Only 1.94 million out of 25 million Australians are fully vaccinated, which is 7.7 percent of the population. This places Australia near the bottom of OECD countries that have embarked on a population-wide vaccination program.
Chang opines that Australians may be reluctant to support the vaccination program unreservedly because the vaccine—whether it is AstraZeneca or Pfizer—does not offer total immunity but “simply reduces the severity of the symptoms.” In addition, he points to vaccine-related deaths, presumably the well-documented cases of blood clotting, and more generally, the safety of the vaccines.
He makes the disturbing and revealing point that seniors in their 70s cannot get access to the Pfizer vaccine but “all prisoners, including those in their 70s, can.”
Undoubtedly, these reasons have contributed to the shambolic rollout of the vaccination program which, because of constantly shifting goal posts, could well be referred to as Australia’s “vaccinegate.”
However, there is one critical reason for the demonstrable reluctance of Australians to embrace the government-sponsored vaccination program.
As is well known, the national cabinet, which consists of the prime minister as well as the premiers and chief ministers of the states and territories, have repeatedly moved the goalposts with regards to the age groups eligible for different vaccines.
At first, AstraZeneca would be the saviour vaccine for all Australians.
But when reports emerged of blood-clotting issues, it was decided that under 50s should only receive Pfizer, and that over 50s—the older and presumably more vulnerable Australians—should receive AstraZeneca.
Later, the cabinet recently decided that people under 60 could receive Pfizer but people older than 60 would still have to accept AstraZeneca.
The government’s approach is problematic because the distribution of benefits and burdens ends up being determined by a person’s age.
If, as appears to have happened, people over 60 are practically compelled to accept AstraZeneca, they would suffer the consequences of a potentially defective risk assessment policy.
This is because firstly, the freedom of seniors to choose their vaccine would been abrogated; second, they would effectively receive a vaccine which, according to medical reports, is inferior in its performance to the Pfizer vaccine; and third, perhaps most importantly, the government rules on the distribution of vaccines condones a form of age discrimination by depriving older people, and indeed all people, of the opportunity to make up their own mind as to which vaccine they would like to receive.
It unfortunately leads to the creation of a two-class Australian society, where some are more equal than others.
The relevant government vaccination rules are also inflexibly administered, and older Australians are only offered AstraZeneca even if they, or their GPs—based on medical opinion—prefer them to have the Pfizer vaccine.
I experienced this issue firsthand, as I have had blood-clotting issues in the past and use blood thinners, my GP gave me a letter where he asked the COVID-19 clinics to arrange a Pfizer vaccine for me.
Previously, the Metro North Emergency Operations Centre at the Royal Brisbane and Women’s Hospital emailed me saying that the current recommendation “as per the Australian Technical Advisory Group on Immunisation (ATAG) would be for you … to proceed with the AstraZeneca vaccine.” But that ultimately they were ”happy to accept and review emails/referrals from your GP or specialist doctor and vaccinate you based on their recommendation.”
However, when I presented myself for vaccination, I was told by an attendant who manned the reception desk that, in accordance with the applicable government rules, I was not entitled to Pfizer but should accept the AstraZeneca vaccine instead—or just leave without being vaccinated.
In my experience, it is difficult to negotiate a preferred outcome when rules are implemented strictly without consideration of their real world impact. I left the vaccination clinic, unvaccinated and frustrated.
It would be demeaning to argue that the reluctance of older Australians to accept AstraZeneca is based on ignorance.
It may be reasonable to believe that the rollout would go substantially smoother and more successfully if national cabinet were to adopt a non-discriminatory freedom of choice policy.
However, the implementation of this freedom of choice policy would not necessarily result in the vaccination of more people. Indeed, if people over 60 were allowed to choose their preferred vaccine, they would probably be competing for the same limited amount of the Pfizer vaccine, while leaving AstraZeneca stockpiles untouched.
Such a situation could lead to fewer people being vaccinated since the limited supply of Pfizer would be exhausted quickly. In such a case, Australia would have to wait for new deliveries, which would result in delays for the projected vaccination timeframe.
However, it could be argued that the removal of age discrimination in the context of the distribution of vaccines is a price that society should be willing to pay.
This argument is based on the expectation that in a liberal democratic country, people should be respected and allowed to make up their own mind. Because without freedom of choice, the reluctance to accept what is potentially a less-effective vaccine is only likely to harden.
Of course, even in a liberal democracy, there is often intergenerational conflict. Regarding the vaccine rollout, governments and health officials have created a two-class society, where the interests of one group are served at the expense of another.
What we need in Australia is consistency in risk assessment.
Although risk changes, the government’s response should be to ensure that no group in society is unnecessarily disadvantaged.
The government is always involved in risk assessment when it decides on the conferral of benefits and the imposition of burdens. In the pandemic context, the national cabinet has recently decided that people under 40 can now have the AstraZeneca because the risk of getting blood clots is negligible.
It should therefore also accept the corollary, namely that there are seniors in the over 60s category who are at higher risk because of their vulnerability to blood-clotting and other complications: these people should be allowed to access Pfizer as their preferred vaccine.
It should be left to GPs to determine whether their patients are prone to health complications; their assessment and professional opinion should not be dismissed.
Of course, the vaccination program has been hampered by supply issues. However, it is fair to say these problems are grounded in unwise government decisions made many months ago to purchase and produce huge stockpiles of a single vaccine, rather than buying enough of each available vaccine—a practice which would have minimised the risks AstraZeneca now presents.
In putting all its eggs in one basket, the government effectively committed itself to market the AstraZeneca vaccine, rather than conceding it made a mistake. Indeed, once the purchase of AstraZeneca—now also produced in Australia—was completed, negative reports about the effectiveness and safety of the vaccine reached the country. This information, in turn, worried the over 70s age group, the concerns of which have slowed the vaccination program.
Governments are not infallible, and the federal government should have the courage to admit that in this case, it made a mistake.
If the government were to revisit its risk assessment policies, it would likely choose to offer greater freedom for Australians to choose which vaccines they take. This would go a long way to speed up, and even possibly rescue, the program.
