COVID-19 vaccine information and resources

These chapters are also marked on the YouTube video progress bar.

0:00​ Welcoming Professor Ben Cowie
0:55​ Professor Cowie’s opening remarks
1:26​ Formal presentation – vaccine rollout update
15:09​ Vaccine side effects
16:59​ Accompanying someone whilst they get vaccinated
17:17​ Working with vulnerable, but not vaccinated
18:57​ Is AstraZeneca safe?
23:37​ Family violence refuge and support workers
24:22​ I don’t have a regular GP – who do I see?
25:42​ Street-based communities
28:00​ Visiting low immune people after vaccination
29:41​ Vaccinating volunteers
30:29​ Getting groups vaccinated
34:46​ Can I get choose the Pfizer vaccine?
36:26​ Vaccine(s) and pregnancy, breastfeeding etc
40:07​ Getting sick before your vaccine appointment
41:08​ Declaring underlying conditions when under 70
42:39​ Already had COVID-19?
43:16​ Talking to anti-vaxxers
46:05​ Talking to young people
49:43​ Reporting side effects

Please check against delivery.

EMMA KING: We’ll now shift focus to the mechanics of the vaccine rollout itself. It’s an understatement to say there’s lots happening in this space. We can see our news bulletins full every single night. There’s lots of information and I have to say lots of misinformation that’s floating around and I know that’s been challenging for all of us as well. So to bring you the absolute lightest and also to explain key components of the effects, we have very thrilled to welcome back Professor Ben Cowie from Victoria’s department of health.

Ben is a senior advisor to the COVID-19 immunisation programme. Ben, a significant welcome and thank you from all of us. As a lot’s been happening over the last week and since we last had our Vaccinating Victoria, our first briefing series. So perhaps if I hand over to you to begin with to give a kind of general update and then we’ll jump straight into questions, thanks.

BEN COWIE:  Thank you so much, Emma for the opportunity to be here today, it’s a great pleasure to be here and to discuss with all of you the vaccine programme and hear your perspectives and advice. I will present an update briefly and then we can get to the Q and A but before I do, I do want to acknowledge that I’m on the lands of the Wurundjeri people of the Kulin nation and acknowledge the elders past, present and emerging and acknowledge the elders of the lands where I live, the Boonerong people of the Kulin nation.

So I would like to share my screen and then we’ll get going. So hopefully that’s presenting okay. So thanks for the opportunity, Emma as I said and colleagues. So we have spoken about the vaccination programme previously. Just to reiterate though, that there are three pillars for the programme. And I’m sure that these are very close to the hearts of all the VCOSS members and friends and colleagues that are present on the call today. And that these are fundamentally founded on principles of equity of access, both geographically but also in terms of the appropriateness of the vaccine programme and wherever people are accessing vaccination that that is done in the highest levels of safety and quality. And thirdly, that we maintain public trust and confidence. As you mentioned at the start of just before when you were introducing me Emma, public confidence has taken a hit in the last couple of weeks. We have to acknowledge that and we have to find ways to relate the absolute evidence base and the accurate information, at the same time as having a view to maintaining confidence of people in these vaccines, which remained very safe for the vast majority of people and also very effective and will protect Australians as they are already doing overseas from the devastation that COVID-19 has caused in so many countries and in so many health systems internationally. So this is a Commonwealth programme, it’s the Commonwealth government who have procured the vaccines.

It’s the Commonwealth who distributes the vaccines both through their direct programmes, such as in residential aged care and residential disability care and also through the general practise network. But it is also the Commonwealth who distributes the vaccines to States and territories for use, in our state supported programmes. So the Victorian government clearly has responsibility for commissioning and supporting additional vaccination clinics. And as was announced by the health minister, Minister Foley yesterday there’s been an increase in access through the state programme which I’ll come back to later in my update but also ensuring that we have our own state-based policy and safety mechanisms and training in place to ensure that irrespective of where a Victorian is vaccinated, that we’re doing that in the best and safest way we possibly can and following the best public health advice that’s available to us. But ultimately it’s the people doing the vaccination who are the critical element here along with the community members coming forward to getting vaccinated, because it’s the vaccine centres, whether it’s a hospital whether it’s a high volume or a high throughput site right down to a mobile team, vaccinating some people in a priority community that has to be done in the safest and highest quality way we can ensure. So we’re currently working our way through phase 1A and 1B of the Commonwealth’s vaccine roll out nationally, and these groups certainly nationally agreed.

Here in Victoria we have added some groups to be vaccinated alongside 1B and that really reflects Victoria’s experience of the second wave of COVID-19 here in Victoria and ensuring that we have high levels of coverage of some of those groups who we know from tragic experience last year are at greater risk of acquiring COVID-19. I’m thinking particularly about, for instance people living in high density, public housing and some other priority groups that we’ve identified. So in relation to the issues that we were just mentioning about confidence in the vaccination programme and particularly around the AstraZeneca vaccine we have seen a reduction in the number of people coming forward to be vaccinated through a state programme. And there’s also been a relatively smaller downturn in the fantastic work being done by our GPs in Victoria.

These numbers are just over 164,000 doses delivered up ’till yesterday in the state programme, which is roughly matched by the number of vaccines that have been given by Victorian GPs in recent weeks. And we’re continuing to work really closely with our GPs ’cause they’re doing a fantastic job in what is quite a difficult environment for them to be vaccinating Victorians but we’re really grateful for the work they’re doing. So one of the important aspects of the AstraZeneca vaccine is that it doesn’t need to be kept at such cold temperatures for long-term storage as does the Pfizer vaccine. And this really is why it’s the vaccine that’s been rolled out in general practise, but it also gives us the opportunity to have more, I guess, diverse delivery models for vaccination. So not just limited to our hospital immunisation hubs nor our high volume vaccine centres, but really opens up other opportunities such as mobile teams being able to deliver a vaccine to priority communities close to where they live also through the fantastic work of community health centres, who were so important to serving the needs of so many Victorians last year who either were affected by or at higher risk of COVID-19. And so we’re really excited about working with our community health partners in delivery of vaccination, again, through their networks.

I guess the other really important structural part of how we’re trying to coordinate vaccination closer to local communities is that these hospital hubs that were the initial sites that Pfizer vaccine was made available through, they’re also aligned with our local public health units in Victoria which are going to be part of our public health infrastructure going forward. And I’m excited about the potential for local public health units to really have that connection to their local communities in a way that our whole of state health department level really can’t. And I’m really also hopeful that by supporting our local public health units or LPHUs to take on this regional coordination approach for vaccination against COVID in their catchments that that will help build those connections with local community, with local health providers, with community organisations, so that this can become part of really driving forward that public health reform in Victoria. So our high volume or Vic Icon centres are a part of what we’re trying to offer. Now, these are specifically offering AstraZeneca vaccine at this point in time and we now have six up and running. The initial two at the Austin or the Heidelberg Repatriation Hospital and at Sunshine Hospital, joined by the Melbourne Convention and Exhibition centre and South Wharf run by the Royal Melbourne, the Royal Exhibition building in Carlton run by St Vincent’s and the old Ford factory in Geelong run by Barwon Health alongside the Mercure Ballarat organised by Ballarat health. And we also will be having the Melbourne showgrounds joining the fold in the next couple of weeks.

The reason that I’ve highlighted the convention centre, the exhibition building and the Ford factory is because those three were announced yesterday by Minister Foley as opening their doors to all eligible 1A and 1B Victorians from this Wednesday. So I’m really quite excited about that for a variety of reasons, but essentially it’s starting to really build that open access principle. We anticipate that this will most largely be used in the first instance by Victorians aged 70 years and over one of the eligible 1B groups. Look, it is still the case that the best place to get health advice, including advice about COVID-19 vaccination is with people’s GPs. And if people have access to being vaccinated by their GP they should really take that opportunity. The high throughput centres are really about us adding options for people and trying to get as many eligible Victorians vaccinated against COVID-19 as quickly as we can because we want to have high levels of immunity in the community going into winter. So that’s the mission, if you like, of opening up these high volume vaccination centres or Vic Icon centres to all 1A and 1B populations including people aged under 50, but I’ll come back to that point following the in a moment. So how can people book into these sites? Well, on this slide you can see the hotline that can be called to book in an appointment and you can also visit the website at coronavirus.vic.gov.au/vaccine. These slides go into a bit of detail, but in summary it’s clearly been a very significant couple of weeks in the vaccination space in Australia and indeed internationally.

I’m thinking particularly about the evidence of an association of the AstraZeneca vaccine with a serious but very rare adverse effect or side effect involving clotting, particularly in people aged under 50 years. And as a result of a review of the evidence, ATAGI, the Australian Technical Advisory Group on Immunisation have advised that the Pfizer vaccine is preferred in adults aged under 50 years. So AstraZeneca can still be given under 50 years but that needs to be done in consultation with the person seeking vaccination and with appropriate informed consent and consideration of the risks and benefits. But this does introduce significant complexities to the vaccination programme. So it is a very rare side effect. It is roughly one in every 200,000 people vaccinated. So it’s of a similar order of magnitude to being struck by lightning in a given year, slightly more frequent, but it is very rare, however, it is serious and it is something that obviously we all need to take seriously. So ATAGI’s age-based recommendations really are trying to strike the balance between vaccination in a population where fortunately we don’t have active ongoing COVID transmission, but still seeking to protect the community. Because if transmission of COVID does commence again the risks of serious outcomes of COVID-19 are vastly greater than is any risk of this clotting disorder. And that’s the balance we’re trying to strike. So I note that I’m getting a little bit over time.

I won’t go into too much detail, but essentially for people over the age of 50, it’s still recommended that they proceed with AstraZeneca vaccination as previously. For people under the age of 50, if they’ve already had their first dose of AstraZeneca vaccine, it’s safe to go ahead and get the second dose. If someone has not yet had any COVID-19 vaccination Pfizer is now preferred, but because of the limited supply of Pfizer in the community, this will need a discussion between each individual and a decision about how they go forward in relation to vaccination, waiting for Pfizer or receiving AstraZeneca. So there are some challenges here and I think that that’s the central one at the moment, this dialogue around Pfizer and AstraZeneca. That’s my last slide so I’ll stop there. And once again, thanks for the opportunity to be here and to talk with you today.

EMMA KING: Thank you so much, Ben we’ve got lots of questions coming through. I might just throw to you one because it relates to your last point and it’s from Julie, who said that her husband had quite severe side effects from the AstraZeneca vaccination, the first dose. Is he likely to experience the same in respect to the second?

BEN COWIE: So great question. And look, let me start by saying the best person to ask for personal health advice is your doctor or your healthcare provider, and really going and having a chat with your GP is the best idea here. It really depends on the nature of the side effects that were experienced. There are, from any vaccine, expected adverse events. Things like fatigue, headache, local pain in the site of the vaccination. That’s the only one I got after my AstraZeneca vaccine, and sometimes fevers and chills. And they can be quite significant.

We know that around 20% of people following AstraZeneca vaccine after the first dose found that it either interfered with their work the next day or with their activities, their usual daily activities. So they can be significant, but they are expected. What is different about the AstraZeneca vaccine is those side effects that happen usually in the two or three days after vaccination are significantly less after the second dose. And that’s the opposite for the Pfizer vaccine where people have more side effects after their secondaries. It’s interesting. But if it’s that sort of side effect expected side effects following immunisation, then on average they are better the second time round.

EMMA KING: Thank you, and I’ve got another question from Bruce in terms, if I take my elderly dad to one of the mass vaccination centres, can I stay with him the whole way or will I need to leave him at some point in the process?

BEN COWIE: People can have support people to attend the vaccination sites. That’s absolutely fine.

EMMA KING: Fantastic, thank you. I think you’ve answered this question actually in your presentation, but I’ll just touch on it ’cause it was one of the questions put through earlier in terms of if I work at a disability service and I’m in category 1A but I still don’t have my vaccine yet, what should I do?

BEN COWIE: So it really does come down to your age at this point in time. So Minister Foley yesterday announced that our high throughput centres those three that I’ve mentioned, the exhibition building, the convention centre and the Ford factory, and they will be joined by more in coming days, that any eligible person can receive AstraZeneca there. And that includes people who up until now had been really the focus of the Commonwealth vaccination programme, including aged care and disability care workers in residential settings. So we would welcome anyone who’s over the age of 50 or if you’re under the age of 50 and are happy to consider getting AstraZeneca following discussion of the risks and benefits, we would welcome you at our high throughput sites. For people under the age of 50, who are choosing to receive Pfizer vaccine that is now significantly more complicated. We will be providing Pfizer through our hospital immunisation hubs for people aged under 50 years. But that is going to take longer because of the significant supply constraints with Pfizer vaccine. And we’ll be providing more information on how particularly 1A and 1B workers can access Pfizer through those hubs in the coming days.

EMMA KING: Thanks Ben, and we’ve had quite a few questions coming through both before today and also today as well in terms of, I guess, the message to people over 50. And I think there’s been quite a few people coming and saying, ‘Look, I’m 51 or 52’, and you’ve got this magic threshold of 50. They’re still worried about the AstraZeneca vaccine. What’s your message there?

BEN COWIE: So, there’s a few layers on which I would discuss that. Look, I totally understand people’s concerns and I totally get that people have questions, that’s really healthy. And I think it’s really good that people are considering the risks and benefits at their individual level. I’m not quite 50. I’m not far shy of it, but I’m not quite 50 and I got the AstraZeneca vaccine, and I think a significant number of people under the age of 50, are continuing to choose to receive AstraZeneca vaccine. That magic cutoff, you’re absolutely right. It’s a line in the sand, it’s not based on there’s risk below 50 and zero risk after 50. Whenever these sort of thresholds are determined it’s about the balance of risk and benefit. We know that the risk of serious adverse outcomes of COVID-19 increases with each decade in age and it’s not, again, it’s not a hard cut off. It increases with every increasing decade of age. It seems at this stage that the risks of these very rare but serious side effect are particularly under the age of 50 and all cases in Australia, for instance that have been potentially associated with AstraZeneca vaccine have been aged under 50 years. So it really is about making that call.

