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ADMITTING to “getting it wrong” is hard for anyone. It is particularly difficult for a senior public servant when the tradition has been to obfuscate or to create a smokescreen.
When Australia’s chief medical officer Brendan Murphy admitted that he (and the department) had got it wrong over availability of the flu vaccine, it reflected a much more open and transparent approach than is normally associated with the public service.
Prof Murphy demonstrated strength of character when he addressed the issue of shortage of flu injections for “under 5s” at the Biennial Immunisation Conference held in Adelaide last week by the Public Health Association of Australia.
He said that demand had outstripped supply considerably. The predictions made by the department fell way short of the more than 30 per cent increase that was demanded by consumers.
He went further, speaking about the much more nuanced approach needed regarding encouraging people to vaccinate. The “No Jab – No Pay” and the “No Jab – No Play” policies may have encouraged those who missed vaccinating. However, understanding those who are “less accepting” and “less engaged” will need more work to improve vaccination rates.
Coverage rates for Australian children under one year old have now reached 94.05 per cent across the country, with the ACT at 94.87 per cent. This is just a whisker short of the 95 per cent goal. However, in the long term, Australia should be aiming even higher to eliminate some of the endemic diseases that are so harmful, particularly to children. Health advocates recognise there are risks associated with vaccination, but those risks are minuscule compared to the risks associated with the diseases.
In the hard-to-reach groups and reluctant vaccinators, those who have real doubts about the value of vaccines or those who are simply opposed, the combination of carrot and stick might be much more effective than just using the virtual cane. This is an important lesson for those politicians who until now have thrived on tough “anti-vaxxer” rhetoric. It is time to take a more thoughtful approach.
Improved understanding of the part played by vaccination is critical. As Prof Allen Cheng told the Immunisation Conference: “Hyperbolic predictions and unreasonable claims potentially erode trust”.
The flu vaccine certainly is not perfect. He suggested that messaging should explain “influenza is common; although usually mild, severe disease can occur even in otherwise healthy adults and children. The vaccine is far from perfect, but is one of the best tools we have to reduce your risk of complications”.
Openness and transparency are simply good governance.
Debate over the shortage of flu vaccine has probably been more of a positive than a negative as more Australians are now demanding access. Another message from the National Immunisation Conference for older Canberrans, was the protective factor of the flu vaccine against heart attack in the elderly. This was a side message – but an important one.
Babies have been the focus of most of our vaccination rhetoric. However, without losing focus on babies and young children, it is now time to consider in more depth where the greatest need lies. University of NSW academic, Prof Robert Menzies, argued that although 6.7 million Australians are eligible for vaccination, it is the over-65 age group that are medically at the highest risk, but are also the most under-immunised group.
Influenza vaccine was just one topic on the agenda. One of the great success stories of vaccination in Australia and internationally, is the decline in Human Papilloma Virus (HPV) infections that are a precursor to cervical and other cancers. The virus also causes genital warts and, in Australians under the age of 25, there has been an almost 90 per cent decline in new cases of these warts since the introduction of the vaccine.
Internationally, Australia is one of the most successful immunisation countries in the world. We can still do better. However, good governance, openness and transparency are absolutely critical to ensure that there is not a “fake news” backlash as has been seen in some countries. Prof Brendan Murphy has demonstrated the importance of openness. Let’s hope such an approach is infectious!
Michael Moore is a former member of the ACT Legislative Assembly (1989-2001) and an independent minister for health in the Carnell government.