By Rhiannon Hoyle
SYDNEY -- To reach indigenous clans in northern Australia,
vaccinators must navigate monsoon rains that can ground aircraft
and waterways infested with crocodiles. Once they reach
communities, they face another tough challenge in convincing those
groups to accept the shots.
First Nations people like those in East Arnhem Land -- more than
600 miles by road from the closest city of Darwin and a bastion of
traditional Aboriginal culture -- are next in line in Australia's
vaccination program that began last month and has focused on giving
priority to health and other workers on the front lines of keeping
Covid-19 out of the country.
In many ways, the vaccination program is a litmus test for
nations with large indigenous groups that feel marginalized and
distrustful of government policy. Almost 150,000 indigenous
Australians lived in remote areas in 2016, according to the most
recent government data available. In East Arnhem Land, life
expectancy is around 50 years and half of Aboriginal children
develop a severe hearing, lung or other health problem by age
4.
"What we're hearing now is probably 50-75% will say no," said
Eddie Mulholland, chief executive of Miwatj Health Aboriginal
Corp., an indigenous-controlled primary health service for roughly
8,000 people across East Arnhem Land.
Concerns have increased among indigenous Australians after
reported cases of rare blood clotting in people in Europe who had
received the Covid-19 shot developed by AstraZeneca PLC and the
University of Oxford, though regulators found no link between the
clots and the vaccine and recommended its continued use.
Australian regulators also analyzed reported cases of suspected
anaphylaxis but concluded that the risk of a severe allergic
reaction was no higher than with any other vaccine. Australia has
ordered 53.8 million doses of the AstraZeneca vaccine.
Mr. Mulholland, an indigenous Torres Strait Islander born on
Thursday Island, said the troubles facing AstraZeneca had been
widely shared on social media.
Local indigenous groups already don't believe in Western
medicine, said Mr. Mulholland, who had earlier hoped for a 75%
vaccination rate among adult indigenous Australians in East Arnhem
Land, to help safeguard against infection risks when travel
restrictions are eased.
Australia aims to have its adult population receive at least a
first vaccine shot by the end of October and complete the program
before the year ends. It will happen in five phases, with most
adults in later stages and children last in line, should the
vaccines be authorized for them.
Australia has no plans to stop using the AstraZeneca vaccine,
Prime Minister Scott Morrison said.
Given entrenched health problems in remote Australia, some
doctors have advocated for indigenous groups to get priority access
to the Pfizer Inc.-BioNTech SE vaccine, which has been shown to be
97% effective against symptomatic Covid-19 cases in Israel when two
doses were administered.
Australia has ordered 20 million doses of the Pfizer-BioNTech
vaccine. However, authorities face a daunting distribution
challenge because it requires cold-chain logistics that don't exist
in the hot and sparsely populated areas where many Aboriginal
Australians live.
The Pfizer-BioNTech vaccine has to be kept at temperatures
around minus 94 degrees Fahrenheit, although Australia's regulator
recently decided it can be stored at standard freezing temperatures
for up to two weeks.
Still, many indigenous groups move among communities across an
area almost as large as the contiguous U.S., raising concerns about
whether all would receive the second vaccine dose.
No Aboriginal or Torres Strait Islander people in remote
settlements have caught the virus, but authorities and health
experts worry it could be introduced by people traveling from
cities.
In places where the virus has spread uncontrollably, such as the
U.S., indigenous people have been overrepresented in the number of
hospitalizations and deaths.
"This is a highly vulnerable group of people," said Dr. Michelle
Ananda-Rajah, a Melbourne-based physician in general medicine and
infectious diseases. "This is the very group that should be getting
the most efficacious vaccine."
According to an analysis in medical journal the Lancet, rates of
chronic disease, including diabetes and hypertension, are higher
among indigenous Australians than other Australians. Indigenous
Australians are twice as likely to have three or more chronic
conditions, it found.
Paired with higher rates of smoking, overcrowding in
multigenerational houses, and poor access to water and sanitation,
that puts indigenous people more at risk of dying from the
coronavirus.
Hugh Heggie, chief health officer of Australia's Northern
Territory, which includes East Arnhem Land, said the federal
government had agreed that remote Australia shouldn't use the
Pfizer-BioNTech vaccine.
"I have confidence we have that plan in place," Dr. Heggie said,
referring to the overall inoculation plan. "It's a bit like,
though, flying the plane while you're building it."
Getting enough vaccinators who can travel to remote communities
is another worry, said John Paterson, chief executive of Aboriginal
Medical Services Alliance Northern Territory. The territory relies
on clinicians from other states or New Zealand, a system that was
strained by state and international border closures to contain
outbreaks.
While most remote communities have rough airstrips, outstations
-- where families or small groups live on traditional lands -- can
be several more hours' drive on dirt tracks.
"Some of those remote communities can only be accessed by
aircraft at this time" as the Northern Territory is enduring an
especially bad wet season, Mr. Paterson said. "Roads are cut off.
Some of them can just be little islands until the water
recedes."
Last year, Australia's leaders restricted intrastate travel to
stop the virus from reaching remote communities. The Northern
Territory, where Aboriginal and Torres Strait Islander people make
up roughly 30% of the population, banned nonessential travel to and
from remote communities. Those who needed to travel there had to
isolate for 14 days.
Australia's experience will offer lessons to Pacific nations,
where border closures mostly prevented outbreaks. Governments there
face challenges including remote populations on islands and in
highlands, a scarcity of vaccinators and a mistrust of
vaccines.
"Everyone is sharing information about how this is done," Prime
Minister Morrison said.
For Miwatj Health's Mr. Mulholland, getting the rollout right is
crucial.
He expects vaccines in only roughly 150-dose parcels from the
government, which has been facing supply-chain bottlenecks. That
would require him to either stockpile vials or make many trips by
plane to give shots to the communities his service treats, the
largest of which is home to more than 2,000 residents.
While a botched rollout would hurt the reputation of regional
health services among indigenous communities, low vaccination rates
could be catastrophic.
"If they don't do it, and someone comes in, they could wipe the
whole place out," he said, referring to someone introducing
infection.
Write to Rhiannon Hoyle at rhiannon.hoyle@wsj.com
(END) Dow Jones Newswires
March 27, 2021 08:14 ET (12:14 GMT)
Copyright (c) 2021 Dow Jones & Company, Inc.
AstraZeneca (NASDAQ:AZN)
Historical Stock Chart
From Feb 2024 to Mar 2024
AstraZeneca (NASDAQ:AZN)
Historical Stock Chart
From Mar 2023 to Mar 2024