In Australia, vaccine information has been distorted by transmission through both mass and social media. It is not surprising that the level of vaccine hesitancy in rural and remote communities has been elevated. To address this, the federal, state and territory governments are now working hard to focus their message and encourage people in rural and remote communities to be vaccinated.
The National Rural Health Commissioner, Professor Ruth Stewart, is working closely with the COVID-19 Section of the Australian Government Department of Health and she co-chairs the Rural Health System Preparedness Roundtable. This roundtable has allowed rural and remote stakeholders to voice concerns and identify gaps for their communities and priority groups in vaccination rollout and ‘living with COVID’. With borders soon to be opened, rural stakeholders fear the impact on communities where fewer people are vaccinated.
The pandemic has demonstrated both the resilience of healthcare providers in rural and remote communities, and the pressure points in this already stressed workforce. Now, more than ever, it is vital for healthcare providers to actively encourage communities to be vaccinated. Respectful conversations about vaccination efficacy are needed. Healthcare providers can build on their established relationships with community members to hold constructive vaccine discussions.
Australia has seen civil society contribute to and support the nationwide vaccination rollout. Communities of faith and social organisations have supported vaccination programs by allowing use of their facilities. They have provided culturally safe spaces for communities to engage with healthcare providers and consider evidence-based vaccine information. Healthcare providers who are part of their community hold positions of influence and can engage with otherwise difficult-to-reach populations and priority groups in rural and remote communities. We see the impact of their work as vaccination rates rise amongst pregnant women and First Nations people.
In remote communities, healthcare providers have made considerable efforts to make vaccines accessible, even providing door-to-door vaccinations and pop-up vaccination clinics in community centres and local stores. The need for significant resources to vaccinate First Nations people is recognised by the federal government. In September, it announced an additional $7.7 million for the National Aboriginal Community Controlled Organisation to support 30 priority areas to vaccinate First Nations people. Importantly, this funding enables liaison officers to support informed decisions on vaccinations. These efforts prioritise vaccinating First Nations people, which is important as Australian National University research clearly demonstrates the association of social determinants of health.
In deciding whether to be vaccinated, pregnant women think of their unborn baby first and place their own health needs second. A recent survey in Ireland identified that many pregnant women decided not to have the vaccine because of concerns about the safety of vaccination for their unborn infant. Sadly, in the United Kingdom, the National Health Service reports that one in six of the patients needing the highest level of life support are unvaccinated pregnant women. Our communication about the COVID-19 vaccine needs to focus on the safety and efficacy of the vaccine for pregnant women, and the reduced risks of critical COVID-19 complications for mothers and babies when pregnant mothers are vaccinated. We need to remind pregnant women that their babies need their mothers to stay well so that they can safely grow to term.
Vaccination of rural and remote communities will be our best protection as international borders open and we reach ‘living with COVID’ stages. The Commissioner and federal government are working closely with healthcare providers across Australia to ensure our communities are ready for ‘living with COVID’, but it is the work of healthcare professionals in each community to promote vaccination that will really make the difference.