World / Aus PM clarifies potential COVID-19 vaccine won't be compulsory

Canberra: The health minister Greg Hunt says the federal government will not “force vaccinations on any Australian” and Scott Morrison has clarified they would not be compulsory after experts expressed concern that earlier talk of “mandatory” vaccination might drive hesitant Australians away.

The prime minister announced on Tuesday night that a letter of intent had been signed with the British pharmaceutical giant AstraZeneca to supply Australians with the University of Oxford Covid-19 vaccine if it clears clinical trials.

Asked whether the vaccine – if it is proven safe and effective – would be mandatory, Morrison said he “would expect it to be as mandatory as you can possibly make”, with exemptions on medical grounds.

Later in the day, the industry minister, Karen Andrews, said the prime minister had made it clear that “we are looking at it being a mandatory vaccine”.

“Look the prime minister has dealt with that issue this morning and he’s on the record as saying that we will make this as mandatory as possible,” she told 2GB radio. “That basically there will be medical exemptions that will be considered but the prime minister has made it clear that we are looking at it being a mandatory vaccine.”

The government’s language had concerned leading experts on vaccine hesitancy and refusal, who feared such a discussion was dangerous and could drive some Australians away, given the vaccine was not yet proven effective and safe.

Morrison subsequently told 2GB there was no plan to make the vaccination compulsory.

“It is not going to be compulsory to have the vaccine, OK? It’s not compulsory. There are no compulsory vaccines in Australia,” he said on Wednesday evening.

“There are no things that force people to do things. What we want to achieve is as much vaccination as we possibly can should the vaccine actually prove successful and get through those trials. I mean, Australia has one of the best records in the world of getting high rates of immunisation.”

The PM said there would be “no compulsory vaccine but there will be a lot of encouragement and measures to get as high a rate of acceptance as usual”.

A spokesman for Hunt told the Guardian the government could not force vaccinations on any Australian. He said there was overwhelming support for a tough stance on immunisation and that the benefits were important enough to “underpin certain policy decisions”.

“As the prime minister outlined today, the government does not make vaccinations compulsory,” the spokesman said. “We cannot force vaccinations on any Australian. Our goal is to ensure as comprehensive coverage as we possibly can, as we do with all critical vaccinations.”

Earlier on Wednesday, Morrison talked up his credentials as the “the social services minister that introduced no jab, no play” – a coercive strategy to improve childhood vaccination – but did not outline what coercive measures would be used to make a Covid-19 vaccine mandatory, if any.

The acting chief medical officer, Prof Paul Kelly, suggested the vaccine would be voluntary at first, saying: “Of course, the first will be a voluntary call for people and I’m sure there will be long queues – socially distanced, of course – for this vaccine. It will be incredibly welcomed by many.”

Vaccine hesitancy – defined by the World Health Organization as the “delay in acceptance or refusal of vaccines despite availability of vaccination services” – has been identified as a problem in 90% of countries.

The WHO included hesitancy in its top 10 threats to global health last year, and the body’s vaccines advisory group says it is driven by a range of complex factors, including complacency, inconvenience in accessing vaccines, and a lack of confidence.

One of Australia’s leading researchers on vaccine hesitancy and refusal, Julie Leask, of the University of Sydney and the National Centre for Immunisation Research and Surveillance, says pre-emptive discussion of a “mandatory” vaccine is dangerous.

“It concerns me quite a lot to see this being talked about before we even have a vaccine, and before we even know what that vaccine looks like, and before we have even attempted to address the priority groups,” Leask told the Guardian.

“However, I’m not surprised that this topic comes up … it plays well politically to talk up using coercive measures to get people to vaccinate their children.

“But it’s really important with this disease and this vaccine, that we get this discussion right, we can’t be playing political games with discussion about how we get high coverage of a Covid-19 vaccine. We need to be as reasonable and careful as we possibly can.”

The consequences of discussing coercive measures this early were potentially serious, Leask said.

She said the public has not had the chance to build up knowledge about the vaccine candidate or develop trust in its safety and efficacy. That risked driving people away from any future vaccine.

“It will only be produced and distributed if we have trials that show it has an acceptable safety and effectiveness profile, that’s important, but the public haven’t even had a chance to know what it looks like and develop trust in the vaccine based on information about it,” she said.

“So if you jump to talk of coercive measures, you can risk getting what we call ‘reactance’, which is a kind of anger that you see when you talk up people having to do something before you’ve even had a go at using all the other measures available to do something, if indeed it’s worth them doing it, and it’s effective to do that.

“Those people who are a bit ambivalent, if they’re then being told ‘by the way you will have to have this vaccine’ … then you risk pushing [more] people away from the vaccine than you might have otherwise done.”

Efforts to combat vaccine hesitancy are complex and multifaceted. A paper in the Lancet last year said the advice of doctors had been shown to be the most important predictor of vaccine acceptance, making it crucial that health workers were given the tools and resources they needed to communicate with patients.

Governments and health policymakers also had a critical role to play, the paper said, including through public education, the promotion of vaccination, and policies that reduce public health risks associated with hesitancy.

The US’s Anthony Fauci, the director of the National Institute for Allergies and Infectious Diseases, has identified online misinformation as a critical issue in vaccine hesitancy.