pfizer to be the preferred vaccine for people under 60. This was due to an increased risk of the rare blood clot syndrome known as TTS (thrombosis with thrombocytopenia syndrome) associated with the AstraZenenca vaccine in this age group. This advice is still current for most parts of Australia.

But in outbreak areas, ATAGI now advises people under 60 to consider having the AstraZeneca shot now, if the Pfizer vaccine is not available. Again, in an outbreak, starting on your road to becoming fully vaccinated may be better than hanging on for a Pfizer shot, which may not arrive for a few months.

Yes, people under 60 are at increased risk of those rare clots compared to older age groups. But the risks are still small, and you should balance that with the potential benefits of vaccination during an outbreak.

Risk estimates of TTS are updated regularly as new cases are reported. The latest figures show if you’re under 60, your risk of TTS is 2.6 per 100,000 doses. If you’re aged 60 or over, the risk is 1.6 per 100,000 doses.




Read more:
Concerned about the latest AstraZeneca news? These 3 graphics help you make sense of the risk


Your GP or vaccine provider will also discuss what to look out for should you experience these rare blood clots. If you have symptoms including: a new severe and persistent headache (appearing a few days after the vaccine or one that does not improve after simple painkillers, and which may be accompanied by nausea and vomiting), abdominal pain, pin-prick bruising or bleeding, chest pain, leg swelling or trouble breathing in the few days to few weeks after the AstraZeneca vaccine, you will need to seek medical advice.

This could be due to the rare clotting syndrome and the earlier it is recognised the earlier it can be treated.

Common side-effects from the AstraZeneca vaccine include headache, muscle aches, fatigue, fever and pain or redness at the injection site. These usually start in the first 24-48 hours after vaccination and may last a few days. You can manage these with over-the-counter medicines for fever and pain, such as paracetamol.




Read more:
A history of blood clots is not usually any reason to avoid the AstraZeneca vaccine


One last thing to think about

If you are having trouble booking in at your local GP clinic, you can attend one of the NSW mass vaccination hubs, which may be out of your local government area.

Although you are permitted to leave the home for medical care (including vaccination), please only do so if you have no COVID symptoms, however mild.


The Conversation, CC BY-ND

The last thing we want to see is people spreading COVID while trying to get vaccinated, with the potentially devastating impact on health-care workers, clinics and the wider community.




Read more:
The symptoms of the Delta variant appear to differ from traditional COVID symptoms. Here’s what to look out for


The Conversation


Nicholas Wood, Associate Professor, Discipline of Childhood and Adolescent Health, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

View from The Hill: No, this isn’t based on the medical advice


Michelle Grattan, University of CanberraWe follow the medical advice, has been a Morrison government mantra since the pandemic’s start.

Well, not any more. With the rollout struggling and half the country in lockdown, Scott Morrison is now encouraging younger people to get the AstraZeneca vaccine, despite the Australian Technical Advisory Group on Immunisation (ATAGI) not recommending it for the under 60s.

Morrison’s Monday night announcement of the government’s new position was quite a significant moment.

It marked a break with the experts in a move that, if it were to backfire, would leave the government facing the heat without the “shield” of its advisers.

One can understand why Morrison is going down this path. The government needs to get the population vaccinated much more quickly. We are at the bottom of the OECD with our rollout. There is plenty of AstraZeneca, which is home made at CSL, and limited amounts of the imported Pfizer, the vaccine ATAGI recommends for the under 60s.

The hugely infectious Delta strain is putting the fear of god into federal and state governments, and many in the public. The current lockdowns show how quickly activity can be semi-crippled even by small numbers of cases.

All this when the younger part of the adult population, the under 40s, aren’t yet even in the current vaccination queue.

However, the contradiction is obvious. After AstraZeneca was associated with rare blood clots, the government took ATAGI advice on who should receive which vaccine – AstraZeneca for over 50s, Pfizer for those under.

In embracing the ATAGI advice it knew it would be contributing to hesitancy about vaccination generally and AstraZeneca in particular, but it said it felt it had no option.

Then ATAGI became even more cautious and recommended AstraZeneca be given only to those 60 and above. The government accepted the revised advice, which was likely to make people even more suspicious of AstraZeneca.

When Morrison in effect parks his attachment to the experts and says to younger people, if you are so inclined just talk to your doctor and make your own decision about taking an AstraZeneca jab, the danger is the public become confused or cynical or both.