Can I make one other point? This situation is different in Australia than the vast majority of countries because we’re not in the middle of a wave of the pandemic which is resulting in hundreds, thousands of deaths every day, and a lot of the other countries are. And so it makes this risk benefit equation more complicated. There’s no question. But if we were to be in the situation like Victoria was last year in the second wave and we all hope obviously, and we’re all going to work so hard to make sure that doesn’t happen, but if we had the same level of transmission in the community, the benefit of vaccination would exceed the risk of this clotting problem all the way down to people aged 18 and over. So it really won’t take much for that risk benefit to be very different. And that’s what we’re facing here is trying to balance the rare but serious risk of this disorder versus the risks of community of having low levels of immunity and therefore a greater chance of ongoing COVID transmission as we head into winter. It’s a difficult thing to do on a public health level and it’s a difficult thing to do on an individual choice level but that’s the guidance we’ve got and that’s what we’re trying to put into place.

EMMA KING: Thank you, I think this next question might go to one in terms when you’re saying, consult your GP but we’ve had a question coming around saying, look if you’re over 50, you’ve got a history of blood clots and you’re on blood thinners, is the AstraZeneca vaccine safe?

BEN COWIE: So the advice again from ATAGI is that really the only contra-indications to the AstraZeneca vaccine over the age of 50, apart from a history of anaphylaxis or severe allergic reaction to AstraZeneca vaccine or to one of the ingredients in it. If we’re thinking about this syndrome the contra-indications or the people who should not receive AstraZeneca are firstly people with a history of that specific type of clotting in the brain. So cerebral venous sinus thrombosis, which is exceedingly rare. Or people with a rare side effect from a blood thinning agent called Heparin which causes the platelet count to drop very profoundly. It’s called HITS or heparin induced thrombocytopenia, HITS. And those are the groups who ATAGI are recommending not to receive AstraZeneca. So yes, indeed, please have a chat with your GP but at this point in time, other forms of clotting or being on an anticoagulant drug are not contra-indications to AstraZeneca.

EMMA KING: Thank you, that’s really helpful. I’ve had another question, so I’ll just come back to the groups that you had at the beginning which was the 1A, 1B et cetera. A question about what group do family violence refuge and support workers fall under.

BEN COWIE: So I might have to take that one on notice. So certainly, there’s a range of support groups that have been put forward in the Commonwealth’s guidance and certainly people who provide care to individuals who are in the 1A or 1B categories are included, but I might come back to you with that specific example so we can give you an accurate response if that’s okay.

EMMA KING: That’s fantastic, thank you. In terms of another question here around saying, ‘My client doesn’t have a regular GP that they deal with’, in terms of looking at other options for GPs. I’m assuming going from the earlier slide that looks at areas such as community health, et cetera but would you mind touching on that a little more?

BEN COWIE: Yeah, for sure. So certainly as we’ve said, regular GP, or if you don’t have a regular GP, another GP who you can consult, community health centre, if you’re a patient of a hospital outpatient service and you’ve got an ongoing relationship with a health service these are all fantastic sources of information. Ideally it’s someone who knows you and who knows your health and who knows your situation, but if that’s not the case and if you can’t see another GP or attend your local community health centre, we certainly have a lot of trained immunizers. And for instance, at our high throughput centres we’ve got both expert nurses and doctors available to talk to people. The idea of those high volume centres is really as the name suggests to be able to give access to as many people as possible. But if you have no other obvious route of access to vaccination, we want to support you. And therefore attending those sites, you can discuss your own individual needs with a nurse or a doctor.

EMMA KING: Thank you. In terms of the vaccination, I guess, this is a specific question around the vaccination plans and approaches for people who are homeless, perhaps street-based community members affected by alcohol and drugs or mental illness and trauma. Are you able to touch a little bit more on the processes that have been put in place for people in those situations?

BEN COWIE: So look, absolutely. And I think as I said at the start of my presentation, Emma equity of access is a fundamental principle that we’re seeking to enshrine in the vaccination programme. So in part that involves ongoing partnership with groups such as HARA and other structures that have been set up to address the needs of people with unstable housing or uncertain housing throughout the course of the COVID pandemic. And continuing to ensure that those groups who have vulnerable accommodation situations are absolutely a target of our vaccination programme. So obviously the high throughput centres but our partnership with community health centres and particularly around mobile outreach, all of the public health units will have mobile outreach capacity as part of their offering as well. So this is not just something that’s a central Melbourne issue, it is something that we can ensure that as we identify priority groups in different areas that have lower degrees of access to existing vaccination options that we can try and tailor that to meet their needs. I think the one difficulty there that has been introduced since the ATAGI guidance is the need to offer Pfizer vaccine as the preferred vaccine to those aged under 50 years, and with the difficulties that the Pfizer vaccine brings in terms of storage and distribution that’s going to take some more work thinking about how that works with mobile offerings.

It’s not impossible by any means, but it’s going to take a bit more programmatic work to ensure that we can do that, but absolutely. And like the C-19 consortium who have already been up and running and vaccinating through those health centres are certainly looking at mobile options and particularly thinking about vulnerable populations.

EMMA KING: Thanks, Ben, that’s great. We’ve got a question from Gina around saying, ‘Given the vaccine doesn’t stop transmission, should I continue avoiding visiting my immune-suppressed mum even once she’s vaccinated because, you know I just don’t want her to get the disease?’

BEN COWIE: Yeah, so look, while we’re still building the evidence base here it is clear that these vaccines both Pfizer and AstraZeneca do prevent transmission to some degree. We’ve got increasing evidence for instance from healthcare worker surveillance in the United Kingdom that even asymptomatic infections when people are being swabbed every week regularly to see if they’ve got COVID, that is significantly reduced in vaccinated individuals, even after the first dose even when they have no symptoms. So it does block infection. And we also know that a vaccinated person even if they are infected in the short period after their first dose from about 12 days onwards they have less amount of viral shedding compared to someone who wasn’t vaccinated. So their infectiousness is less. So these vaccines do block transmission to a degree and they do prevent ongoing transmission. So that’s really important. The other point I’d like to make here is that if someone is either a paid or voluntary carer for a person who’s eligible for vaccination, then they too are eligible for vaccination. And so that additional element of protection if they are a carer as defined under the Commonwealth guidelines, then they too could be vaccinated, which adds to the protection of that vulnerable individual.

EMMA KING: And then just building from that as well ’cause that actually segues nicely into another question I had around volunteers who are sometimes working face-to-face with people. Do they fit into that same category as well? I know your definition around carers. Can you explain what happens in terms of volunteers who are working with people who are in vulnerable circumstances?

BEN COWIE: Yeah, so we certainly can, and I can again provide some more information on that. There’s some Commonwealth definitions that we can post through so people have got the actual written information in front of them because there is some differences depending on the type of care and voluntary or paid that is delivered and to whom. So we can make sure that those resources are available because the last thing I want to do is to mislead anyone. So we’ll provide links to that.

EMMA KING: Fantastic. In terms of another question, ‘We run a supported accommodation facility.’ ‘Are we able to take a group of our clients to a mass vaccination centre and is this advisable?’

BEN COWIE: So it really comes down to an individual decision. I guess, the high throughput centres or the high volume centres are really geared around people who ideally don’t have complicated needs, quite mobile, are able to provide informed consent for themselves obviously, when they come to the site. And eligible obviously for vaccination at the time. I think that model would probably be tested by a group of people attending, particularly if they’ve got differing needs, different ages, also differing abilities to provide informed consent on site. So what I would recommend there is if there’s a group and clearly the Commonwealth is still primarily responsible for delivery of vaccination in supported accommodation in residential disability settings the Victorian government is continuing to work with the Commonwealth on trying to improve the implementation for both residential aged care workers and disability workers and residents in Victoria. So we’re hoping that we’ll have some more information available in the coming days on that. My gut feeling would be that whilst I totally understand and greatly appreciate the enthusiasm of people to get their clients vaccinated, just my gut feeling is that that would test the ability of a high throughput centre to provide adequate service to those individuals. Perhaps something we could discuss a little bit further before that step was taken.

EMMA KING: Yes, and again this builds onto another question which I’ll just talk as well in terms of from NDS, National Disability Services , which is around how can disability service providers book for an outreach team to attend and deliver vaccination with individuals at a day centre, employment centre, et cetera who’d find it overwhelming to attend one of the larger vaccine sites? Just wanted you to touch on it the same to segue with the previous question as well.

BEN COWIE: Yeah, look, absolutely. And to reiterate that certainly for the residential setting that that’s still the Commonwealth running that who has responsibility for that centrally. We understand that there’s been and I think the Commonwealth have also mentioned that they would like to see that happening faster than it has been. We understand there’s some frustrations amongst residents and amongst those caring for them around the pace of the roll out particularly in the residential disability setting. And I know that we’re not just talking about residential services here, we’re talking about a broad offering and also the day residential, sorry, the day centres, et cetera, I guess. Yes, absolutely. The hubs have a regional coordination role and can help in those discussions around access for those groups in 1A and 1B, noting that again there is issues around Pfizer access and being able to ensure that Pfizer vaccines are available by choice for those under the age of 50.

The other thing that I would like to suggest is that, and this is certainly the Commonwealth have put this forward for some groups in their area of responsibility, is partnering with local general practise and finding out what options are available through those local practises. I think people who have got established healthcare relationships with their GPs, that gets around some of the concern and understandable hesitation at attending a big hospital or a site that you’ve never been to before. And so I think that partnership with local general practise is something that I’d really found all of these conversations in, but if for whatever reason that’s not a possibility, then yes, our hubs do have that regional coordinating function and can discuss other options as time goes by.

EMMA KING: Thank you, and again, probably leading on from the previous question around the Pfizer vaccine, we’ve had Lisa asking, ‘We’re looking for a clinic that provides the Pfizer vaccine.’ Is there an easy way to do this or will it involve them sort of phoning around?

BEN COWIE: Yeah, so for noting, really it’s only the hospital immunisation hubs who have Pfizer vaccine at this point in time. There is outreach from those to, for instance other health services in Victoria to vaccinate for example, 1A healthcare workers, emergency departments, COVID wards, et cetera, and to sites like hotel quarantine environments, to the airport, et cetera, really since the ATAGI advice was issued 11 days ago we’re doing a lot of work with our hubs and our local public health unit partners to think about how we can facilitate access to Pfizer for eligible people aged under 50 years. We will have more information available on that in coming days, but at this point in time I would basically advise against just ringing around different clinics ’cause essentially no general practises have access to Pfizer. And it’s really only those nine hubs in Victoria that are central locations for Pfizer to be rolled out from. So I think that would lead to a certain degree of frustration on the people making the calls when they ring around and can’t find anywhere other than the big hospitals. So we will have more information available in coming days and we get that this is a real priority.

EMMA KING: And thank you, ’cause I know a number of GPs also have been in contact saying they’re just inundated with the phones ringing off the hook as well so I think it’s really helpful to have that information. We’ve had another question around clarifying specific risks to the vaccine for women maybe looking for example, at women who might be on the pill or might be breastfeeding or IVF, those sorts of things as well.

BEN COWIE: Yeah. So I’ll answer that in two parts, if that’s okay, Emma. The first is about guidance around pregnancy and breastfeeding in general and then secondarily about the particular clotting concerns there. So firstly, both the vaccines have been advised as being safe in the setting of breastfeeding and in people who are either planning to or trying to get pregnant, noting that now for people under the age of 50, Pfizer is preferred. That adds that other dimension there because clearly there’s that age-based criteria and which applies to women who are breastfeeding and who are planning or trying to get pregnant.

For women who are currently pregnant, the advice is currently that vaccination is not routinely recommended. That’s not because we have evidence or concerns about specific safety issues in pregnancy it’s we just don’t have enough data to be able to say that it is categorically safe to do so. There has been a lot of pregnant women vaccinated overseas in countries where the pandemic is really causing a serious health problem clearly, and we’re waiting for further information on those cases so that we can provide more evidence-based advice. So in summary, for pregnant women not recommended routinely to receive any kind of vaccination and for women who are breastfeeding or who are planning to become pregnant or trying to get pregnant, it’s okay to get vaccinated and it’s considered safe, but noting the age preference for Pfizer and up to those aged under 50 years. In terms of the specific clotting issue, again sort of similar to the question before about someone who’s had previous, for instance, deep vein thrombosis in the leg or is on Warfarin or another anticoagulant for whatever reason, no specific evidence of increased risk in the groups that you mentioned of this very specific type of clotting. It does appear to be more common in females overseas but it’s certainly seen in males as well. And similarly, whilst it is more common significantly more common in people aged under 50 years and it has been exclusively people under 50 in Australia, that’s not the case overseas. And there have been older individuals who have experienced this very rare disorder. I do want to just come back again. It’s understandable that people have such a degree of concern and focus on this issue.

Can I just reiterate whilst it is a serious side effect, it is incredibly rare. We are talking about one in every 200,000 people vaccinated on average, whereas the risk of tragically losing one’s life on Australia’s roads is about 10 times that in any given year, it’s about one in 25,000. So it is really important that we understand these risks and we address them and we’re open about them. But I think for a lot of people, big numbers like one in 200,000 is hard to relate to but maybe thinking about that putting in perspective of, for instance, the number of people who lost their lives here in Victoria from COVID last year and thinking that if we had that sort of transmission in the community, again, the risk of vaccine is much, much less than the risk of even getting really sick from COVID-19.

EMMA KING: Thank you. Another question here as well, in terms of if I’m booked in for a vaccine and I become sick should I cancel my appointment?

BEN COWIE: Yeah, that’s a good question. So essentially the contra-indications to any vaccine not COVID but any vaccine, if someone’s got a fever, so a suspected infection and they have a fever they shouldn’t come forward to get vaccinated. Someone who’s got acute medical issue, of course, they should also not come forward and get vaccinated. If you’ve got a chronic background health issue that is just grumbling along that is not associated with any particular acute illness then it’s okay to come and get vaccinated. But really if you’ve got a fever or I should really say if you’ve got symptoms that could be consistent with COVID so fever or cough or respiratory symptoms, please don’t come and get vaccinated. You should isolate and get tested. But for other illnesses it’s as I’ve said previously.

