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Introduction
Thank you for giving me the opportunity to officially open the Public Health Association of Australia’s 2021 National Immunisation Conference.
Before I begin, I would like to acknowledge the traditional owners of the land from which I am speaking, the Ngunnawal people, and pay my respects to Elders, past and present.
I extend that respect to other Aboriginal and Torres Strait Islander people with us today.
Before I go any further, I would just like to acknowledge the hardship caused by the current lockdowns in NSW, Western Australia and the Northern Territory. My heart really goes out to everyone affected.
Hopefully these lockdowns will be relatively short, and enable contact tracers and public health officials in these jurisdictions to get on top of what are potentially serious outbreaks of the coronavirus. I know these lockdowns are incredibly disruptive – but implementing them really is the right thing to do.
This is the 17th National Immunisation Conference, first held back in 1987. Since then, this conference has cemented itself as Australia’s premiere forum for bringing together a very broad range of professionals involved in immunisation – and so I am delighted to be speaking to you today.
Given the world we are living in right now, there could only be one theme for this year’s conference: “Immunisation in the COVID pandemic era”.
While COVID-19 is seemingly all encompassing, and with so much of our focus rightly on encouraging as many people as possible to be vaccinated against the coronavirus, it is vital our efforts in responding to the pandemic continue to be viewed through the wider prism of the benefits immunisation can deliver.
In my opening address, I’d like to touch on the importance of vaccination, the role it plays in pandemics (past and present), where it fits into our broader public health program – and what the future might hold.
Why we vaccinate
Why do we have vaccination programs?
Because they save lives. Because they prevent people from becoming seriously ill. Because they ensure our hospitals’ intensive care units don’t become overwhelmed, resulting in unnecessary deaths. Because they allow us to live with greater freedoms and more certainty.
Vaccination is an important public health tool to help us respond to pandemics.
Vaccination, as we all know, is a vital part of a wider public health program to prevent infectious diseases.
For COVID-19, this program has included implementing “rings of containment” that start with strong border and quarantine controls, as well as building up the capacity of the primary healthcare sector, and ensuring we have sufficient personal protective equipment for people at higher risk of contracting disease.
We have also built up the capacity of our public health system and ensured we have the resources to quickly test, trace and isolate people who have contracted – or are suspected to have contracted – COVID-19.
Comparing the Spanish Flu and COVID-19 pandemics
If we look back a century, the Spanish Flu pandemic that first struck Australia in 1919 provides some perspective when we consider the COVID-19 pandemic. It is also instructive when we consider the role of vaccination within a wider public health program.
As is the case with the COVID-19 pandemic, Australia’s response to the Spanish Flu pandemic varied across state borders.
Of the Spanish Flu pandemic, the National Museum of Australia’s website notes …
The city of Sydney implemented strict measures in an attempt to limit the spread of the disease. This included closing schools and places of entertainment and mandating the use of masks.
Such measures didn’t prevent the spread of the disease, but did manage to slow its movement.
Sounds eerily familiar!
An effective vaccine was not available for the Spanish Flu.
Up to 40 percent of the Australian population contracted the virus – and some 15,000 Australians died over the course of 1919 alone. Around the world, it is estimated between 20 and 50 million people succumbed to the Spanish Flu pandemic.
Fast forward to 2021, and the death toll to COVID-19 is far lower.
Tragic though all deaths to COVID-19 are, the number of people around the world who have died to COVID-19 is only approaching four million people. In Australia, fewer than 1000 people have died from the virus.
So why have the numbers of cases and deaths in Australia been so much lower for COVID-19 than was the case for the Spanish Flu?
While we need to always consider inherent differences in the intrinsic pathogenicity of the two diseases, a large contributor to this difference is likely to be because of how much better our response to this pandemic is.
Our surveillance systems, and widespread access to laboratory testing, mean we are able to detect, isolate and contact trace cases far more quickly, including in quarantine.
We now have a far better equipped and trained healthcare system, including access to antibiotics and other medications to fight secondary bacterial infections. Rapid dissemination of research findings and other methods of sharing knowledge mean that successful approaches to public health controls and to treatment are able to be quickly disseminated and learnt from.
Despite this, it should be noted the death rate from COVID-19, globally, has been increasing, with more people dying this year in less than six months compared to all of 2020.
So what’s the key now to slowing the spread of COVID-19 and reducing its ability to mutate and thrive? Vaccination.
We are very likely to be living with COVID-19 for many years to come, but widespread vaccination will put us in a position where we are controlling the virus – and not the other way round where the virus is controlling us through the imposition of measures such as lockdowns and travel restrictions.
