Byron’s vaccination coverage is 20 per cent below the rest of NSW and it needs to lift – quickly. Political and health leaders suggest ‘vaccine hesitancy’ as the problem, but the main issue has been vaccine supply. With thousands of Byron Shire adults not due to receive a first COVID vaccine dose until October, creative solutions – and a greater sense of urgency – are needed to get us ahead of what’s coming.
The recent Shire-wide lockdown resulted from just one Sydney traveller visiting a few Byron shops on her trip from Ballina Airport to Kingscliff. The travel was permitted, but the retail therapy was not. The traveller later tested positive for COVID, and within hours more than 100,000 of us were back in a snap seven-day lockdown.
The whiplash-inducing hard shift from ‘mostly-open’ to ‘mostly-closed’ is a regional NSW peculiarity designed to protect places like ours that have been largely COVID-free, but which also have below-average vaccination rates. Byron Shire has the second lowest first dose vaccination rate in NSW today – an extraordinary 20 per cent below the State average.
If you watched any of the daily COVID updates recently, Byron’s low vaccination rate – and what that means for the October statewide reopening plans and regional travel – is finally getting attention in Sydney. But there’s something a bit off. The questions lead with an assumption of why the vaccination rate is trailing; an assumption that respondents are too willing to reaffirm.
Take this example from 22 September:
Interviewer: ‘What’s the strategy to get the vaccination rate up in Byron Bay, Mullumbimby…?’
NSW Premier: ‘Well as I said, unfortunately there are pockets of resistance… And even if you don’t care about the safety of those around you… And even if you don’t care about your community, I think people are looking forward to doing things we haven’t been able to do for a while, and I think that’s a big incentive. But as we know there will always be pockets of resistance, but we are trying to identify those communities that legitimately have lower vaccination rates, it might be access issues… and as you know we have done incredibly well as a state considering the lumpiness of the supply we have received… it’s been a challenge for us to make sure it gets to the right places… I know there are some regional communities that are slightly behind the state average and we are trying to increase those as quickly as we can.’
Wow. That’s as unsubtle as it gets. Let me translate: There are a handful of places with legitimately low vaccination rates (problems the government is working hard to fix!), and then there are places like Byron where the rate is illegitimately low owing to the selfish (in)actions of some.
While the State government concedes there’s a problem in Byron, it can’t then offer a solution without revealing that the actual cause is something it is responsible for. This ‘regional community X is good, but regional community Y is bad’ setup might help the premier duck responsibility, but it’s bad for everyone else. It’s also deeply misleading.
Vaccine hesitancy is real, but we are a long way from seeing its impact. Hesitancy can partly explain a vaccination coverage ceiling, as well as a brake on vaccination pace as that ceiling gets closer. But what it doesn’t explain is a Shire-wide first-dose rate that only recently hit 60 per cent when the NSW average was at 80 per cent (and some parts of Sydney are now above 95 per cent!).
The reason we know the ‘hesitancy’ explanation is faulty is twofold. Firstly, prior to the vaccine rollout Healthy North Coast (HNC) – a not for profit with a key organising role across the region – undertook a region-wide COVID-19 vaccine sentiment survey. The results (perhaps surprising to some) showed that people up here were just as likely to get a COVID vaccine as those elsewhere.
But the second explanation is clearer still.
In preparation for writing this article I contacted medical practices across the Shire to check Pfizer appointments. If our low vaccination rates today is caused by ‘vaccine hesitancy’ then you would expect to find plenty of vaccine options for the days ahead. But you can’t. Karina Masterton, the practice manager at Bay Medical, described the issue:
‘As soon as we were advised that our allocation of Pfizer vaccine was to double from mid-September we created hundreds of additional appointments and got word out – those appointments were booked almost the same day. On a typical day we might get a dose or two left spare due to a no show, but we have people on standby for those doses. Looking ahead the next available Pfizer appointment is October 13.’
This pattern was typical across the Shire – next available Pfizer jabs are mid- to late- October. The second lowest rate in the State, and yet thousand of adults will still be waiting well into October for their first vaccination.
How is it that in the Hills Shire (in north-west Sydney), where the first-dose vaccination rate has passed 95 per cent, you can get a Pfizer appointment within 48 hours?
The NSW Health response is that Pfizer availability in Bryon is improving after months of low supply. AstraZeneca (AZ) has been more widely available for longer, but outside of the Greater Sydney COVID hotspots, AZ has only been recommended to those over 60. Moderna has recently started shipping to our local chemists, but the delivery focus is on 12–15 year olds.
Compounding the vaccine supply problem, unlike Tweed, Lismore and Grafton, there is no mass vaccination clinic in Byron. And while Tweed and Lismore are in the hood, it’s still a 100km round trip.
Perhaps more alarming than the first dose rate is the fully vaccinated rate – also about 20 per cent below the State average.
Seventy per cent of NSW adults will be fully vaccinated around 7 October, a figure that rises to 80 per cent roughly two weeks later. These are key milestones flagged in the NSW ‘freedoms for the fully vaccinated’ roadmap – a document informed by Doherty Institute assessment of the vaccine coverage needed to ensure TTIQ (Test, Trace, Investigate, Quarantine) measures work and health systems don’t buckle.
And for us, where will we be?
Even with the recent vaccine-supply lift, we are still tracking to be a month or more behind than the rest of NSW. When NSW passes the key first of the Doherty milestones Byron Shire will be closer to 50 per cent fully vaccinated. This is a figure not discussed in the modeling, and indicates significant vulnerability. When we’re a month late to get to 50 per cent, 70 per cent might not seem too far away, but keep in mind the Delta variant of this virus spreads fast. And anyone with even a passing familiarity of our region’s hospital capacity should be concerned – particularly if fingers-crossed optimism, and half measures, prove misplaced.
Last week a multi-party group of North Coast MPs called on the Premier for a delay to removing the current travel restrictions until our vaccination rate catches up. While this tactic (mostly) worked while Greater Sydney was locked down, it’s harder to see it working as effectively after the long Sydney hibernation ends. Whether via ‘permitted workers’ or unpermitted travellers the virus is likely northbound, and overly relying on a ‘ring of steel’ approach will almost certainly fail.
If we don’t get across this gap expect to see more of the lockdown sledgehammer deployed to keep large-scale spread under control until the vaccination rate catches up. Massive disruption will result.
But there is another option available – get vaccination coverage up much quicker.
Byron Council recently voted to make the Cavanbah Centre and Civic Memorial Hall in Mullumbimby available to NSW Health to use as a pop-up clinic. And the evidence shows this rapid deployment action works. Across Sydney, and in parts of regional NSW, mass vaccination, mobile, drive though, and pop-up vaccination clinics have helped to rapidly lift vaccination rates and improve vaccine access.
And even though it was only a week back that NSW Health created a pop-up clinic in Goonellabah, for reasons unclear none of these options are planned for Byron Shire. That’s a missed opportunity that we could all come to regret. We posed questions to NSW Health about their assumptions and caseload planning scenarios but are yet to receive their answers.
The Sydney and Melbourne experience shows us that Delta is a beast once it gains a toe-hold in a community. But with a greater sense of urgency there are steps we can take to minimise the impact. This will require political and health leaders to turn some of their attention from where the fire still burns, to where it is likely going. The clock is ticking.
♦ Rod Palmer studied at UTS and Curtin University, where he was a researcher at the Graduate School of Business. He swapped a weekly commute to Canberra, where he worked for the federal government, for the incalculably greater pleasure of regenerating rainforest at his property – Altitude 261 – in Main Arm.