EMMA KING: Thank you. And in terms of, if you’re attending a vaccination centre, do individuals have to, it goes actually to a question, do individuals have to provide proof of underlying conditions if they’re under 70 or is their word considered okay?

BEN COWIE: No, they do actually and that’s the case for anywhere. So if they’re attending their own GP, then the GPs medical records suffice in terms of that evidence. But if they’re attending somewhere else they will need either, for instance, the download or the transcript from their My Health record, or they might use a letter from their regular GP saying what their medical condition is ’cause it’s not any medical condition. There’s a list on the Commonwealth eligibility check-out of which medical conditions are eligible under 1B for vaccination. If someone can honestly not provide either for instance, a discharge summary from a hospital a letter from their GP, a download from their My Health record or any other documentary evidence, they can fill out an attestation form which is available on the Commonwealth eligibility checker where they basically attest that they have a medical condition that makes them eligible. So again, the eligibility checker which Mel is just very helpfully posted in the chat. I’m seeing Mel’s been working furiously in the background answering all the questions that I haven’t been able to. So the eligibility checker there is the place to go.

EMMA KING: Thank you, and just to shout out to Mel as well you’re doing an amazing job Mels. I keep seeing it flash across the screen. So a question here went, so if someone tested positive for COVID last year do they still need the vaccine?

BEN COWIE: Yes, they do. And in fact, we know that the immunity from COVID-19 is neither absolute nor does it last forever. We’ve seen second waves of infections amongst people who have previously been confirmed to have COVID-19 occurring overseas. So yes, please do get vaccinated against COVID-19 even if you’ve got documented evidence of having had it before.

EMMA KING: Thank you. If someone’s very against vaccines, should I try to reason with them or argue the facts with them or is this not a very effective technique?

BEN COWIE: Yeah, look, that’s a really interesting question and it really comes down to, well, a range of factors, I think. We know that on average and look, I think a lot of people are more concerned now than they were say a couple of weeks ago and that’s understandable. We understand that. But prior to this happening, it was pretty consistent that around 70% of the population were intending to be vaccinated, around 20% were uncertain. And those two varied, okay? So the uncertain people might go up and the people who are intending to get vaccinated went down and they varied. The people who really didn’t vary was those who were not intending to get vaccinated. They were stuck at around 10% and didn’t really budge.

We believe that there are some people who for reasons of their own irrespective of much else are committed to not get vaccinated. And I guess where we’re focusing a lot of our energy and attention is on that 20% of people who are uncertain. So if you feel comfortable talking to someone I think the strategy that I use when I’m discussing this with people who are uncertain is first of all to questions. To ask why they’re not intending to be vaccinated or ask what the concerns are and to explore where they come from. And if it’s something that I feel is amenable to discussion I never try and tell someone that they’re wrong of course, nor do I say, well, the facts and figures say this so therefore you’re not right. That’s not the way to approach it at all. I think having a discussion finding out what their perspectives are what their sources of information have been. And I think one other question to ask is have they had other vaccinations? And if it’s someone who’s happy to or has had other vaccines who are particularly concerned about the COVID vaccine that opens a point of discussion that can be explored. But honestly, this is a universal but a voluntary vaccination programme, no one has to get vaccinated. And by the same token no one I think should be forced to have the sense that their choice is being undermined, but providing information and I think providing not just facts and figures but narratives is going to be really important. Why people are choosing to be vaccinated, why they’re choosing it, what it means for them, how they feel about being vaccinated, that’s just as important evidence as numbers, statistics and facts.

EMMA KING: Yeah, thank you, and then a question’s just come through which I think is different but related. So I’ve heard this from a few places in terms of attitudes and feelings of young people as well. And we’ve had a question I’ll just read it out verbatim. ‘Young people are losing trust and confidence in the vaccine programme, as they will largely be vaccinated in the last phase of the rollout and are being recommended a vaccine that’s hard to access.’ ‘How should youth workers be communicating with young people about this?’

BEN COWIE: Yeah, it’s a really, really good question. And again, can I just put a personal perspective. If I was to have the choice again, so I had the choice to get AstraZeneca or Pfizer and I chose AstraZeneca for a variety of reasons.

For me personally, and I’m not saying this should be anyone else’s decision-making but for me personally, the risk and benefit was so much in favour. And by getting AstraZeneca, that means that there’s another dose of Pfizer available for a young person as we go forward. So I think that is also part of my own personal way of looking at this, that the more people who get AstraZeneca over the age of 50, the more doses of Pfizer which are very constrained, become available for people under the age of 50 who are eligible whether they are 1A or 1B or as we go forward. So that’s the first, and that’s just my own personal viewpoint, I’m not assuming that that should be anyone else’s. I think for young people, again, it’s perhaps a little bit alienating to hear these conversations about who’s going to get what right now when they see their time horizon as being quite distant. And I guess for young people who are eligible so whether they’re working in a 1A or 1B cohort or whether they have a medical condition for instance or a disability that makes them eligible for vaccination we really need to find ways of giving them choice. And if that’s Pfizer, then we need to get it to them and we need to find ways to facilitate that.

Despite the fact that most young people will have milder COVID-19 and on average will not get seriously ill with COVID-19, there are exceptions to that. And I looked after some in hospital last year and, you know, some people do get significantly unwell even quite young people with COVID-19. So I don’t know that I’ve answered the question. I think the principles are we need to follow the eligibility criteria because they’ve been established to guide us from a public health and clinical perspective. And so they’re trying to balance the risks versus the constrained supply that we’re facing. But I think finally that, that ultimate element of trying to use as much AstraZeneca as we can to protect those for whom either vaccine is preferred, and I’m thinking particularly people aged 50 and over, so that we have as much Pfizer to use as possible for people under 50, for whom it is preferred. And I think that that’s a principle that is going to be one that is occupying a lot of not just vaccine programme people, but in fact the general community as these conversations continue.

EMMA KING: Yeah, and it’s a good point, and I have to say one I haven’t heard before that makes you think about it, made me think about it anyway, in a bit of a different way as well. In terms of looking also about being able to report adverse effects, I’ve had a couple of questions come through around saying, well, how can the general community report adverse effects other than talking with their GP? And I understand from another question that’s come through that somewhere in the U S but I’m not familiar with it, you can report adverse effects. Just interested in your observations around that.

BEN COWIE: Sure, so there are a range of ways and we want people to have a number of different routes to inform about this. I think one of the concerns about the vaccines in general is that it would all be conducted in secret and things would be hushed up. Well, if there’s one thing that we can take from the conversations that have been happening in the media over the last couple of weeks it’s clearly that this is being transacted very openly and that these reports are made available to the public both by the TGA and discussed by ATAGI and that there’s no question I hope in anyone’s minds anymore, that anything’s being hidden because if you’re going to hide something, you know, we wouldn’t be having these conversations right now. And I think that’s important as we reassure people about the safety mechanisms that are in place. Secondly, for people who are vaccinated through our state services that are using the information system called CVMS, they get sent texts after their vaccination. I think it’s day three and day eight, and then further down the track to monitor what their symptoms are and to check on how they’re going. So we have that passive information feed coming in from that route as well. Yes, any medically attended adverse event needs to be reported to SafeVic here in Victoria which is a surveillance mechanism and safety monitoring for all vaccinations. And in addition, people can report their own side effects if they didn’t see a doctor either through SAEFVIC or to the TGA directly. So there’s a route of different ways people can notify but again, if you’re feeling side effects and you’re concerned about them, I would strongly recommend you make an appointment and catch up with your GP.

EMMA KING: Thanks, Ben, and I think in closing as well it was a nice personal question for you which you don’t need to answer but I think it shows the appreciation for the work you and your public health colleagues are doing which is actually a question for Ben. When do you get a holiday and where will you be going? I think we are all in awe of you and the broader public health team in terms of leading Victoria and leading the nation through this pandemic. The work that you’re doing is just phenomenal. So I think, there’s a couple of questions coming through actually saying, ‘We think you’ve earned your holiday about a million times over, and hopefully you get a chance for a break and a bit of time out as well.’ And I think that probably reflects the way that we’re all feeling. I know that you are back to back probably every day and just about all night in terms of the work you’re doing and yet you’re so generous in terms of being able to spend your time with us today and make sure that everyone is informed and knowledgeable as possible. So I just want to pass on my sincere thank you to you and the team that you’re working with. You’re fantastic to work with. You’re always incredibly generous in your time as you’ve been again today. And I know also how much it’s appreciated ’cause you’re just really straight in giving the answers and then going look, I don’t know, these things are changing. This is what we’re going to come back and say, so it’s very, very much appreciated. So I just wanted to pass on my sincere thanks and also say thanks to everyone who’s online ’cause we’ve had lots of comments coming along those lines as well. I want to say a huge thank you. I’m not sure… if there’s anything you wanted to say.

BEN COWIE: Well, I just thought that I’m really touched by that, thank you.

EMMA KING: Yeah, it’s as I said, a number of questions have come in along those lines and I think we’re in awe of the work that you do, and you look at it it’s interesting watching our public health professionals become the new rock stars really in terms of looking at leading the world and literally saving lives. So it’s phenomenal. Thank you.

BEN COWIE: Thank you. As long as you’re not talking about the fact I need a haircut, Emma, but thank you.

EMMA KING: Yeah, but you could take that as a compliment anyway.

BEN COWIE: Thank you so Much.

EMMA KING: Thank you. So a huge thank you to all of our presenters today. As I’ve just mentioned having Ben back online with us and Mel also from department of health, looking at every question that’s coming through and providing as much information as possible. Also to Melissa and Taboka from law firm Justitia, and to our Auslan interpreters as well. We’ve got Julie and Jinaya who are online and have been online through the whole presentation. So a huge shout out to both of you, we really appreciate it. And of course, to everyone who submitted questions to the public health team, you’re phenomenal. You always are. We love working with you and you’ve just been brilliant to work with. And the VCOSS team, everyone behind the scenes who works to make these events happen. We have hundreds of people register for every one and we also know they’re watched regularly afterwards. As we mentioned earlier, please feel free to share the webinar from today as far and wide as you want. We want appropriate, accurate information getting out as far as we possibly can. We know not everyone’s able to jump online at the time so feel free to share it. We will email it to you. You can share it after that as well and remember that everything will be fully captioned. It’s really important we make sure that all information can go to all members of our community. We will be running a third event in the Vaccinating Victoria briefing series, so do keep an eye out for that. And if you have any particular topics or series of questions that you’re particularly interested in, do let us know. We want to tailor these to the things that you want to know more about. So feel free to reach out, let us know we’d really welcome and appreciate any feedback that you’ve got. So I’d just like to finish by thanking everyone again and thanking all of you for joining us. Have a wonderful afternoon. Thanks everyone.

These chapters are also marked on the YouTube video progress bar.

0:00​ Introduction
0:10​ Basic things you should know
2:00​ Employer’s rights to direct employees
5:26​ Employer’s OHS obligations
7:01​ Requiring staff vaccinations
13:51​ Abstaining from work with vaccine concerns
19:29​ Acting in good faith
21:12​ Liability if staff get sick post-vaccine
23:57​ Framing risk
25:29​ How to ask staff vaccination status
28:39​ Disciplining staff on vaccine issues
30:55​ Examples of mandatory vaccines
33:17​ Staff members’ right to privacy.
34:28​ Asking if staff have been vaccinated
35:08​ Liability for ‘unexpected outcomes’
38:38​ Obligations for volunteers and casuals
39:23​ Mandatory vaccinations currently
40:29​ Vaccine rights and work from home

Please check against delivery.

EMMA KING: Good morning and welcome to the second event in our Vaccinating Victoria briefing series. My name is Emma King. I’m the CEO of the Victorian Council of Social Service and it’s my absolute pleasure to welcome you here today. I’d like to begin by acknowledging the Traditional Owners of the land and acknowledge that our meeting on the lands of the Wurundjeri people of the Kulin nation and pay my respects to Elders past, present and emerging. And of course, to acknowledge that sovereignty was never stated.

The COVID-19 vaccination programme has been underway for several weeks now. More than 160,000 Victorians have being vaccinated and we clearly have a long way to go. Many of us still have lots of questions about the scheme and today we’re going to try and get you some answers. But some quick housekeeping to begin, today’s event is being recorded and fully captioned as well and it’ll be made available afterwards. We’ll send you an email when it’s ready. Please do feel free to share this information as far and wide as possible. It really is a priority for us to make sure that everyone has accurate information and as many people have it as is possible.

Today’s session is broken into two parts. Part one is around the vaccination rollout and about the workplace. Shortly, I’ll hand over to Melissa Scadden and Taboka Finn from the law firm, Justitia. They’ll run us through some of the key issues regarding how the immunisation rollout relates to employers and employees rights, responsibilities and obligations, your duty of care, workplace safety and so on. There is plenty to talk about. So to submit a question, just type in to the zoom Q and A box on your screen. We know in the last session that we ran, there was so many questions about workplace responsibility, so it’s great to have Melissa and Taboka joining us today as well.

And for part two, we’ll be joined by Professor Ben Cowie, a senior advisor to the Victoria’s COVID-19 vaccination programme. Ben will run us through all of the key information about the vaccine rollout including some new information that’s become available over the past 72 hours. And of course, we’ll take your questions. This session is scheduled to run until midday, we’re in no rush and there will be plenty of time for questions. To submit a question again, just use a Q and a box on your screen, I promise it’s really easy. And as per our last session, we’re going to aim to get through as many questions as we possibly can. I’ll now hand over to Melisa and Taboka who’ll take us up to about 11:00 AM with their session. Thank you.

MELISSA SCADDEN: Thanks Emma. And thanks to VCOSS for inviting us to speak on a topic that is very much front of mind for everyone at the moment. And certainly front of headlines. As with most aspects of the global pandemic, the speed at which multiple, effective vaccines have been developed and approved worldwide, as well as the scale of the rollout is truly unprecedented. And given what we’ve had to endure over the past year, the vaccine rollout is certainly something to be celebrated. But it also does have broader impacts that must be considered particularly in a workplace context. Under the federal government vaccination strategy, vaccination is voluntary. And so the government is relying on an educational campaign to encourage as many people in the Australian community to get vaccinated as possible. Now state and territory health agencies may make public health orders that require some workers to be vaccinated. For example, those considered to be working in high risk workplaces.