There is ongoing debate about what percentage of the population needs to be vaccinated to meet the aspirational goal of “herd immunity”.
It is not clear when we might approach herd immunity given the many uncertainties, including the duration of immunity conferred by a vaccine and how effective vaccines are against emerging variants of concern.
What we do know is the more people who get vaccinated, the more chance we have of getting in control of COVID – and preventing severe COVID and deaths.
Victorian and NSW residential aged care facilities and COVID-19
We only need to look at the vastly improved situation in Victoria’s residential aged care facilities to see the benefits vaccination can deliver when we achieve high coverage rates.
More than 1960 people living in residential aged care facilities in Victoria became infected with COVID-19 during the second wave between June and November, 2020. Tragically, of these people, 648 died due to the effects of COVID.
Today, all 2566 residential aged care facilities across the country, including 596 in Victoria, have received their first dose COVID-19 vaccination clinics through the Commonwealth’s vaccine rollout.
All 2566 facilities are expected to have had their second dose clinics by the end of this week – which is an achievement I think we should be celebrating.
On top of this, the Commonwealth established 50 additional roving teams to return to all residential aged care facilities in Tier 1 locations, as defined by Victorian health authorities, to deliver first dose vaccines to any residents and workers not yet vaccinated who wished to be vaccinated.
In response to the current situation in NSW, the Commonwealth has increased the number of roving teams deployed to vaccinate residents and workers not yet vaccinated – and will now cover 238 residential aged care facilities in that state across 18 local government areas.
Of course, vaccination is only a part of what has been done to improve protection levels for residents and workers in aged care facilities. For instance, we now have an infection control lead in every facility, improved infection prevention and control procedures and statewide coordination, assisted by the Commonwealth.
But without doubt, the widespread vaccination of aged care residents has made a big difference. And the result? The outbreaks of COVID-19 in Victorian residential aged care facilities this year were quickly contained – and no one died.
It shows the clear benefits of improved preparedness and IPC practices, and of course, vaccination.
Widespread vaccination – benefits and lessons to learn from
Widespread vaccination will also give us the confidence to reopen our borders, knowing our population will be protected against the worst effects of COVID-19.
Widespread vaccination will give businesses more confidence and provide us with more certainty to plan important events – for instance family reunions and much-needed holidays – with less likelihood of them having to be cancelled or disrupted by a COVID-19 outbreak.
Widespread vaccination will give Australians more certainty to plan for the future and alleviate some of the stress and anxiety uncertainty brings.
We know that some of the measures that have been imposed to respond to the pandemic, including lockdowns and movement restrictions (which in turn have had an impact on things such as schooling and work) have taken a toll on people’s mental health.
Widespread vaccination gives us a powerful tool to control COVID-19, potentially allowing us to look at less reliance on these blunt responses – especially the measures implemented 100 years ago!
And importantly, every person who is vaccinated will be helping to protect the health of their family, friends and community – and give us greater hope of returning to a sense of normality.
I would urge everyone listening and associated with this conference to encourage everyone to be vaccinated against COVID-19 with two doses of the same vaccine as soon as they become eligible – and supply allows.
It really is the only way we can return to something like normality. As I have said before, vaccination is the key to us getting to the other side of this pandemic.
This pandemic has also shown us, as a global community, what can be delivered if we put sufficient effort and resources into achieving an outcome.
To produce multiple effective vaccines to COVID-19 within a year is an extraordinary achievement – and a testament to the collaboration of medical scientists and regulatory authorities around the world.
I didn’t believe this would be achieved so quickly – and I’m really glad I was wrong!
I think it has probably forever changed the way vaccines are developed, evaluated and manufactured going forward – including in future pandemics.
I also firmly believe we need to consider how best to vaccinate our population in the next pandemic – which we know will inevitably occur sometime – in a more business-as-usual way.
The way we are rolling out the COVID-19 vaccines is absolutely the right approach – today. But it is not sustainable.
There will be lessons to learn from our COVID-19 response – and we need to heed them.
Conclusion
In conclusion, I’d like to thank everyone for participating in this important conference – and thank the work of the organisers who have managed to bring everyone together in a virtual, COVID-safe fashion.
The work we do in Australia to prevent and control diseases is first class – from our researchers to our manufacturers and medical regulators, and to those who roll out our vital immunisation programs. I thank you for everything you do.
I trust this conference will stimulate important discussions and an environment in which information and ideas are exchanged.
I wish you all the best – and officially declare the 2021 National Immunisation Conference open.
Thank you.
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