Hal Swerissen

Early on in the vaccination program vaccinations were prioritised for the most vulnerable and for front line workers. Later we focused on older people. Now we are focusing on younger adults. Soon there will be debate about preschool and primary school children.

There has been much less focus on disadvantaged communities. But there is evidence a vaccine divide is growing.

First dose vaccination rates in Victoria have now hit 60 percent. Nearly 37 percent of Victorians are fully vaccinated. 

But averages hide large differences across population groups. Queenscliffe has twice the first dose vaccination rate of Broadmeadows (Hume). 

Generally younger, poorer, metropolitan areas have lower vaccination rates. 

On average rural communities are older than metropolitan communities, so more people have already been vaccinated – 63 percent have had a first dose and 39 percent are fully vaccinated, compared with 54 and 33 percent in metropolitan areas.

Lower socio economic local government areas have significantly lower vaccination rates, particularly in metropolitan Melbourne. 

The three metropolitan local government areas with the lowest socioeconomic status, Greater Dandenong, Brimbank and Hume have first dose rates in the low to mid 40 percent range. Vaccination rates in the three wealthiest areas, Nillumbik, Bayside and Boroondara are 20 percent higher. 

The availability of GPs, health services, language, culture and social and community networks all affect vaccination rates. Add to that work pressures and personal costs associated with vaccination. It’s harder to find information and get vaccinated in poorer communities.

This  means it’s important to focus the message, engage communities and make vaccination delivery, flexible, practical and easy for more disadvantaged communities. 

Delta makes it more important to address the divide

Ideally we would wait until everyone has had an opportunity to be vaccinated.

But Delta has made it much more difficult to manage the pandemic with testing, tracing, isolation and quarantine. Even hard lockdowns probably won’t work once the virus gets beyond 50 to 100 cases per day. The tracing teams quickly get overwhelmed as has happened in New South Wales

As a result, the Berejiklian Government has given up trying to get back to zero and the Morrison Government is warning that we are going to have to learn to live with COVID.

There is now enormous pressure to lift restrictions at least in New South Wales even though case rates are high and hospitals are already under pressure. It remains to be seen whether Victoria and the ACT can turn the tide.

The problem is that as restrictions lift the burden falls on the unvaccinated. When vaccination rates vary across communities that means the burden won’t be fairly and evenly spread. At the moment poorer, younger, more diverse communities have relatively lower vaccination rates and will end up with more infections, hospitalisations and death.

We have already seen the recent woeful performance in delivering vaccinations for vulnerable, indigenous communities in rural New South Wales. 

It would be a terrible outcome if younger, poorer, more diverse communities end up bearing the brunt of the pandemic as pressure to open up grows. 

There is not much time to fix the growing vaccine divide.