Now at the moment we’ve got Western Australia and Queensland who have either issued public health orders for certain industries or are in the process of doing so. But there are currently no laws or public health orders in Victoria that mandate vaccination in a particular industry or that specifically enable employers to require their employees to be vaccinated against COVID-19. So when employers are looking at vaccination in the context of their workplace, we must look to our existing employment and OHS laws. And the question that many are asking is under these laws, can an employer require an employee to be vaccinated or even are they obliged to require this in certain circumstances to comply with their OHS obligations? But before we launch into these rather vexed questions and of course the audience questions as well, I think it might be worth taking a step back and considering employers rights and obligations in this space more generally. So Tab, can you tell me a little bit about an employer’s rights to direct employees generally?

TABOKA FINN: Yes, so generally speaking, there’s a few important steps that employers will look to take before directing their employees. First, they’ll need to consider any relevant obligations under an employee’s employment contract or any applicable enterprise agreement or awards. And most people understand that they have entitlements and that employers have obligations under employment contracts but it’s sometimes less well understood that there can be additional obligations under enterprise agreements, which are documents that are negotiated between an employer and its employees or awards, which are legal documents that outline minimum conditions that apply to a range of industries and occupations. So employers will need to make sure that any direction that they are giving is consistent with those workplace obligations and also with any other policies that they may have that would impact these types of decisions.

Whether or not an employer can or should direct an employee, will also be impacted by obligations under the fair work act and anti-discrimination legislation and we’ll touch on all of that, I’ve no doubt. But assuming the direction is consistent with any of these obligations under contract, et cetera, then the real consideration comes down to whether the direction is a lawful and a reasonable direction. And Mel, I know we’re to talk about lawful and reasonable directions a bit in the questions but if an employer gives an employee a lawful and reasonable direction, then the employee must follow it. So broadly speaking a direction is lawful, if it complies with contracts, awards, agreements and other laws, which is one of the reasons employers will look to those things first and the natural flip side, I suppose, of this is that employees are not required to follow an instruction that is unlawful.

What is going to be the real sticky, the real tricky part will be what is reasonable. And what is going to be reasonable is difficult to determine. Employees will need to look and an employers will need to look at the specific facts and circumstances that apply to their organisation, to their workplace or their work force, that can be different sites involved, different groups of employees and also individual employees. So it can be a really complex set of factors, risks, considerations that need to be balanced in reaching that determination of what is reasonable for many directions and certainly for directions that we’re talking about today, in relation to the COVID vaccination. Part of that considerations matrix, we’ll be taking into account the health and safety obligations, both the employers’ health and safety obligations and also employees have health and safety obligations to themselves and to other employees.

So, that’s it in a nutshell but unfortunately there is no one answer for when a direction will be lawful and reasonable. It’s a determination that is made on a case by case basis and we’ll turn on as I mentioned before, those specific facts and circumstances and importantly for our discussion, the risks in the workplace.

MELISSA SCADDEN: Thanks Tab. So you’ve spoken about risks in the workplace. You spoke about the health and safety obligations. So I think before we actually launch into the vaccine related questions, it’s probably also worth reminding ourselves of what an employer’s obligation is to manage risks in the workplace under OHS legislation. And most of the obligations under the OHS act in Victoria are underpinned by this concept of what is reasonably practicable. Basically an employer has to take steps and measures that are so far as reasonably practicable in order to ensure the safety and health of its employees, contractors or other persons who may be in the workplace. Now obviously begs the question, what is reasonably practicable?

First of all, the legislation requires you to identify the nature of the hazards and the risks. And then you essentially have to look at the potential severity of these risks. Once you’ve assessed that, it’s in a case of looking at what are your means and methods of controlling those risks, what are the suitability of those options? How effective are they? So for example, the concept of the vaccine, is it available? Is it effective? Is it safe? Then the last consideration and it is only the last one is the reasonableness of the costs involved in controlling that risks. And it is worth noting at this point that the courts and the work health safety legislation have made it clear that cost is only a factor, if it is grossly disproportionate to the risks. So it’s not one of those easy outs by saying it’s too expensive, it must be evaluated against the risk. So, having covered off these underlying concepts, we can now I think turn to one of the million dollar questions, would it be a lawful and reasonable direction for an employer to require an employee to get vaccinated? What do you think Tab?

TABOKA FINN: Mel, you know I hate to give the answer that I’m about to give but the answer is it depends. And I hate it, I hate it as it comes out of my mouth but it really does. It’s going to depend on the individual facts and circumstances. And as such, it will be yes for some organisations, for some workplaces somewhat forces and it will be no for others. It will turn on what is going on in the workplace and those risks that the workplaces will be identifying. Part of the reasonableness factor will as you’ve mentioned, include considering whether requiring the vaccine is a reasonable practical step to take, to eliminate the health and safety risks in the workplace. And this is certainly top of mind for a lot of employers and a lot of employees but it’s not the only consideration. And depending on the workforce, it may not be reasonable to mandate in all circumstances.

Having given “it my depends” disclaimer and assuming it’s otherwise lawful, I’m also, Mel, going to give my general feel. And my general feel is that for workplaces where there is a high risk of getting or transmitting COVID, especially risks to transmitting to vulnerable people or people who can’t otherwise take some other precautions, then I think the matrix of considerations is going to fall on the side of a direction to mandate being reasonable. This may extend to workforces where there may be an increased risk once international travel truly kicks off again or where social distancing or other protective measures are just not possible.

For workforces in Australia at the moment where the risk of actually contracting or transmitting COVID is low, then my feel is that requiring the vaccination, which we must not forget is a medical procedure , will not be reasonable. And this would extend to workplaces that can adapt with more remote working, social distancing and those other protective measures. But this could all change, it’s a constantly changing area. So I’ll restate my initial caution, which is it really does depend. And it depends on that matrix of considerations.

MELISSA SCADDEN: Thanks Tab. And so, when you’re talking about this matrix of considerations, I think that as you’ve said, one of the key questions is whether or not it would be considered to be a reasonably practicable measure under the OHS legislation. So it almost is essentially, I suppose, whether or not it’s a step further. So not only can I require my employees to get vaccinated but do my OHS obligations require me to ensure that employees have been vaccinated? And so I think when we’re looking at that point, a really good starting point is looking at both the position of the Fair Work Ombudsman and of Safe Work Australia at the moment. Now they are both saying that deciding to mandate vaccinations in the workplace, does face a very high threshold because they’ve assessed the community risk and the workplace risks as quite low, generally. Because we must remember and obviously this does fluctuate, that we’ve got no community infections.

We’ve had no community infections in Victoria for quite some time. We do have 10 active cases but they’re relating to hotel quarantine. So at the moment Victoria is essentially COVID free. They’re the low level of restrictions we are currently enjoying, does demonstrate that the government considers the risks of catching and transmitting COVID in the general population to be very low. Now, if you look at the systems that workplaces or employers can use for controlling risks, we look at what’s called this hierarchy of controls. And at the highest level, you have controls that would eliminate a risk. You then work down through those controls to ones that might merely isolate it, that might substitute the risk with something else, that minimise the risk, et cetera. Now, vaccination is clearly a pretty high order control, that it would, if not eliminate, it would significantly reduce the risk of COVID. But when we look at how that relates to the current level of risk, the question is, is it too much? Is it too severe? Particularly when you have other controls that are effective and perhaps more proportionate. So we’ve got masks, social distancing, improved ventilation, as well as things like education campaigns, strong encouragement, et cetera. So certainly at the moment, the position of the Fair Work Ombudsman and Safe Work Australia and other regulators is that generally in workplaces, mandatory vaccines is too severe.

Now, if you look at the high risk workplaces, which is where Tab has been talking about, it may be more reasonable to do so. Many industry associations have still stopped short of suggesting that vaccines should be a mandatory requirement. And it certainly seems like hotel quarantine might be one of the main exceptions. But it’s really important to remember that this is a point in time assessment and it’s based on the severity of risk at the moment. Now, global infection rates of COVID are at record highs. We’re seeing many variants, which are causing quite a few problems. If we get more outbreaks in Victoria, in Australia, if international borders open, the risk of community infection may increase and other control methods may be no longer effective. And in those circumstances, certainly the highest order control might be justified. So effectively, the answer is at this stage, generally and it does vary in terms of workplaces and their might or high risk workplaces, doesn’t seem to be enough COVID in the community for the government to be suggesting that vaccinations become mandatory. But it’s really important that employers are regularly checking all the right sources, Ombudsman, Victorian health, Work Safe, Safe Work Australia, et cetera. Okay, you need to make sure you’re looking at them because they contain a lot of scientific factual information about the current state of the infection rates. And they come with the right recommendations and they are crucial for feeding into your own risk assessment. And it’s also really important that you’re consulting with your workforce at the moment. Okay, you need to be talking to them, understanding what the risks are in the workplace, what certain vulnerabilities you might have, as well as the approach your employees are taking to vaccines. So you need to know now whether or not an encouraging or an education campaign is going to be sufficient or if your risk assessment changes, and if the risk of catching COVID in the workplace increases, what challenges might you face if you want to try and achieve these high levels of vaccination in the workforce.

Now we have had some questions coming in. So what I think it might be a good one to start with, would be considering the question of whether or not, if a staff member does actually refuse to come to work because of vaccine concerns. So for example, that they’re concerned that their colleague hasn’t been vaccinated and therefore there might be a risk. Can an employer initiate disciplinary action?

TABOKA FINN: So there are going to be a range of reasons that employees refuse to be vaccinated. There will be those that refuse for medical reasons. Those that refuse based on an attribute protected by anti-discrimination laws for example, religious reasons, disability, pregnancy. Those that refuse because they broadly disagree or don’t believe in vaccinations and those that don’t have a specific reason but just don’t want to participate or potentially a bit wary. Employers are going to need to have sufficient information about the reasons for the refusal, in order to determine whether the direction is lawful and reasonable and the employee’s individual circumstances, will go into into that considerations matrix. Assuming the request for information is lawful and reasonable, which it’s likely to be to comply with the employer’s health and safety obligations, then they’ll gather sufficient information that they need. And I must say to be ware of privacy issues when collecting medical information in particular but for any type of personal information about employees, employers should be careful with that information.

Where an employee is refusing based on medical grounds and the employer has sufficient evidence about or information about those medical grounds to confirm that the vaccination may not be safe for them to take, then the employer will need to consider whether having the vaccination is an inherent requirement of the role and I’ll talk a little bit more about that in a minute, I want to talk about the other categories first. Where an employee is refusing on the basis of protected attributes under anti-discrimination laws, then there will be additional protections and as such additional consideration for employers. So for example, under the sex discrimination and the disability discrimination act, it’s unlawful to discriminate on the grounds of pregnancy is a good example and disability, for people who are pregnant or have a disability, a blanket rule mandating the vaccination is likely to be indirect discrimination under these acts. Broadly, indirect discrimination occurs when a person is required to comply with a general requirement, so there’s a requirement across the board, across the workforce to have the vaccination and they are unable to do so because of that protected attribute and it has the effect of disadvantaging them. So, a direction will not be indirect discrimination, if the requirement is reasonable in all the circumstances but the burden of proving that reasonableness will fall on the employer. So employers must consider if there are any reasonable adjustments that can be made for a person with a disability. And assuming they’ve taken all of this into account, the question then becomes again, is the vaccination and inherent requirement of the role?

The last two categories that I mentioned, so those that refuse because they broadly disagree and those that refuse not for a specific reason but just because they don’t want to participate or a bit wary. And we do have some anecdotal evidence from our clients who are conducting these initial discussions, these initial consultation is that most people fall into that last category, they’re just a bit wary at the moment. For these two categories, the question for the employer will still be, what are the inherent requirements of the role? And the reason I keep talking about this inherent requirements test is that, employees must be able to perform the inherent requirements of their job. This is the case even if the employee has a disability, if once the employer has considered all of the particular facts and circumstances that apply to the workforce, to the workplace, to the employee’s role and they decide that having the COVID vaccination is necessary for the employee to perform the inherent requirements of the role, then you could direct them to have the vaccination and assuming that they don’t follow that lawful and reasonable direction as we discussed, the full employees have an obligation to follow lawful and reasonable directions in that circumstance, then yes, the employer could take disciplinary action for a failure to comply with that reasonable and lawful direction. I must say though, this is very uncharted territory. There’s very little guidance from the Fair Work commission or from any of the courts.

There’s very little to go by to give some solid, some hardened, fast rules or get those bumper bars of the edges of what we’re talking about. So I definitely encourage any employers who are considering mandating vaccinations or certainly considering taking disciplinary action in particular, termination of employment, to get legal advice before they do so because it’s really all up in the air at the moment.

MELISSA SCADDEN: Thanks, Tab and in related to that is actually we’ve got a question from the audience saying, is there likely to be a future test case that will determine this reasonableness test for the COVID specifically? And could we be found to be unreasonable in retrospect, will it be okay if we act in good faith at the time? And I mean, it does just go to the fact that so much uncertainty, will there be test cases, will there be a future guidance? I’d say so in the meantime?

TABOKA FINN: Definitely yes, I certainly agree. I think this is a hot topic. There will be workforces or workplaces that do, down the track when the risks in Victoria are a bit higher, do potentially mandate and that’s where we’ll see some test cases coming out of that. But certainly in terms of, will you be judged harshly in the future? I think it really goes back to that and maybe we’ve not stressed it enough, Mel, but certainly our recommendation is talking to your workforce, talking to your employees, consulting, discussing, like everyone’s talking about this anyway. Employers should be out there saying, “This is what we’re thinking of doing. This is what we’re not thinking of doing.” And keeping those lines of communication open. It also helps address some of those wary concerns. Sometimes, you can let people know you’re taking other steps to ensure their safety in the workplace, things like that.