Heath Minister Greg Hunt on Tuesday explained things this way: “So the advice is very clear on two fronts. One is the medical advice; two is the access.

“AstraZeneca remains the preferred vaccine for people 60 years and over. That has not changed, the advice of ATAGI, and Pfizer is the preferred for people under 60. And the clinical advice of ATAGI, again, has not changed.

“However, as has always been the case … on the basis of informed consent, individual patients and their doctors have been able to make a decision to take up the AstraZeneca on the basis of their individual circumstances and their own judgement,” Hunt said.

“Some GPs have reported that they have excess supply [of AstraZeneca]. And so if there are people who wish to access it, via informed consent, via the existing ATAGI rules, then that’s simply being enabled.”

It might have “always been the case”, but now people are being actively encouraged by the government towards this independent position. Australian Medical Association President Omar Khorshid described the PM’s announcement as “a really significant change in the vaccine program”.

So a 30-year-old woman may find herself weighing the ATAGI advice and the advice of her doctor (who, incidentally, is being provided with a professional indemnity giving “additional certainty” to those advising on vaccination).

Who knows where she will land if the two sets of advice differ?

The AMA and the Royal Australian College of General Practitioners both said on Tuesday they hadn’t received advance notice of the government move.

Karen Price, President of the RACGP, tweeted: “Phones are ringing off the hook at GP clinics. We had no warning of last night’s announcements and this isn’t the first time this has happened to general practice. It’s vital that government provides significant support to GPs to implement these changes to the vaccine rollout.”

She said on 2GB if doctors were to operate outside the ATAGI guidelines “we need to be super clear about what that means”.

Khorshid told The Guardian, “It took us by surprise”.

“Our recommendation is still really for patients to follow the ATAGI advice. Be patient and have the ATAGI-recommended vaccine when it’s available. I am certainly still backing the expert advice at this stage.”

Khorshid said he thought the government had taken this step because it wanted “to provide nervous Australians who are going into lockdown this week with something that they can actually do to improve their chances of getting through this and to push the nation’s vaccination program forward”.

It will be interesting to see how ATAGI now reacts.

Meanwhile there must be questions about how the officials let the doctors apparently be caught on the hop.

Just as the “medical advice” has stopped (at least in this case) being sacrosanct, so criticism of federal health officialdom continues to sharpen over its operations in the rollout. It’s no coincidence that a military man, Lieutenant General “JJ” Frewen has been put in charge of trying to get the program on track.

The official medical and health experts are finding themselves a good deal more challenged by their federal political masters than a year ago.The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

New AstraZeneca advice is a safer path, but it’s damaged vaccine confidence. The government must urgently restore it


Jane E Frawley, University of Technology SydneyThe federal government’s recommendation last week that the Pfizer COVID-19 vaccine is now the preferred vaccine for adults under 50 has shaken public confidence in the COVID-19 vaccine rollout.

The Australian Technical Advisory Group on Immunisation (ATAGI) advised the AstraZeneca vaccine, previously planned as Australia’s main vaccine, will no longer be the preferred vaccine for adults under 50. It came after an extensive review of data from the United Kingdom and Europe which found an association between a very rare type of blood clot and the AstraZeneca vaccine.

Public confusion has already resulted in mass cancellations of vaccine appointments at GP clinics, by adults both over and under 50.

It’s important to remember the Australian government can afford to choose a safer path because we are not in the midst of a large COVID-19 outbreak.

But a decrease in vaccine confidence may be an unintended consequence of this path.

Now, the federal government must urgently restore public confidence in the vaccine rollout. It needs to quickly reassure adults aged over 50 the AstraZeneca vaccine is safe.

It’s essential the government gets this right. Concerns about one vaccine can damage public trust in other vaccines.

Why has a safer approach decreased confidence?

Vaccine confidence can be fickle. There are many recent examples of established vaccine programs that have been undermined by unrelated events or errors. This has led to mass disease outbreak and preventable death. For example, in the Philippines, a new measles outbreak that infected 47,871 people in 2019 and killed 632, mostly children, was fuelled by a drop in measles vaccination spurred by concerns about a dengue fever vaccine.

Vaccine program resilience is an even bigger ask during a new vaccine rollout where rare effects are expected once the vaccine is given to hundreds of millions of people.

Research from the Australian National University published last week found young women are the most likely to avoid vaccination. Women who did not approve of the government’s handling of recent sexual harassment scandals were less likely to accept a COVID vaccine. This demonstrates the importance of trust, and shows a lack of trust in one area of the government’s remit can spill into other areas.

