Australia How does Australia's vaccination efforts compare with other Asia-Pacific countries?

00:25  18 april  2021
00:25  18 april  2021 Source:   abc.net.au

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While Australia has fallen significantly short on its deadline to vaccinate 4 million people by the end of March, millions of people have already been vaccinated in other Asia-Pacific countries, including China, Indonesia and India.

The number of vaccine doses administered per 100 people are higher in those countries too.

How did others in our region vaccinate so many people so quickly and how is Australia doing in comparison?

Who is ahead of us in the region?

According to Our World in Data, as of Friday Australia had provided about 5.1 vaccine doses per 100 people.

The country with the highest vaccination rate in the Asia-Pacific region – and by a long way – is Singapore (28.5 doses per 100 people) followed by China (12.5), Cambodia (8.7), India (8.3), Indonesia (5.8), Australia and then the rest.

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Burnet Institute epidemiologist Mike Toole said Australia is about 90th in the world in terms of vaccines delivered per capita and within the Asia-Pacific region we are around the middle of the pack.

"We are ahead of South Korea (2.6) and Japan (1.4)," he said.

"Singapore is well ahead of us. Indonesia is about same as us. Papua New Guinea has barely started while New Zealand is behind us (1.9)."

Malaysia has given out 3.2 doses per 100 people, Thailand 0.8 and Vietnam only 0.06.

So how is Australia doing really?

Well, comparing the vaccine rollouts in different countries is complicated.

For a start, the severity of local outbreaks has affected whether health authorities prioritise getting the vaccines out quickly or taking time to assess the safety and efficacy data first.

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Indonesia, which is still reporting thousands of new cases per day, has been less fussy than Australia about where its vaccines are coming from and has already started rolling out both the AstraZeneca and Chinese Sinovac vaccines.

Cambodia is in the middle of its first big outbreak and has close links with China so the Kingdom is getting both China's Sinvoac and Sinopharm vaccines, along with AstraZeneca doses produced in India.

India and China, like the US, UK, Russia and EU, are producing their own vaccines, which means they have a relatively secure and reliable supply.

Singapore has the virus under control and has had to import all its doses like Australia but it also has a much smaller, geographically concentrated population and a top-tier publicly funded health system.

— securing a load of the Moderna vaccine back in June last year and Pfizer and Sinovac vaccines in August.

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Australia struck a deal for the AstraZeneca vaccine in August and for .

Australian National University infectious diseases expert Peter Collignon the only really comparable countries that had the virus under control like Australia were New Zealand and Taiwan.

"We're ahead per capita of both of those countries," he said.

"New Zealand's probably a couple months behind us.

"Then if you look at Japan and South Korea, which had good control of the virus until more recently, we've got more vaccines administered per capita than those as well."

What could we be doing differently?

Professor Toole said one of the big reasons some countries had been so successful in vaccinating their populations was their use of hubs instead of general practitioners as distribution points.

"I think the strategy [of using GPs] has its benefits in that people can talk to their GPs and they can clarify their concerns. But in terms of quantity, it's a very cumbersome system."

He said one of the good reasons Australia was behind some countries was the government was cautious in the approval process.

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"The bad reason is of course, that we probably didn't have as diverse a range of vaccines to pick from," he said.

He said Australia's health authorities should be looking further afield for vaccines, including Russia's Sputnik V.

"I wouldn't rush into getting the Chinese vaccine, but I think we should be looking at the Russian one, particularly as we can probably manufacture it here we would have to get a license," he said.

"But I think now that Johnson & Johnson is off the table, we should be looking as broadly as we can."

China also isn't doing as well as they would like

, China aims to vaccinate 560 million people by the end of June, and another 330 million by the end of the year, covering 64 per cent of the total population.

However, Beijing has already had to adjust its targets once after failing to vaccinate 50 million people by the beginning of February, pushing that target back to the end of March.

China's vaccination campaign began in earnest in January with local governments opening hundreds of vaccination sites including in schools, shopping centres, and stadiums.

However,, in part because of concerns about their safety and also because China has been so successful in suppressing the virus.