MELISSA SCADDEN: Absolutely and we should probably mention as well that there are obligations to consult under your OHS and the OHS act as well. So there’s quite strict obligations under section 35 of the OHS act. So important to make sure that you do keep talking, keep consulting and that assist in demonstrating that you have acted reasonably in the circumstances, even if the guidance does come out, that might put us off in a different direction. And I suppose related to that as well, Tab is that there’s a lot of uncertainty as to whether or not there might be any liability for employers in certain circumstances. So for example, we’ve had one question. So does this mean that should we be prompted by our employer to have the COVID vaccine and we become unwell, are they liable?

TABOKA FINN: Yeah, look, it’s a good question. I’m not and we are not work cover experts, workers’ compensation experts, but I would say very broadly, the test is sort of the connection to the workplace, whether there’s sufficient connection there. And I would say if you were mandated and you were required to get it for your job, then I think it has that link to employment and link back to the employer. And there’s potentially workers’ compensation fallout from that and things for risks for employers of their premiums and things like that going up. I definitely think there are some risks in that area.

MELISSA SCADDEN: Yeah and I think also if you look at something where the other risks might be, so obviously with our OHS obligations, that there’s a question I suppose, of whether the regulator would prosecute. Now, I think that looking at it at the moment, given Safe Work Australia guidance and have the health authority guidance, I think that doesn’t look like Work Safe would prosecute, if you don’t mandate vaccines, for example. And certainly if you are just following the guidance and then a risk arises or occurs in the workplace or an employee, for example, would have fall ill in the workplace because you haven’t mandated. So let’s say you haven’t mandated vaccine and an employee does fall ill. I think it’s highly unlikely that would say any kind of Work Safe prosecution in those circumstances as well. The question would be though, has the employer taken other necessary steps to appropriate in terms of managing or controlling that risk? So do you have your COVID safe plan in place? So you ensuring social distancing, masks, sanitizer et cetera.

If you’re looking at sort of more common law, as if someone does actually, for example, catch COVID at work, there’s a question of whether or not you could prove negligence if looking at whether or not there’s a duty of care and has that duty have been been breached and certainly at the moment where we’ve got our risk, again, it comes back to that risk assessment, where the risk of catching COVID at the moment is pretty low, unless you haven’t complied with your other obligations in terms of managing COVID risks in the workplace, in accordance with the directions at the moment. It’s probably unlikely that an employee would be held negligent in the circumstances.

TABOKA FINN: And Mel, I’ve just seen a question here, which is one of the things we’re constantly talking about, which is it says here, “Given the current COVID-19 vaccinations do not prevent transmission, how will the risk be framed? And were constantly watching the stuff on transmission cause there is sort of my understanding, some evidence that having the vaccination impacts transmission but Ben speaking after us, better ask for him. But certainly, I think that is a real relevant consideration. So, at the outset we were sort of hearing that the vaccination was going to prevent transmission almost at all. That was almost the language we were sort of hearing in some of the headlines. And that obviously has a different feel for, if you have a workplace where you have vulnerable clients, if getting the vaccination stops you from transmitting at all, that’s a very different risk assessment, then I think you’re right. The current evidence is sort of pointing that it doesn’t impact transmission in that way at least, then it does change that risk assessment and that risk discussion.

MELISSA SCADDEN: That’s so important. Just keep on top of the actual, the national cabinet meeting today, talking about the vaccine rollout. So who knows we could get off this webinar and things may change, so it’s really important that we keep up to date there, I think. Another question we’ve got, “Has vaccination become mandatory for travelling into state? Not certainly not at this stage, we haven’t seen anything suggesting that that is the case. I’m interested in current approaches about asking staff if they have been vaccinated given it is private health information. Tab, what do we think about that?

TABOKA FINN: I think privacy is a big one for this. I mean, from an employment perspective, you can ask your staff for the relevant information that you need to make your decisions. But the collection of this information certainly raises privacy issues and employers need to consider whether the privacy act applies to the organisation. And even if it doesn’t, we would recommend adopting some of the best practise steps that you can have in place that ensures you collect, handle, use, store this information appropriately. The office of the Australian information commissioner has specific guidance on understanding privacy obligations to employees when it comes to COVID vaccinations. It’s fantastic. You can find it at oaic.gov.au or by simply Google OAC and privacy COVID privacy and that will bring up that document. But it’s really important for both employers who are covered by the privacy act and those that aren’t, making sure that you are not asking for information that you don’t really need or asking for information that is just a catch all in case, really being thoughtful in your communications, getting the information, only the information you need and then using it in ways that are appropriate and respectful and also comply with your privacy obligations.

MELISSA SCADDEN: Thanks Tab. So another question we’ve got is, “I manage a home support CHS programme workforce, with staff providing personal care support to aged.” I think in aged care, so it’s aged in private homes, excuse me. “We are concerned that clients will exclude our staff if they are not immunised. Does this change the risk for our organisation and consequently our ability to mandate vaccination in the workforce?” So I think Tab, this is probably looking more at that inherent requirements of the job pace.

TABOKA FINN: Yeah, it really is. And it’s sort of difficult to give you a blanket answer. But if you were having all of your clients stop allowing you to work for them because of the risks and the risks are real and you identify them and you can’t put in place other safety mechanisms, then it really does, Mel, you’re absolutely right. It comes down to looking at whether that is an inherent requirement of the role. And when I talk about inherent requirements, it’s probably important to clarify that inherent requirements is something more than just looking at a role description or just looking at what you’ve previously done. It really is delving down into and it’s kind of in the title, inherent, what is fundamental? What if you took it away, would make the job not the job anymore? So it may be in that circumstance, you need to look at if the job can be done in a different way. And if you can’t, whether having the COVID vaccination is ultimately going to be an inherent requirement of that role.

MELISSA SCADDEN: Excellent, thank you. We’ve had another question which I think sort of goes back to again whether or not you can discipline someone for refusing to come into work because others have not been vaccinated. So essentially from what you were saying and natural as that, it does very much depend again on various factors but certainly if it is a lawful and reasonable direction in the circumstances for them to come in and they’re refusing to do so, it could be reasonable to discipline but probably look at it being a bit of a last resort really and see what other things you could do.

TABOKA FINN: And I would generally be pretty sensitive at the moment, it’s understandable. I probably want to have a chat to them, get a bit more information about why they say it’s not safe to come in, even under the OHS laws they still have to the concern has to be real. So if you actually have a workplace where all of these other protections can be in place and it’s not a real risk, then maybe you could proceed down a bit more of a strict pathway asking them to come back in. But certainly I agree with you, Mel. I just, you know, it’s all a bit tricky at the moment but I’d want a bit more. I’d probably want a little bit more information about why they don’t want to come in and why they say it’s unsafe and really targeting whether it’s sort of a preference rather than a genuine concern about their health and safety.

MELISSA SCADDEN: And I think it’s also, as we say, having those conversations and perhaps being creative I mean, certainly 12 months ago would never have thought we could move people to working from home. And I do appreciate that many roles quite simply cannot be done remotely but we certainly found out last year that a lot more roles could be done remotely than we’d originally thought. So certainly let’s be creative, have some conversations with your employees to see if there are other ways that you can try and manage the risks, check whether or not there might be misunderstanding because there is a lot of incorrect information floating around there. So the educational piece is really important in these circumstances as well.

TABOKA FINN: I should lastly mention obviously, there are those workplace injury and work cover risks we mentioned before. If you determine that somebody needs to be in and they’ve said that they’re at higher risk or they don’t want to come in cause they’re at risk, those are going to be the other side of the risks that you’re thinking about.

MELISSA SCADDEN: Absolutely, a question of what are some examples where a vaccine is already a mandatory requirement for a role. So, sorry, go on Tab.

TABOKA FINN: No, no, no. So, I know, not the COVID vaccination, but in meat works is an industry where there are a number of vaccinations that are mandatory as part of the work. There are also some workforces which require things like the flu vaccine or have required things like the flu vaccination have been mandatory. I’m not aware of anywhere that’s any employers that have mandated COVID yet though. That’s I don’t know if, Mel, if you have a different view.

MELISSA SCADDEN: No, not that they haven’t necessarily mandated it. There’s certainly been some very strong encouragement, very firm encouragement but I haven’t heard of any across the board mandating yet. So, which is interesting to say but certainly again, as we say given the risk assessment, risk levels keep changing, it will be. Watch this space, I feel. Another question and is it not a safe assumption that if the government is not mandating this in high risk instances or workplaces and this, I think perhaps with this question is getting at is, basically given the government hasn’t mandated, how can we? And look, that’s a really good question. And certainly I think there are probably some industries or workplaces that are perhaps feeling a bit frustrated. They haven’t got some clear advice from the government. Look, I think ultimately what the government is saying that across the board, they’re not going to mandate it. They’re going to make it voluntary but they have in all of their material and all of their guidance, they have said that this, you still have to ensure you comply with your obligations and you still have to perform your own risk assessments in the workplace. And so they’re recognising that it will differ, it will depend. And, it’s really important if you’ve got your own obligations that we’ve spoken about and simply saying, “Well, the government hasn’t done it, so I don’t have to,” would be insufficient. You’ve still got to perform your own risk assessments.

TABOKA FINN: I agree with that, Mel. I think it’s good. You should definitely have turn of mind to it. It should definitely be part of your conversation but it’s not sufficient on its own because it doesn’t delve into the individual facts and circumstances that we’ve been talking about. Your workplace could be a unique butterfly and it needs its own process to go through.

That’s pretty nice.

MELISSA SCADDEN: So I’ve got a question about staff members’ right to privacy. “My organisation supports people living in the community with a disability. We have clients who have requested only staff vaccinated to work with them. And where does informing clients on whether a staff member has been vaccinated or not fit? It’s an interesting one.

TABOKA FINN: Oh, that’s a good question. I think that again is definitely my immediate reaction to that is you would not be able cause it’s private information of your employees. So I’d be really careful with how you do that. I’m trying to think of a practical solution though. Mel, you’d have to have some kind of communication where you ensured that there was safety stuff in place but certainly you couldn’t just tell your clients if a person was vaccinated or not without the employee’s consent. That’s private and sensitive health information.

MELISSA SCADDEN: Absolutely and I think that’s what it comes down to those, that there’s a consent. So have a chat with your employee and say, “Look, you know they want someone work back then just be working with them. Now, are you comfortable with us saying that you are vaccinated or alternatively, you’re not?” So then it becomes that separate conversation that we’ve already spoken about or whether they’re actually able to perform that role in those circumstances. “If an employer does not mandate vaccination for the workforce, is it reasonable to ask whether staff have been vaccinated?” And again, I think it’s going to that question of not whether or not you can, in fact ask for this information.

TABOKA FINN: And I think the same answer, look you can’t just go telling other employees about other employees’ personal, private, sensitive health information. There are some under the privacy act. And again, check that privacy note I mentioned. There are some abilities to do it with consent, for example, but I definitely wouldn’t be doing it as a matter of course.

MELISSA SCADDEN: We’ve got another question here that goes to employer liability which I think is something that’s probably at the forefront of many employees minds but they said, “Assuming or cautionary procedures taken an employee agrees to vaccinate,” so that it’s not a mandate, it’s an agreement as required, “what is the employer’s liability if unexpected outcome occurs?” So we’re talking about death after vaccinating, would it be covered by work pack cover et cetera?

TABOKA FINN: So with this, I mean, it’s going to be in terms of workers’ compensation. So I’m just thinking somebody does have an adverse reaction. You haven’t mandated it but you’ve encouraged it. I think maybe the link to the employment is a little bit less but I still think there’s a bit of a work cover risk there but you know it it’ll be the workers’ compensation authority that determines whether the injury or illness was adequately connected to employment. So again, a bit of that considered, it would be considered based on the individual circumstances.

MELISSA SCADDEN: Yeah and certainly I think if we go back to looking at whether or not there’d be some other liabilities. So if we look at terms of the regulatory perspective from Work Safe prosecution, if you’ve gone through a cautionary procedure, you’ve gone through all the other control measures, it is voluntary. So the employee, if it’s fully informed,

TABOKA FINN: Truly informed.

MELISSA SCADDEN: Truly fully,

TABOKA FINN: Voluntary.

MELISSA SCADDEN: Absolutely, I think it’d be pretty unlikely that you get a prosecution or indeed even any kind of liability at common law because I couldn’t really see the circumstances as described there where you could say that you’ve breached that duty of care, if you have ticked all those other boxes. Certainly most recently we’ve seen that there’s been and Ben probably about to speak to this better from shortly. But the AstraZeneca rollout was halted for waking Victoria, as they were trying to work through liability issues for doctors in terms of actually providing this vaccine when there might be these additional risks and that’s what they’ve been working through. So certainly I would be surprised in these circumstances, whether or not if you were following all the recommendations as they’re suggested in this question, that they would be any found to be any breach or liability there.

TABOKA FINN: And I mean, it’s a good point to note, Mel. It’s not actually the employer giving the vaccination, it’s through another entity doctor, so it sort of falls under that category.

MELISSA SCADDEN: Absolutely, yep, absolutely. “Will they be a guide for employers to develop the matrix of considerations?” So certainly there’s a lot of guys around a lot of stuff that’s coming out. I’d recommend looking at the Safe Work Australia and the Work Safe websites. There are regular new information coming out that talks about it and certainly it’s being updated quite frequently as well. So there is a lot of guidance as to how workplaces should do that. Also look at your industry associations who are also providing a lot of support to employers, as to how best to go through this matrix there. Okay. What about a situation where a client does not want to work with an un-vaccinated employee? Best practise to have another worker do the work with a client but this is not always possible in small organisations. And look, I think we might’ve touched on this as well, in terms of looking at what those inherent requirements of the role are and just talking. And as we’ve said, seeing with there’s other solutions there as well, I think would be a good one. I’m conscious that we are getting towards the 11 o’clock but certainly we’ll go through and see if we can answer some more of these faster questions. “Do these rules and obligations for employees apply equally to volunteers or ad hoc, casual staff, contractors, et cetera, for example, site visits by disability support workers?’ So from that note, my hedge nest perspective, yes, you owe these obligations to all these individuals that visit your work place. So it includes volunteers, casual staff, contractors, et cetera.