Because the risk of catching COVID-19 is currently so low in Australia, many people are feeling less interested in being vaccinated.

One Australian study, published in September last year, found fewer people were willing to accept a COVID-19 vaccine compared to a similar study done two months earlier. This decrease was evident following a decreased number of new COVID-19 cases in Australia in the time between these two studies. People can change their intention to be vaccinated when they fear the effects from the vaccine more than the disease.

On top of all of this, some members of the community are still concerned COVID-19 vaccines were developed too quickly and without appropriate checks and balances — even though this isn’t true.

Changing recommendations during a vaccine program rollout can compound these concerns.




Read more:
Less than a year to develop a COVID vaccine – here’s why you shouldn’t be alarmed


How can confidence be restored?

While the federal government was quick to accept the recommendation from ATAGI, the confusion has added to the rollout chaos. Public confidence has been damaged, and further vaccine delays are imminent across the board, including for younger health and aged-care workers.




Read more:
4 ways Australia’s COVID vaccine rollout has been bungled


Vaccine program resilience is essential to survive the bumps along the way and the government has not invested enough in understanding public sentiment and developing plain language information resources.

The challenge for public health and the federal government now is to address the understandable concerns and prevent them from contaminating the broader public dialog on COVID-19 vaccination.

With high numbers of Australians needing to be vaccinated to prevent further COVID-19 outbreaks, there’s very little room for vaccine rejection.

The government urgently needs to use clear messaging for all communities and health professionals. This includes communities with diverse cultural and language requirements

These efforts will greatly benefit from multidisciplinary teams of infectious disease, vaccine, social science and communication experts.

We need a compensation scheme

During Australia’s COVID-19 vaccine rollout, so far one man in his 40s has developed blood clots following vaccination with the AstraZeneca vaccine. There’s a 25% death rate following a vaccine-related clot according to ATAGI. Four to six clots are expected per million doses of AstraZeneca vaccine (first dose) and while this reaction is exceedingly rare, it is severe.

This also highlights the importance of a no-fault vaccine injury compensation scheme.

Such a scheme recognises that if the government promotes whole of community vaccination for collective good, then it also accepts the ethical and financial burden for the few people who will sustain a serious injury. The federal government should implement one as a matter of priority.




Read more:
Bad reactions to the COVID vaccine will be rare, but Australians deserve a proper compensation scheme


The Conversation


Jane E Frawley, NHMRC Research Fellow, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Turnbull slams Porter for “nonsense” advice


Michelle Grattan, University of Canberra

Malcolm Turnbull has accused Attorney-General Christian Porter of providing advice to him that was constitutional “nonsense”, as the divisive events around the former prime minister’s removal are revisited.

Turnbull launched his acerbic Twitter attack following reports that the day before he was deposed last August, he clashed with Porter over trying to involve Governor-General Peter Cosgrove in the leadership crisis. Turnbull was seeking to ensure Peter Dutton did not become prime minister if he won the leadership.

Meantime, Dutton has revealed that before the May election he removed himself from involvement in a family trust – an involvement that last term had raised doubts about his eligibility to sit in parliament. The trust received money from his wife’s child care business, and child care receives government subsidy.

Dutton always maintained he was on safe constitutional ground and his spokeswoman on Thursday reaffirmed that he had had legal opinions saying he was not in breach of section 44. During the leadership crisis the Solicitor-General provided advice, taking the view Dutton was eligible, though he left some doubt.

“Nonetheless, to silence those who are politically motivated and continue to raise this; prior to the minister’s nomination at the May election, he formally renounced any interest in the trust in question,” she said.




Read more:
Explainer: is Peter Dutton ineligible to sit in parliament?


Accounts of the contretemps between Turnbull and Porter were published in Thursday’s Australian and by Nine newspapers.

Turnbull argued Cosgrove should refuse to commission Dutton, if he won the leadership, on the grounds he might be constitutionally ineligible to sit in parliament.

Porter insisted Turnbull’s suggested course would be “wrong in law” – that the eligibility issue was not a matter for the governor-general – and threatened to repudiate Turnbull’s position if he advanced it publicly at an imminent news conference.

The Attorney-General had a letter of resignation with him, in case he needed to provide it.




Read more:
Solicitor-General supports Dutton’s eligibility for parliament, but with caveats


The events of last year will be extensively raked over in coming weeks in books by journalists Niki Savva and David Crowe. They featured in a Sky documentary this week.

