The vaccine's progress


Vaccination in Australia

On Wednesday New South Wales reached a vaccination target: 56 per cent of the state’s population was vaccinated. To put that into a more useful frame, that leaves 44 per cent or 3.6 million people in that state who are yet to be vaccinated. And of the 56 per cent who have been vaccinated many, probably around 5 per cent, have received their second dose only in the last two weeks and would therefore have less than optimum protection as yet.

Rather than the deceptive political spin around “70 per cent” vaccination (which refers only to the 16+ population) it would be more truthful to say that New South Wales is only halfway through its vaccination program. As for the other states, apart from the ACT, all are behind New South Wales.

Yet New South Wales some who should know better, and who should be guided by a sense of responsibility to the community, are talking about Monday as “freedom day”. The state’s revised plan – NSW on the road to reopening – is a loosening of an already high-risk plan. Notably the allowed activities, such as attendance at nightclubs and large outdoor events once the state reaches 64 per cent vaccination, apply only to the vaccinated. They will be reasonably safe, but they can still be spreaders to the 36 per cent who will still be unvaccinated.

The plan may work, but it has huge downside risks in terms of the load on an already-stressed hospital system, more people with severe illnesses and more deaths, the dampening effect of fear in the community, and the possible need for frequent lockdowns as cases and hospitalisations get out of hand. The state’s new premier may be more attuned to the petulant voices of small business than to people’s need for safety and a well-performing economy that can move cautiously but assuredly out of lockdown.

That is not to deny Australia’s progress in vaccination. Norman Swan rightly says we can gloat for a little while about our pace of vaccination. We are rapidly making up for the Morrison government’s neglect in securing vaccines, its failure to direct limited supplies to where they were most needed, its stoking partisan conflict between Labor and Coalition states, and its substitute of politically spun media announcements for responsible administration.

Although progress is impressive, there are unavoidable lags between the availability of bulk supplies and people walking out of a surgery or vaccination centre with two-dose vaccination. Even though our speed is impressive we still have a distance to travel. The two graphs below – the first of full vaccination and the second of partial vaccination – show our progress over the last two months.

In the first graph we see Australia’s progress towards full vaccination, particularly among younger people. But there is a long way to go, considering that just over half the population is under 40. Young people aged 12 to 15 (5 per cent of our population) have only recently become eligible for vaccination, and even though children aged under 12 comprise 15 per cent of our population, and are accomplished spreaders of coronaviruses, as yet our authorities have not followed the lead of the US in approving and distributing vaccines for children.

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The second graph shows the rapid uptake of first-dose vaccination, particularly among young people, and an approaching ceiling among older people. These are impressive numbers. In the ACT, the leading jurisdiction for vaccination, 96 per cent of people aged 12 and over have received their first dose, and it is hard to imagine anyone, apart from a few who may have had a severe reaction to the first dose, not going on to full vaccination.

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Cases in Australia

While case numbers in New South Wales have subsided, they are still rising in Victoria. This difference has many observers seeking an explanation, because the infection rate in New South Wales peaked on September 11 when it had reached 37 per cent vaccination (whole population). Victoria reached that point on September 24, around two weeks ago, but in Victoria infections are still on an exponential growth path (6 per cent daily growth and an R around 1.3). By now infections in New South Wales are in exponential decline (3 per cent daily fall and an R around 0.9 or possibly lower). That means vaccination numbers alone don’t determine when the curve will bend.

Even more confirmation of this point is the experience of the ACT, where infections are still rising, in spite of its vaccination level being the same as in New South Wales. Although it has no clear trend, its daily infection rate as a proportion of population could be higher than in New South Wales. There have to be explanations other than vaccination levels.

On Coronacast Norman Swan has some possible explanations for Victoria’s disappointing performance. The New South Wales approach to target particular regions within Sydney has probably been more effective than Victoria’s broad-brush approach. Victoria has had to deal with several sources of infection (all from New South Wales), and possibly there is less compliance with restrictions in Victoria: it’s not that Victorians are different but they have endured long periods of lockdown over the last 18 months. And there have been many gatherings serving as spreading sites when people organised parties to watch some football match at the end of September. Swan also notes that so far in Victoria hospitalisation rates have been low.