TABOKA FINN: And I suppose the key perspective is going to be your hedge nest perspective. But from a general employment perspective, it’s going to depend a little bit. Certainly casual staff would be covered, contractors are likely to be covered through your agreements. And volunteers are generally covered, especially if there’s an enterprise or award that applies.

MELISSA SCADDEN: Better time to slip them more in, we’ve got, “How does mandatory vaccinations currently work in relation to other types of vaccines? And in what way we expect things to be different with COVID vaccines?” And this is an interesting question because certainly we’ve seen comparisons to the flu vaccination, for example. There are certainly roles or industries where you must have a flu vaccination to notice of work. We’ve seen our no jab, no pay scheme in childcare. So it will be interesting to see how COVID is different to that, I think.

TABOKA FINN: And I think that the thing at the moment, Mel, and I definitely look away encouraging everyone that we speak to to start looking at these issues, be proactive, keep the matrix of considerations changes constantly. But the reality is actually at the moment, for employers, most employers, you’re not going to have access. So there’s a sort of a practical step in the way that’s preventing sort of mandating or even rolling out or even encouraging employees to get the vaccination. So that’s a bit of a side issue really at the moment while that that’s underway.

MELISSA SCADDEN: Definitely, now I’m waiting to see, I think we might have time for one more. “I’ve been employed since mid COVID and have completed all work from home. Would it be reasonable to mandate that I get the vaccine to come into the office if I can and have completed or work from home?” Another interesting one, we’re seeing a lot of people come back into work after working from home for a significant period of time. And there is that question about whether or not that can be required and how the vaccination plays in. And what do we think about that, Tab?

TABOKA FINN: Yeah, look, I suppose there’s two perspectives on this. Firstly, we do need to acknowledge that although everything has been changed and a lot more remote working and things like that at the moment that has really been in response to a very unusual circumstance being the pandemic. So it’s not the usual practise or it’s not your usual role, not the usual way that you work. And now that some of those restrictions originally the reason everyone had to work from home is it was government mandated. So those restrictions have obviously come off. So the reasons that your employer has to send you off to work remotely have, in Victoria, in Australia at the moment, more or less disappeared. So that’s kind of one side of it but I certainly agree with what you’re getting at, which is the nature of work has changed for a lot of roles and it may require people to re-look at what are really the inherent requirements. So I think Mel touched on this before. Certainly I have seen some roles that previously we thought part of the inherent requirements was being in the office because there wasn’t the ability to work at home. Various things have changed. There now is the ability to work at home. Perhaps actually being in the office is no longer an inherent requirement. If you really delve into what is required to perform that job. But certainly there are things that do require face-to-face interactions and do require to be in the workplace. So there may be inherent requirements that require you to come in, even if you have been working mostly or all remotely for a while.

MELISSA SCADDEN: And certainly I think, if in order for someone to come in and work in the workplace safely, the only way that you can comfortably do that is to mandate a vaccine is required them to have the vaccine and they can work effectively from home, allowing them to work from home I think would be more reasonably practicable kind of control order from that risk than requiring them to have the vaccine.

TABOKA FINN: Yep.

MELISSA SCADDEN: Excellent, now, Emma, I think we may have run out of time. We’re still got so many questions but hopefully we’ve managed to answer many of them.

EMMA KING: Melissa and Taboka, I cannot thank you both enough. That’s been a fantastic session and it’s really a sincere thanks to both of you and to Justitia overall, in terms of your support today as well. I can’t begin to thank you enough. I think you’ve got a beautiful double act going there and I know we are going to be back in touch with you because we have so many questions as you say in the Q and a section as well. I just want to say a significant thanks as well because in the last session that we ran, we had lots of employment questions and we just weren’t in a place to answer them. And it’s been fantastic to have a really significant part of today set aside to work through those questions. And as you’ve mentioned, it’s an ever-changing space. So I know we’re going to hold another one of these events. It would be fantastic if you can come back and I just want to thank you both for your generosity as well. It’s very much appreciated. So thank you for what’s been a fantastic session. I think we’ve all learned a lot and as you say, it’s a continually evolving space, so lots more to learn. So a huge thank you to both of you.

MELISSA SCADDEN: No problem. Thanks Emma, thanks for inviting us. We enjoyed it.

EMMA KING: Thank you, it was fantastic. Thanks so much. And also a reminder to everyone else, that we’re going to have a copy of this presentation made available on our website within a few days. We’ll send you the link as soon as it’s available as well. I’m sure you will all agree, lots of fantastic information in that session. And you know, as I said, our plan is to hold more of these sessions as well as more information becomes available as well. Justitia or I should say just Justitia, I keep mixing the name up slightly, so forgive me, have also produced a series of other blogs and other videos on this topic. And we’re going to share those with you as well because they’re fantastic. And I think they’re going to be a really great resource for all of you as well.

EMMA KING: So today we are very lucky to be joined by two senior advisors to Victoria’s COVID-19 immunisation program. Professor Benjamin Cowie is an infectious diseases physician, normally at the Royal Melbourne Hospital and The Doherty Institute.

Jade Hart holds a Master’s of Health Service Management and is also an expert in clinical governance. Many of you will know Jade through her fantastic work at the Victorian and Tasmanian Primary Health Network Alliance. Thank you both for joining us today, Ben and Jade. We really appreciate it.

I might ask both of you just to very briefly introduce, introduce yourselves to talk about your role in the rollout that we’re seeing underway at the moment, and then launch into your final presentation. When you’re finished I’ll join you again, and we’ll step through some of the questions that we’ve already received and looking forward, of course to receiving more as a presentation continues. So thank you and over to you, Ben and Jade.

BEN COWIE: Thank you so much for that very kind introduction, Emma. So I might start by introducing myself very briefly and then I’ll hand back to Jade and then we’ll go through our presentation with me first and then again Jade bringing it home.

So yeah, my name is Ben and I’m an infectious diseases specialist. I usually work at the Royal Melbourne clinically and at the Doherty Institute as a researcher but I’m currently seconded full-time to the Department of Health to share the role with Jade of Executive Director for Engagement and Partnerships within the COVID-19 vaccination program here in Victoria. And I’ll pause while Jade introduces herself.

JADE HART:  Good morning, everyone. My name is Jade Hart, Executive Director supporting Engagement and Partnership work working with Ben Cowie. Look forward to some discussion today around the program and how we can work with you in terms of next steps.

BEN COWIE: Thanks Jade. So we do have some slides, I’ll start sharing my screen. I’ll talk through some of the details of the vaccines and the program and how Victoria is planning to implement the Australian Government’s COVID-19 vaccination program in this stage. And then Jade is going to take over and talk more about our approach to engagement and partnerships which is obviously a subject that’s very close to both our hearts. So colleagues, I’m going to stop sharing my screen now. So that should be projecting now. So as I’ve mentioned, we are going to give an update at this exciting time when we’re now on our third day of the rollout of the Australian Government’s vaccine program here in Victoria. And there are three pillars behind it the program that we’re implementing here in Victoria that we’re committed to ensuring. And the first is that all Victorians have access to this vaccination program. It’s free for everybody in Victoria. And we really want to ensure that we make the vaccines easy to access for all eligible Victorians.

As we move through the phases of the vaccination program which I’ll come back to and talk about in more detail later on in this presentation. But we also want to make sure that these are accessible locally for all Victorians that they’re easy to access. There’s a vaccination available close to home and in a range of settings that are appropriate for Victorians in all walks of life and from all communities across our state. And it’s important to ensure that not only are these services accessible but that we’re delivering the entire vaccination program with the highest levels of safety and quality. These vaccines are very safe and I’ll come back to that point but we need the program itself to have the highest levels of safety with expertly trained workforce and the ability to ensure that the entire process from the time people receive that invitation to be vaccinated all the way through to the follow-up following their completion, their second dose has the highest quality and safety standards underlying it because that’s how we’ll build public trust and confidence. We need all Victorians to feel that the program being implemented here in Victoria is transparent that they have all the information they need about the program and the vaccines and that we’re engaging really fully with all Victorians in this what essentially is the largest public health undertaking in our national history. It’s a huge opportunity and we want to grab it with both hands.

So I’ve made this point but it’s actually really important when we think about the entire vaccination program including the phase 1A release. And that is that this is a Commonwealth program. It’s the Commonwealth government who’s purchased the vaccines. It’s the Commonwealth who is distributing the vaccines and has established for example, the prioritisation under which we’re offering these vaccines to the population based on level of risk. So it, whilst it’s a Commonwealth program we want to implement it as effectively and safely as possible here in Victoria. And that’s our express objective to vaccinate every eligible Victoria over the course of this year because this is an important part of how we protect our health, look after each other and keep Victoria as open as we can in the face of COVID-19.

So the Commonwealth has those clear roles one of which is to provide vaccination for disability care residents. So residential disability care residents and staff here in Victoria. So the Commonwealth is running that program. The Commonwealth is also responsible for private residential aged care staff and residents as well. We’ll come back to some of those details around the different populations subsequently but the Victorian government is responsible clearly for providing guidelines for establishing some of the health service based vaccination such as the hospital vaccination hubs which are already up and running now and had over 1200 Victorians vaccinated in the last two days and there’ll be hundreds more today. So the health services are doing a great job at getting this program established and building up calmly and steadily to the sort of numbers we all want to see. Because they, the vaccine centres are the ones who are doing the real work here. They’re the ones who are out there giving the vaccine to Victorians. But also we know that our health system, our providers, our partners are the ones who really are the trusted sources of information for all Victorians. And so as well as putting vaccine and arms they’re also already putting it in people’s hearts and minds.

And that’s really critical. I’ll spend a little bit of time talking about the vaccines. As Emma said at the start we’ll have plenty of time for questions and answers and I’m looking forward to hearing those and to working through those with everybody online. And also, I always learn from that process. So I’m looking forward to it, but in the first instance one of the issues that comes up is why do we only have the nine vaccination hubs. Four up and running at the moment three in metropolitan Melbourne at Western and Austin and Monash Health. And then in the regions Barwon is up and running as well five more to come. But why are there only nine? This is part of the Commonwealth government’s rollout. And one of the really essential points of knowledge about the Pfizer vaccine, which is the one we have now is that it needs to be kept at negative 70 degrees. That’s much, much colder than our usual cold chain for other vaccines. It’s very, very cold and it requires special freezer capacity and distribution networks.

So that’s why this can’t be more broadly offered at different places in Victoria.

However, our hubs are doing a great job not just vaccinating on site, but for example, Alfred Health in partnership with Monash is doing onsite vaccination in our hotel quarantine program. And Western Health is doing outreach to the airport and Barwon Health is doing outreach to the port of Portland, which has already started. So there is some outreach occurring already in the first days of the program. I’ll talk more about this subsequently, but the AstraZeneca vaccine which we believe we’ll be receiving later probably late March that requires normal cold chain vaccination, storage and distribution. So that will be available at far more sites across Victoria other health services, general practice I’ll come back to those points in a moment, pharmacies a whole range of settings. That’s going to make it a lot more accessible for many more Victorians. These vaccines are really safe. They’ve been used in initially in clinical trials which have included tens of thousands of volunteers to receive these vaccines. And that’s just for the Pfizer and AstraZeneca vaccines. And they’ve now been used in tens of millions of people worldwide. And we’re getting really exciting results real world results showing that hospitalisation and even transmission of COVID-19 is significantly reducing in those countries where significant proportions of the population have been vaccinated. That brings me to the question of efficacy or the effectiveness of the vaccine.

These biggest here are the ones that have been largely reported in the media. It’s important to note that the difference between these vaccines, firstly, is significantly less when the spacing between the AstraZeneca vaccine is made longer. And that’s why here in Australia we’re probably going to be looking at 12 weeks spacing between doses of AstraZeneca vaccine in the trials that suggested we’ll get up above 80% protection against symptomatic COVID infection, which is more similar to that that we’re seeing with a Pfizer vaccine. But the second point, and this is just coming out this week from the United Kingdom that the AstraZeneca vaccine is actually protecting very substantially above 90% reduction in hospitalisation for COVID-19 amongst those who have been vaccinated. These are great results and they’re exciting. And we look forward to seeing the benefits of these vaccines, particularly in those countries of the world who are experiencing tragically such substantial infection and illness and tragically loss of life from COVID-19 currently.

So we’ve received around 11,000 doses of vaccine from the Commonwealth government this week for the Pfizer vaccine. That’s going to double in a few weeks as we move through and do the second doses for the people who’ve already been vaccinated but also continue to vaccinate a larger sections of the population in particularly that priority 1A which I’ll come back to, but the AstraZeneca vaccine as well as being available in far more places across Victoria, we’re going to have a lot more doses. And we understand that at peak we’re going to have around 250,000 doses of that vaccine available to us every week.

This is a huge challenge but it’s such an opportunity to protect our community from COVID-19 and really move towards that COVID normal way of life that we’re trying to get back to. So if you think about this over the course of 2021 we’re really in that initial buildup phase at the moment we’re only three days in and we’re going slowly and steadily, but we’re really going to ramp up. And that ramp up will kick off properly once we have the AstraZeneca vaccine. And then as you see from this graph we’re hoping that at peak, between May and August we’ll be vaccinating hundreds of thousands of Victorians every week. And that’s a really exciting prospect. So I’ve referred a few times to the prioritisation, who goes first, who comes next, as we go through the vaccination program. The priority 1A group, which has shown on this slide on the left hand side includes frontline at risk healthcare workers. It includes obviously our quarantine and border workers who are, as we all are aware and the events of the last two weeks have reaffirmed for us amongst the highest risk individuals we want to protect but it also includes aged care and disability care residents and staff. And this comes back to that important point I made earlier.