Turnbull refought his battle with Porter on Thursday, tweeting: “The discretion to swear in a person as PM is vested in the Governor General. The proposition advanced by Mr Porter that it is none of the GG’s business whether the would be PM is constitutionally eligible is nonsense. The GG is not a constitutional cypher.

“During the week of 24 August 2018 there was advice from leading constitutional lawyers Bret Walker that Dutton was ineligible to sit in the Parliament and thus ineligible to be a Minister, let alone Prime Minister. I ensured we sought the advice of the Solicitor General.

“I took the responsible course of action, obtained the necessary advice, published it and the Party Room was informed when it made its decision to elect Mr Morrison, rather than Mr Dutton, as leader.”

Porter, speaking on radio on Thursday, confirmed the accuracy of the media reports, including the tense nature of the meeting. “Sometimes meetings in government aren’t all potpourri and roses,” he said.

Porter said an attorney-general’s role was to provide advice they considered accurate and legally correct.

“Sometimes that advice is not always what people want to hear. But I’ve always taken very seriously the role and the fact that the role requires to give advice to the best of your legal knowledge and ability you think is accurate and correct.

“And that’s what I’ve always tried to do, that’s what I did during the course of that very difficult week.”The Conversation

Michelle Grattan, Professorial Fellow, University of Canberra

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Solicitor-General’s advice on Dutton’s eligibility to come before Friday Liberal vote


Michelle Grattan, University of Canberra

Prime Minister Malcolm Turnbull will invite a leadership “spill” motion at midday Friday, once a majority of Liberals formally ask for a party meeting.

He will not contest the subsequent ballot if – as anticipated – the spill is carried, Turnbull announced to a lunchtime Thursday news conference.

Before the meeting, the Solicitor-General on Friday will provide an opinion on the constitutional eligibility to sit in parliament of challenger Peter Dutton.

Early Thursday afternoon, the final signatures for the party meeting request were being gathered.

The delay and the early provision of the Solicitor-General’s advice give Treasurer Scott Morrison extra opportunity to build support for his own bid for the leadership as an alternative to Dutton.

After a morning of chaos and multiple ministerial resignations, including that of Senate leader Mathias Cormann, Turnbull told his news conference that if he is ousted he will quit parliament – increasing the prospect of an early election.

He said he had “made it very clear that I believe former prime ministers are best out of the parliament”.

The government has a one seat of majority and his seat of Wentworth, although it has a strong margin, would be vulnerable in a byelection because Turnbull is personally very popular there. A byelection would not be needed if there were an early election.

Turnbull said that assuming the spill was carried, the new prime minister would “have to obviously satisfy the Governor-General that they can command a majority on the floor of the House of Representatives.

“In the case of Mr Dutton, I think he’ll have to establish that he is eligible to sit in the Parliament.”

Turnbull delivered a swingeing attack on those who have undermined him.

“A minority in the party room, supported by others outside the parliament, have sought to bully, intimidate others into making this change of leadership that they’re seeking.

“It’s been described by many people, including those who feel they cannot resist it as a form of madness,” he said.

“It is remarkable we’re at this point, where only a month ago we were [in the public polling] just little bit behind Labor and in our own polls a little bit ahead – but in any view thoroughly competitive.”

Turnbull has been under consistent assault not only from Tony Abbott and other Liberal critics over a range of issues, especially energy policy and immigration, but also from commentators in the Newscorp media, especially on Sky, and from shock jocks on 2GB.

Turnbull said that what was happening was “a very deliberate effort to pull the Liberal party further to the right.”

Stressing how vital it was to resolve the issue of Dutton’s eligibility, he said: “This is a very, very significant point. As we all know, section 44 has been a companion of this 45th parliament.

“I cannot underline too much how important it is that anyone who seeks to be prime minister of Australia is eligible to be a member of parliament – because a minister, let alone a prime minister, who is not eligible to sit in the House is not capable of validly being a minister or exercising any of the powers of a minister.”

Legal experts suggest Dutton could be ineligible under the constitution’s section 44 provision on pecuniary interests. This says a person is incapable of sitting if they have “any direct or indirect pecuniary interest in any agreement with the Public Service of the Commonwealth”.

Dutton through a family trust has an interest in child care centres that receive Commonwealth funding. The key question is whether this involves an agreement with the public service.