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The most revealing feature of this series of graphs, updated every week since mid-August, is the absence of any surge in death rates in those European countries, particularly the Scandinavian countries, that have been most advanced in loosening restrictions. Of course there are lags between the lifting of restrictions, infections, hospitalisations and deaths, and all progress could be negated by the arrival of a more deadly variant, but so far so good.

It should also be noted that these figures are for vaccination rates across entire countries. Countries such as the US and the UK, that have significant regional disparities in social conditions, have pockets of vulnerable and unvaccinated people. Also a crucial variable influencing death rates, not revealed in national figures, is the proportion of older people who have been vaccinated. In view of the high vaccination rates of Australians over 70 we seem to be in a good position to keep our hospitalisation and death rates down.


The world

About 35 per cent of the world population is fully vaccinated, and 47 per cent have received at least their first dose. The New York Times has an informative interactive map of vaccination levels, showing that African countries and the “stans” (Pakistan etc) stand out as having extremely low rates of vaccination. In our region Myanmar (7 per cent) and Papua New Guinea (< 1 per cent) are notable low-vaccination countries.

After waiting for the US to move, Australia has finally backed a plan to let developing countries make low-cost Covid-19 vaccines. Our local pharmaceutical lobby group, Medicines Australia, however, is still opposed to such liberalisation. Once again, the point should be made that most ground-breaking research in vaccines has been done by government-funded agencies. Morally the intellectual property of such basic research does not belong to private corporations.

The WHO Weekly epidemiological update interactive map continues to shows a declining number of Covid-19 cases and deaths. These are subject to the qualifications we have mentioned in previous weeks.

The scatter diagram below, an update of the same diagram from previous weeks, shows vaccination levels and recent death rates in high-income “developed” countries (plus Portugal because of its high level of vaccination). The green markers are islands that have had strong border controls. Again we have left the US off: its vaccination level seems to be stuck at 57 per cent and its daily death rate of 5.5 per million would be off the scale. At least it’s down from 6.2 per million last week.

In most European countries included in this group, vaccination rates are still growing, but slowly.

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The most revealing feature of this series of graphs, updated every week since mid-August, is the absence of any surge in death rates in those European countries, particularly the Scandinavian countries, that have been most advanced in loosening restrictions. Of course there are lags between the lifting of restrictions, infections, hospitalisations and deaths, and all progress could be negated by the arrival of a more deadly variant, but so far so good.

It should also be noted that these figures are for vaccination rates across entire countries. Countries such as the US and the UK, that have significant regional disparities in social conditions, have pockets of vulnerable and unvaccinated people. Also a crucial variable influencing death rates, not revealed in national figures, is the proportion of older people who have been vaccinated. In view of the high vaccination rates of Australians over 70 we seem to be in a good position to keep our hospitalisation and death rates down.


Country differences in vaccination

The vaccination data in the previous section covers only a few high-income countries. Some of these countries are doing badly, while some low-income countries are doing comparatively well. Why has Chile, a comparatively poor country, achieved 74 per cent vaccination, while in the USA vaccination seems to be plateauing out at around 57 per cent? Notably in our part of the world Cambodia has achieved 66 per vaccination, on the way to 80 per cent or higher.

There is no clear equation that can predict what level of vaccination will be achieved in any country. Cultural and political factors are hard to model.

On Deutsche Welle’s To the point program three observers from different backgrounds and nationalities discuss the cultural and political factors that help explain differences between countries: COVID-19 and the fourth wave: pandemic for the unvaccinated?. Erik Kirschbaum of DW notes the extent to which vaccination has become a factor in political polarisation. (26 minutes)

On the same point William Galston of the Brookings Institution describes the partisan divide in America: For COVID-19 vaccinations, party affiliation matters more than race and ethnicity. He cites surveys by the Kaiser Family Foundation describing huge differences according to partisan affiliation: 92 per cent of adult Democrats have been vaccinated compared with 56 per cent of Republicans for example.


Data sources

See the separate web page of hyperlinks to generally reliable information and analysis about Covid-19, including data on vaccination and the WHO Covid-19 epidemiological updates.