For aged care the residents and staff in private residential aged care will be a the vaccination program is run directly through the Commonwealth, through private parole providers whereas for public sector, residential aged care it’s the state of Victoria through our hospital vaccination hubs that are responsible for providing that initial rollout. For disability care residents and staff the Commonwealth government again is providing that whole program both on the private and public sector. So that’s an important point of difference that it will be being run through private providers, contracted directly from the Commonwealth and not through the state system for the disability care sector. But then we move through the other phases and for phase 1B, which we hope to be able to get to maybe in early April, that will start to include a much broader range of Victorians including all people aged 70 years and over completing vaccinating our entire healthcare workforce beginning to vaccinate Aboriginal and Torres Strait Islander people over the age of 55, vaccinating younger adults with an underlying medical condition and that includes people living with disabilities. And other critical and high risk workers including defence, police, fire, and emergency services and people working in certain industries such as meat processing. And then as you see through phase 2A and phase 2B the age groups come down and the breadth of the offering in the Victorian and Australian population really sort of increases.

So these are our hospital vaccination hubs, the three in metropolitan Melbourne that I’ve already mentioned. And then the six regional local public health units Barwon, Goulburn Valley, Latrobe, Bendigo, Ballarat and Albury Wodonga. And really their express focus at this point in time is vaccinating that priority 1A population that I was mentioning from the previous slide but then we come to the much broader offering that is made possible by AstraZeneca vaccine and whilst our hospitals and health services will continue to have a very important role here.

I’m excited about this, and I know Jade’s been doing a lot of work and thinking about this too about the much broader offering that we can think about including for instance, community health centres. Who’ve had such an important part of our response to the COVID pandemic so far, particularly for some of those vulnerable and priority populations but also general practices and pharmacies, Aboriginal Community Controlled Health Organisations and starting to think about some innovative models such as high throughput or mass vaccination centres and potentially mobile teams. So this is just spelling out some of those details in in a little bit more detail I should say so that you can see that whilst we’re focusing on our 1A population through our hospital hubs right now, we’re putting a lot of thought and energy into how we can broaden this offering out to include the entire Victorian population. An essential part of that is building partnerships and increasing engagement. And I would like to hand over to my colleague Jade Hart. Who’s going to take us through some of the details in this space over to you, Jade.

– Thanks for that, Ben. So this opportunity to speak with you today is really just recognising that you sort of key partners in this work. We see this as a really important and meaningful program of work, and it came to work with you in all next steps going forward. The work that Ben and I are focused on is really about how do we communicate, engage and establish partnerships that is seek to achieve key and agreed goals. We recognise the COVID immunisation program is just one element of Victoria’s comprehensive pandemic response. So we are mindful of the work that you’ve done within your organisations, whether it’s in the preparedness space, the work that you’ve done with your clients in terms of prevention. And what we’re hoping to do is work with you around those next steps, in terms of adding the vaccine to sort of a toolkit in the response.

The work that we plan to do and roll out over the next couple of weeks is really system oriented, tailored. So we’ve started conversations with and they came to work with you around how we can start to think about really mobilising the vaccination health promotion within a broader service system response. One important aspect to really emphasise is that we really need to be responsive to where our clients and where our communities are at. We think about vaccine hesitancy as a spectrum so we don’t think about it as as a yes or no sort of question. We know that that we’ve got those that are really keen enthusiastic and really supportive of the vaccine. So therefore the task ahead for us is how do we support them to have a convenient and high quality experience through the program. We know down the other end of the spectrum that there are a dose that objectors to the vaccine, but importantly there are people that sit within in the middle of those two sort of pop ends of the spectrum. That’s where we know that we anticipate that probably 20% of the population have questions. So here’s for the task for us and the engagement space is how do we build opportunities to provide information, to support whether it’s community leaders, health and human services professionals sort of trusted clinical advisors within the community.

And that can include sort of bilingual workers, for example to support the community to have a conversation about the vaccine, such that we can enable people to move down that path so that as they are invited to participate in the program which refers to the slides that Ben was presenting around prioritisation and access that we can start to have people feel confident and trust the program that they’re able to participate when they’re ready. And finally, it’s important to emphasise that everything that we do in the COVID prevention and preparedness space is integrated. So we really are thinking about how we’re really sensitive to messaging where we’re looking at prevention and preparedness what it means in an outbreak setting and the why in which the vaccine is really missed it in those messages.

So the next slide really just emphasises our important work that we have ahead of us around communications. So this is where the Victorian government is working hand in glove with the Commonwealth around how do we best communicate? We know that there are established universal channels to achieve reach. So whether that’s kind of websites, social media, campaigns based work, but importantly we know the importance of direct engagement and that’s where we’re keen to work with you around questions, methods and strategies to help us really understand how we can best engage communities and clients in the most sensible way. And this is where some of the principles around the role of sort of trusted leaders or key persons within communities and as well as yourselves as key providers of service for clients have an important role in working with us going forward. So this last slide really builds on that in terms of the the strategies that we’re planning to roll out over the next couple of weeks. We know that the task ahead of us is to inform but then what would came to work with you on is how do we best engage and how do we best engage and really empower yourself to support us in really this common cause going forward. Some of the strategies that we have in place are focused around kind of grassroots engagement.

So whether that’s working groups, Ben in particular has been leading a lot of work working with our culturally and linguistically diverse communities. We’ve also really recognised that industry are key partners in this space. So if you think about some of the sort of outbreak experiences, and even that example that Ben had raised in terms of meat processing there’s a task ahead for how we work together with the industry to design models of service delivery in terms of immunisation rollout. That’ll enable us to have the most convenient experience for individuals along the way. Alongside this we are really mindful about priority populations but also the notion of place. So as a team, we are working with local government in terms of working community engagement the work that we’re doing as an immunizer workforce but also questions ahead for us in terms of how do we make sure that we’re building really strong understanding about the vaccine at the with the community itself as the unit of focus.

I think that might be our last slide Ben, but and over to you for closing remarks.

– Thanks Jade. Look, I might hand back to Emma. I think that you’ve really captured the thrust of where we’re going really well. I’ve got nothing to add Jade. So I think with that, I will hand back to Emma. Thank you.

– Thank you so much, Ben and Jade. That was a fantastic presentation, incredibly informative. And I’ve seen lots of questions coming through. One that I’ll just touch on before we hand over to the others. And that is to, for those people who jumped on slightly later, we are recording today’s session. It will be made available. It will be captioned. And we’ll share that with all of you. So if you did jump on slightly late, or you have questions about that, I just wanted to reiterate that as well. Now, in terms of the questions, I’ve got a list of questions that we’d given that will provided by many of you on the line in the lead up to today. So I’ll start with some of those. And also do you remember that you can enter your questions in two ways as is now up on the screen in terms of the Zoom Webinar question box or go to Slido as well with any questions of which we have many. So let’s get started. So first of all and I’m not sure I might just pose the questions Ben and Jade, you can sort of choose who takes them depending on what’s most appropriate. The first question I had was does the vaccine stop the spread of the virus or just protect from the worst symptoms?

– So thanks, Emma. Maybe I’ll start with that one. And initially the clinical trials really were looking at the second part of that question, so stopping symptoms. They certainly both vaccines are very effective at preventing symptomatic or illness from COVID-19. And even more importantly, they were both extremely highly effective at preventing serious disease such as requiring hospitalisation and preventing loss of life from COVID-19. But now in particularly some of the data coming out from Israel have showed that they do prevent transmission of COVID-19 also, this is incredibly exciting because this information is starting to answer that question of, are we just preventing illness or are we actually blocking transmission? And it does certainly seem that we’re blocking transmission. And even after the first dose of the Pfizer vaccine, for example, we are seeing that even amongst people who get infected after their first dose in the days afterwards that they have significantly reduced amount of virus being shared, or in all that’s detectable in their swabs which shows that even if they do get infection they’re less likely to transmit it to others. So these are really exciting and quite new findings which will continue to inform our approach.

– Thanks, Ben, that’s incredibly helpful. One of the other questions I’ve had as well is around children and kids under 16 and a question around is it correct that kids under 16 don’t need to be vaccinated?

– So we don’t have the evidence to answer that yet. What we can say is that the clinical trials did not include people under the age of 16 for the Pfizer vaccine. And actually didn’t include people under the age of 18 for the AstraZeneca vaccine. So what we don’t have is evidence of benefit in in people in that age group, those younger people. That’s why they’re not included in the current roll out of vaccine by the Australian government. They’re not registered for use amongst people under those ages of 16, for Pfizer and in AstraZeneca. As those clinical trials are occurring right now if evidence comes in that they are effective and clearly safe which we expect them to be amongst younger people then though they will be added to the vaccine program once we’ve vaccinated larger proportions of the population. It is important to remember that younger people had much lower rates of serious illness and hospitalisation, even when they got COVID than did adults and older Victorians. So it’s, I don’t think it’s something to be worried about but the evidence is not in yet.

– That’s really helpful. Thank you for the context now. Just stay on this sort of topic for a moment before I flip to some others cause had a question that’s on the flip side of that as well, which is around, is there a tonne of which people are too elderly to be immunised as well?

– So that’s a really important question. We know that COVID-19 some of the real tragedy that we saw last year was amongst more senior Victorians. And we know that with every sort of increasing decade of age, you have a greater chance of having serious COVID and tragically of losing your life if you actually acquire COVID. So there’s that real imperative on the one side so we want to do everything we can to protect senior Victorians. On the other side, we do know that particularly people who are quite frail or have very limited life expectancy that potentially the role of vaccine especially in the absence of community transmission doesn’t have as great an impetus as it does in some other parts of the world. And it can also lead to concerns about, potential side effects of vaccine, et cetera in people who are very frail. So at this point in time, there’s no absolute age limit but particularly for people who are, for instance in palliative care or very, very other medically unstable or very frail, it really has to be taking a case by case basis and the best people to inform individuals and their families and their carers on that is the people who are providing those people their usual care, their GP, that nursing staff and other trusted health providers. But just to be absolutely clear there is no absolute upper age limit, and we really want to protect senior Victorians from COVID-19.

– Thank you, Ben. And I just wanted to flag so I can see lots of questions coming through again for those of you who weren’t on at the beginning we’ve allowed an hour for questions. So bear with us. We have lots of questions to work through but we really are aiming to get through all of them during the presentation today. So I just wanted to let you know that as all of you sort of feeling anxious, that we haven’t got to add to your question yet. One of the other questions I’ve had through is around how will a person, I heard this actually Norman Swan talking about this last night as well on ABC. How will a person know when they can be vaccinated? So they get a letter, an email, a phone call, what sort of system is in place for that at the moment and how might that work?

– So I can start with some of the information systems side of that. I dunno if Jade would like to come in on the communications and the engagement with people around that process as well, but from a from a systems point of view, I guess in the first instance what I would say is that it’s going to change as we work through the phases of people over the course of this year. So at the moment with the priority 1A populations and thinking particularly about workforces, such as hotel quarantine workers, border workers and healthcare workers their employers are providing the department with contact details for those individuals which would be loaded into what is going to be a significant part of the state’s system systematic response called COVID-19 Vaccine Management System or CVMS. And the invitations to be vaccinated will be generated through that system. And so people are actually emailed to offer them vaccination and with schedules, et cetera. So whilst that will continue as we move particularly through some of the public sector or some of the other vaccination sites in Victoria, as we move to a broader population approach with general practice people will actually need to book in with their GPS when they’re eligible for vaccination. And that we’ll use that the Commonwealth has opted to use existing, for instance, booking systems for general practice that are already in the marketplace to for people to be able to book in. So we need to support Victorians to be aware of when their turn is coming up in the prioritisation and ensuring that they then know to book in at their preferred vaccination site, whether that’s their GP or a pharmacy or a community health centre Aboriginal Community Controlled Health Org or another site. Jade, I don’t know if you wanted to speak a little bit more about sort of how we’re going to be informing and engaging with people as we go forward.

– Yeah. So just to flag that the Commonwealth website also provides some details around the priority cohorts so where individuals may fit the Commonwealth has also released it’s sort of an eligibility checkoff. So individuals can complete a sort of short questionnaire and get a bit of a steer on where they may see it across the priority cohorts. So having that sort of base information around where an individual may seater where a client or a workforce type my seat will help us kind of enable us to get messages out to key cohorts as they are invited to the program.

– Thank you. And I guess in terms of, as you said working on this program in partnership and it’s going to be so critical for so many people who are on this call, who work with people who fit into vulnerable cohorts as well. One of the questions I’ve got probably flows quite nicely from that. And I know it was something that came up during the COVID testing process as well, but where some of the testing was changed so that there were arrangements in place for people who can’t easily leave their homes or travel to a vaccination hub. I’m not sure, I’m sure you probably have started to think about this yet. What can you inform us about on that front at this stage?

– As we start to think about the AstraZeneca product in particular and where Ben alluded to the Commonwealth work that’s underway around the role of a general practice, community pharmacy and the Aboriginal community controlled sector as well as the dedicated GP respiratory clinics we just have been stood up nationally. As part of a really I guess, long alongside that Commonwealth rollout there will be a piece of work for the state to think about where are the potential opportunities to extend the depth of reach as part of that then there’s some thinking about what are the modalities that are going to work for particular cohorts. But then a question also for this group is, getting a bit of steer from you around what are the insights that you have that can help us enable us to design a service that is really responsive. In line with that some of the options obviously that you would expect including In-Reach into someone’s home, mobile access really community led sort of approaches. So we’ve heard a little bit from communities around a rugby club that’s really sort of accessible to communities the way in which community leaders can help to support. Those sorts of strategies are ones that we’re keen to kind of work through with partners like those in the line today in VCOSS, so that we can continually sort of tailor the response as well.

– Thank you. And I think it’d be good to, we’ll have a conversation offline as well to work out kind of some of the best ways of doing this which will be fantastic as well. Do you know at the moment, I’m not sure whether this is a a question that you’re able to answer but do you know whether people will have financial support if they need to miss work in order to get their vaccination?

– So we certainly, I can answer this. I mean, neither Jade nor I really sort of across the industrial law aspects of this, et cetera. But I certainly know that the current employer groups such as health services and those employing for instance, hotel quarantine workers are ensuring that workers are vaccinated during paid time. And that for people who and who get some of the expected and almost always very mild side effects that they are able to access sick leave for their time whilst they’re unable to work. If they’ve got symptoms following vaccination which again do occur, that’s a sign the immune system is working and for the vast majority of people they’re are quite mild and that they come and go within 48 hours following vaccination. But yes, they have been included in in the vaccination has occurred during paid hours. I think that this is, I was in a meeting last night with the Victorian Trades Hall Council where this was discussed and their approaches to employers in relation to this and providing information for their members. They’re certainly out there and engaging in this space and as our employers in date, and we’ve run a symposia with a range of employer groups as well. So that certainly has been the case so far through the 1A roll out.