Some local areas are offering incentives, such as fresh eggs and cooking oils to encourage vaccination.

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The result has been that China has managed to administer 12.1 doses per 100 people or about 180 million shots.

Monash University associate professor Hui Yang said the bureaucratic system in China allowed some local officials to take an extreme approach to "wrap up the task".

Dr Hui told the ABC the Chinese approach had benefits.

"China's system can be more efficient when dealing with public health emergencies compared to the bottom-up system," he said.

"But it does not perform well when engaging the community and respecting the individuals' autonomy.

"These important dimensions in biomedical ethics are what Australia emphasises."

Indonesia may be vaccinating the wrong people

According to President Joko Widodo, Indonesia, which is getting both AstraZeneca's and China's Sinovac vaccines, is aiming to have delivered 40 million doses by June on the way to vaccinating .

However, according to Minister of Health Budi Gunadi Sadikin the target depends on the availability of vaccine stock.

The country's health authorities are going to have to ramp up their rates in a big way if they're going to hit their targets.

As of this week, the Indonesian Ministry of Health reported only about 16 million doses of vaccine had been administered since the vaccination campaign started in late January, with about 10.5 million people having received just one dose, and about 5.5 million two doses.

Mr Sadikin said about 300,000 people were getting shots each day but with more vaccine set to arrive by June, they want to increase that rate by 600,000 or 700,000.

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However, Griffith University Centre for Environmental and Population Health epidemiologist Dicky Budiman said Indonesian health authorities were not necessarily vaccinating the right people.

Dr Budiman said the elderly and people with co-morbidities should be prioritised, along with health workers.

"If not, this is dangerous because it will increase the morbidity and mortality rate, even if the vaccination is carried out. Morbidity and mortality numbers will continue to occur if the target is not completed," he added.

He said less than 10 per cent of the older cohort had been vaccinated while non-priority groups such as artists, journalists and entertainment workers had already received their shots.

Even the 'pharmacy of the world' is struggling

Despite injecting the third highest number of vaccines doses worldwide, India has covered only a small part of its 1.4 billion people.

Even the "pharmacy of the world" is struggling to get enough vaccines.

Soaring cases and deaths have come just months after India thought it had seen the worst of the pandemic and have forced the country to delay exports of vaccines abroad.

India is a major producer of COVID-19 shots, and its pivot to focus on domestic demand has weighed heavily on global efforts to end the pandemic.

The country's government said regulators would decide on emergency-use applications for foreign COVID-19 vaccines this week.

India's ambassador to Moscow said deliveries of Russia's Sputnik V coronavirus vaccine to India were expected to begin before the end of April, the TASS news agency reported.

Where do we go from here?

, Australian health authorities had administered about 1.42 million vaccine doses as of Thursday, including 61, 272 in the previous 24 hours.

Prime Minister Scott Morrison has admitted Australia's vaccine rollout faced "serious challenges".

He has blamed the government's failure to hit targets so far on "patchy international vaccine supplies" and "changing medical advice", arguing more cooperation is key to "making our vaccination program as good as it can be".

While CSL is expected to ramp up production of the AstraZeneca vaccine, Australia health authorities have decided to only give it to people older than 50.

Meanwhile, Australia has an agreement for , but that target has now been pushed back until later in the year.

, but these additional jabs won't be delivered until the last quarter of this year.

Professor Toole said it was difficult to even know for sure whether it was supply or actually logistics that were hampering Australia's rollout because of a lack of transparency.

"No-one in Australia today seems to know how many Pfizer vaccines are on the shelf," he said.

"The fact that that those numbers are not known is very troubling to me, because how can you have a plan if you don't know how many vaccines you have, or how many you're getting."

A spokesperson from the Department of Health said as of April 14 Australia had received 1.1 million doses of the Pfizer vaccine and 3 million of the AstraZeneca vaccine but did not provide a breakdown of how many of each had already been used.

"Deliveries from Pfizer are expected regularly and will increase over the coming months. In total 40 million Pfizer doses throughout 2021," they said.

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