Dutton’s legal advice is that he has no constitutional problem, and on Thursday he issued updated legal advice.

The government shut down the House of Representatives but does not command the numbers in the Senate so had to endure question time with senior ministers who had resigned on the backbench.

3:15pm

UPDATE: JULIE BISHOP JOINS THE RACE

Liberal deputy and Foreign Minister Julie Bishop will throw her hat into the leadership ring.

Bishop, from Western Australia, has been deputy Liberal leader since 2007 under multiple leaders. She is a moderate, rates well in the opinion polls, and has a high profile internationally as well as locally. She is in much demand from backbenchers to visit their seats and is a good fund raiser.

But she will go into the ballot with the disadvantage of having made many enemies in a long political history.

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The Conversation

Her entry into the field complicates the situation and makes the outcome even less certain.

Michelle Grattan, Professorial Fellow, University of Canberra

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Queensland Nationals Barry O’Sullivan’s advice on the Joyce affair: ‘don’t shoot your best horse’


Michelle Grattan, University of Canberra

Outspoken Queensland Nationals senator Barry O’Sullivan has declared Barnaby Joyce a “once-in-a-generation type of politician” who remains a big asset to the Nationals despite the sharp grassroots reaction to his affair with his former staffer.

With some Nationals reeling from the backlash to the revelations amid speculation about Joyce’s future, O’Sullivan went on the front foot on Monday night.

“We’ve not seen any government that has done more for the bush than this one, with Barnaby Joyce as deputy prime minister,” he told The Conversation.

“I don’t want to lose one of the best politicians we’ve had in my lifetime. Are you going to shoot your best horse because he jumped the fence and was found in the neighbour’s paddock?”

O’Sullivan’s strong defence came as Malcolm Turnbull was forced in parliament to express his confidence in Joyce.

When Opposition Leader Bill Shorten asked Turnbull whether Joyce would be acting prime minister when Turnbull visits the US next week, and whether he still retained confidence in Joyce, Turnbull kept his answer as brief as possible.

“Yes in response to both questions,” he said.

Turnbull is known to be furious with Joyce, whose affair with Vikki Campion, now expecting his child, has dominated headlines and distracted the government since the story broke in the Daily Telegraph mid-last week.

Turnbull and his office struggled on Monday to avoid being ensnared, as questions were put about the movement of Campion, who was shifted to the office of Resources Minister Matt Canavan after her relationship with Joyce started to cause problems in his office. Later she took up a position in the office of then Nationals whip Damian Drum. She left government at the end of last year.

Under the ministerial code of conduct, a minister’s “close relatives and partners are not to be appointed to positions in their ministerial or electorate offices and must not be employed in the offices of other members of the executive government without the prime minister’s express approval”.

The opposition asked whether Turnbull or his office was involved in creating a new position last year in either Canavan’s or Drum’s office.

Turnbull said he was advised the Nationals were provided with a number of personal staff positions as a share of the government’s overall staffing pool. “The distribution of those staff members between Nationals’ offices is a matter for the National Party,” he said.

“I’m further advised that at no time did the Nationals fill all vacant staffing positions.”

The government is arguing that Turnbull was never officially informed that Campion was the partner of Joyce – who remained married to Natalie Joyce – and so the question of prime ministerial approval did not arise.

O’Sullivan said the Nationals base had expressed disappointment and frustration at Joyce’s behaviour.

“But no-one is challenging his ability to do the great job he has done,” O’Sullivan said. “Do we want to chip away at him until he’s gone?”

O’Sullivan, who said he was not personally close to Joyce, has a reputation as a straight talker. Last year he spearheaded the backbench Nationals move that led to the government capitulating to pressure for a royal commission into the banks, which commenced on Monday. He was critical of Joyce’s demotion of fellow Queenslander Keith Pitt in the December reshuffle.

Treasurer Scott Morrison told the ABC on Monday night: “There’s no-one I know in the parliament who is a stronger advocate for rural and regional Australia.

“While events regarding Barnaby’s private life … are disappointing, most importantly to his family and others, that doesn’t change the fact that Barnaby, over a long period of time in his public life, has dedicated himself to public service and the people he represents.”

The ConversationAsked about the code’s provision about partners not being employed without prime ministerial approval, Morrison said Joyce “can’t have two partners at the same time and he was obviously still married”.

Michelle Grattan, Professorial Fellow, University of Canberra

This article was originally published on The Conversation. Read the original article.