– Thank you and again, this is probably part is just so in terms of the industrial aspect, but other questions have brought around people who perhaps, are self-employed or almost working, don’t have a part-time or regular kind of work engagement with one particular employer. So I guess it’s something to flag. I’m not sure if you’re able to comment on that today.

– So, sorry, Jade, were you going to say something or…

– No you can go.

– Okay. So certainly I’m not trying to suggest that this whole program is occupationally founded. Clearly there are worker groups priority critical workers who we are approaching them through their employer but just to make it absolutely clear, the vast majority of Victorians will not be vaccinated through their employer. There’ll be vaccinated through existing health delivery mechanisms whether that’s their local GP, whether it’s a pharmacy, whether it’s their local council, whether it’s a community health centre, there’s going to be a much broader range of vaccinators. And so it’s not all going to be founded around that occupational interface. Just to make that absolutely clear.

– Yeah. Thank you. That’s really helpful. And I guess one of the other questions that’s come through as we’ve been talking as well is around and Jade I think touched on this earlier, as well as around what it may well be for further discussion but what role do you see the community sector applying when it comes to vaccinations?

– Well, I think there’s many sort of important roles. I think there’s an element of how we work with the sector around how to best inform. So I guess going back to first principles and and we know that there are the relationship with that providers have with their clients are unique. So we’re not coming from an assumption that people have necessarily a GP that they’ve had that relationship lead for two decades. We know that then that an ILO day worker family violence worker can have a really important role in supporting a pathway to have a conversation about the vaccine, that path to participation. So there’s an element around how we support a message to inform our clients where and really being a good position to work through any questions. There’s an element around how we work with you to make sure we design a response that’s a risk sensitive to your city. So whether that’s for your clients but also for your workforce itself. And I think there’s really, I guess a continued focus around how we best engage at that sort of more community level.

– Yeah. Thank you. There’s a few questions that are coming through about different settings, et cetera. But I might jump to a couple of specific questions around disability and eligibility as well. One of the questions I’ve had come through is what evidence do you need to be included in the cohort with a medical condition or a disability?

– Yeah, that’s a really central question. And it’s one that we’re sort of trying to get a little bit more clarity from our Commonwealth colleagues on. So there’s been a range of options that have been put forward. The first is clearly if people have an existing relationship with their GP, their GP has all of their medical information already on file. And so their GP will be placed to be able to address who is eligible and who is not. If they don’t have a usual GP or for some reason they’re unable to see their usual GP for vaccination. For instance, if their GP is not one of those who is going to be giving vaccination, then My Health Record is another way that might be able to demonstrate the existing, for instance medical conditions or even prescriptions for instance, someone’s prescription for insulin, if they’re a person living with diabetes might be the kind of thing that might be used. So I think there’s going to be a range of ways to do this. We do need more information from the Commonwealth but I think existing platforms, existing service provision is going to be a big foundation to that. There has been some discussion of things like statutory declarations, et cetera. But I think in the first instance, we really need to rely on existing existing information sources and existing patterns of care to really be the foundation of this.

– Yeah, thank you. And it raises some interesting questions around the My Health website as well so doesn’t it when people have elected to opt out. So more, more ethical questions, I guess to be answered along the way around how we navigate that. Another question, just sticking with disability for a moment. So more around people who sort of work in disability or into for example, working, disability advocates, language interpreters, et cetera who work in close proximity to people is probably going back to some more of your initial questions. But when do you think that those people are likely to be vaccinated?

– So the prioritisation, which again is run by the Commonwealth. It there’s some detail in there for particularly the 1A cohorts or groups of people I should say. And I liked the term cohort for people but the one I sort of priority groups, I think as we go forward, more detailed will become available for the other sort of 1B, 2A priority groups. Certainly I think it’s important to remember that anyone who is described as a healthcare worker and that’s not just clinical healthcare workers but people who work in the broader health care delivery system if you like are included in 1B. So that that’s an important founding principle. But again, there is likely to be more information from the Commonwealth on that. And again, even for 1A it’s clear that people who are not just employed by for instance an aged care facility but those who provide care within that facility. So I’m thinking visiting general practitioners or visiting allied health practitioners who are actually going into a residential aged care facility. And so their work is taking them there. They are part of the 1A group. So there is some detail available but I’m sure more will be coming. And as a state we’re working very closely to try and get that data because we know people are thirsty for more information.

– Yeah. And thank you. And the next question I’ve got well sits around a different cohort. I suspect she might have a similar answer but one of the questions that’s come through around early childhood educators and whether they’re going to be part of the essential worker rollout as well.

– So again, and this is another group that, I mean, we Jade and I, and a whole team, in fact, fielding a lot of these questions and that’s for very good reason it shows people are interested and it shows people are keen to get vaccinated. And so we love to get these questions. I think partly for the reasons I was talking about with children and the risk of COVID, we it appears the actual risk of infection not just illness is lower in children for reasons we don’t completely understand, but furthermore there is close contact and we understand that people are keen to see where they fit along that spectrum the broader education sector and including early childhood education or care is one that isn’t specifically covered in the Commonwealth prioritisation index to date. And it’s one of those areas of clarification that we’re really seeking with our Commonwealth colleagues. I think it’s fair to say. What I would suggest is that if people have got ongoing questions that aren’t they’re unable to address when they go to the Commonwealth resources online they can feed those questions back to the Commonwealth but we’re also happy to hear them too. And we can feed them into our state process to try and feed back to our common Commonwealth colleagues because we don’t want people not knowing how to address these questions going forward. Jade, do you have anything else you’d like to add to that one?

– I guess I was just keen to sort of connect the thinking around prioritisation to dose supply. So if you think about the Pfizer vaccine has been mentioned we’ve purchased as a state through the we’ve purchased as a country through the Commonwealth government approximately 10 million doses of the Pfizer vaccine. We’ve purchased approximately 15 million doses of the AstraZeneca vaccine which we can also manufactured domestically. So questions around prioritisation is also linked to how we will scale up over the next couple of months. So we would like to hope that you know, that the details around the prioritisation and the focus will start to move to a question of how do we access it and when, and that there’ll be luckily, I guess a softening between the focus around prioritisation as we start to to receive much higher doses within Victoria.

– Thank you. And I think as well, I just wanted to acknowledge I’ve had a number of questions come through around how particular at risk will be targeted communicated with supporter to get the vaccine. And also who will be prioritised. I just wanted to flag this as well for everyone listening. So it’s around they questions range from migrant communities, asylum seekers, refugees, prisons and youth justice facilities those experiencing homelessness, Aboriginal Victorians. So it’s a fairly broad, people are understandably thinking about the particular the people that they work with. I suspect you’ve probably covered the parts around looking at we’ve got the 1A cohort my understanding is am I correct in saying you’re going to be constantly analysing where it’s actually the Commonwealth government will be constantly analysing sort of who is prioritised next in the immunisation process? Is that correct?

– That is correct. And you’re right. It’s an interface between the overarching Commonwealth guidelines which we are seeking and getting more clarity on as we go forward. But secondly, even within that, thinking about 1A populations, we’re really focusing on our hotel quarantine workers and border workers and even amongst the critical health care staff our express focus in the first instance is those healthcare services who actually are who may be receiving people being transferred from hotel quarantine. Because again, we’re taking a very very evidence-based risk approach thinking who is most likely to be exposed to COVID-19. And then the parallel question if someone were exposed to COVID-19, who is at greatest risk of the most serious outcomes, and that matrix is really what’s informing the Commonwealth thinking but also our sub prioritisation here in Victoria and more information will be coming out on this very regularly I suspect. Jade you were about to say something I think.

– I was just going to sort of add, I guess we recognise that despite cohorts coming on online or being invited later in the year, the time to engage is really now. So we’ve been, Ben and I’s team we’ve really structured our engagement approaching in terms of key work streams. So we have kind of a service provider work stream but one that’s looking at sort of priority populations. One that’s looking at place so keen to kind of connect engagement leads with the cost members and start to start a process where we can best inform but then help us get some feedback around designing systems which are going to help us achieve reach amongst those that are most vulnerable.

– It might be great post the webinars today as well to have a conversation about that. So we can hold perhaps specific conversations around that because I’m just thinking, for example some of the questions coming through from homelessness services around, will it be funding for outreach, obviously we’ve for Aboriginal Victorians in terms of, for Accos and others as well. So it’d be good to have a conversation around that. And we might look at setting up some specific conversations to really work through those particular issues as well because it sounds like it’s work that’s well underway but there’s also lots to go through and also very particular nuance for certain groups, as well is that fair?

– Yeah, definitely.

– Yeah. And just picking up on that. So again, the Aboriginal Community Controlled Health Sector is one that the Commonwealth is directly responsible for and that’s coordinated with NACCHO to provide that program to Aboriginal Community Controlled Health Organisations in particular. And we’ve been having meetings with the CEOs of those Accos coordinated by NACCHO so that we’re providing what information we can but it is a little challenging for us because the communications are predominantly coming from the Commonwealth to those programs. But we’re really keen to stand by and support in any way we can, because there’s a key priority populations for all of us and we want to make sure that we’re giving as much information and support as we can.

– Fantastic. Thank you. I’ve got a question, a slightly different direction at the moment as well, and bear with me. So I’m literally reading from another screen. What’s the advice on how consent is attained for residents who lack decision-making capacity and don’t have anyone else, whether it’s an appointed person or a relevant family member to consent on their behalf?

– So there’s some specific guidance has been provided around consent, and particularly with a focus on the aged care sector that’s available from the Commonwealth. That consent process isn’t necessarily document documentary, it can be verbal consent, but there is some statements around that saying that particularly in the aged care sector, documentary consent is preferred and that it works through the setting of someone who doesn’t have the capacity to consent for their own health care which is clearly something that is a broader issue well beyond COVID vaccine and beyond COVID sorry beyond vaccines in general. This is something that many of the sectors that are represented here clearly worked through and are experts at handling these issues to make sure that people get the care they need but that we, that principles of informed consent are respected to the latter. So this is really grafting onto that existing consent process but specific guidance has been provided around the consent process for COVID-19 vaccines.

– Thank you, and obviously that advice also extends beyond aged care. So looking at other settings too. Thank you. In terms of, I’m pretty sure you touched on this at the beginning, but a question has come through around where the individuals will bulk bill it at clinics GP clinics, et cetera, that traditionally don’t bulk bill. I know you’ve said that vaccine is free. Does that mean, for example, someone can go to their GP and get their vaccine for free when they would normally be charged to visit their GP?

– So this, again, I mean, this is very much a question for the Commonwealth and it’s something that’s been put to the Commonwealth. I know that there’s been some messages coming out from the Commonwealth government saying that they expect that practices that are selected as part of the expression of interest for general practices to provide vaccines don’t restrict it for instance, to their usual patient pool that they have to accept patients from or people to be vaccinated outside their usual. So if they’ve got closed books for their practice that’s not going to cut it for the COVID-19 vaccine. There has been some statements in the public domain around the MBS rebates and how they cover the vaccination process. But honestly, from as a state government perspective, we can’t comment on the MBS rules that the Commonwealth is seeking to apply in this space. There has been some public statements made but I wouldn’t want to commit our Commonwealth colleagues to any particular cause of action. Not that I could, if I wanted even if I wanted to, I wouldn’t be able to.

– Not the power that you should have.

– Should or have.

– Should. Another question actually touches on that the federal and state combination, which is in terms of looking at how I guess, and you’ve touched on these to a degree but it’s looking at how the state rollout and the federal rollout are going to intersect on the ground. So thinking very specifically about Commonwealth run facilities that are in Victoria where do you think I guess your kind of guidance on how you think that will roll out knowing that I suspect it might change a little bit over time as the rollout the pace picks up as well?

– So I guess from a departmental perspective there are obviously sort of forums for us to work together around what are the key pieces of infrastructure that are being required? What does it mean for communications and engagement and one of the kind of learnings that we can start to collate recognising that we’re looking to serve the needs of the disability community with disabilities and those that are older Victorians irrespective of the setting within which they live. So we’re obviously sharing information around the timing of activity and collating sort of learning so that we sort of can collectively improve.

– Thank you, bear with me. I’m jumping just a bit here. So I’m trying to capture the questions that are coming in as well as those that sort of come through with anything more thematic and how I’ve captured them. One of the questions that’s come through is around one someone understanding that we want to protect frontline workers, but also thinking around making sure that we, we prevent transmission. The question is wouldn’t it make more sense to vaccinate those who’d be more likely to have really poor outcomes of catching the virus such as immune compromised people as well.

– Yeah. So I think I answered that one in the chat as well while we were, while we were going. But it’s a really important point. I think if I can be clear about this. We’re priotizing both. So the reason that aged care residents are being vaccinated as in the 1A cohort is because they have significant risk of adverse outcomes as we’ve seen tragically in Victoria in the last year with COVID-19 but it also contributes to protecting, from COVID getting into the aged care setting at all in the first instance. The reason why people with medical underlying medical conditions or with disability are included in the 1B group is because of that very risk of adverse outcomes is higher in those Victorians than it is for those without medical co-morbidities. So it’s both, it’s a risk based approach but it’s also risk of serious outcomes. And so both of those are informing the prioritisation. One thing, one point I would make, again I think it’s a really important one. The best way we can protect every Victorian is by stopping the virus, getting in, in the first place. Now Victoria has done in the Victorian people I should say the Victorian community up there amongst very few examples globally of when community transmission is established and ongoing that it’s actually been stopped. And Victoria has an absolute, honestly, the efforts of the Victorian community to do this are globally recognised. The last thing we want to see is for us to lose that. And so by protecting our frontline workers by protecting our hotel quarantine workers by protecting our border workers as they protect us through their work we’re also helping prevent from COVID-19 from getting in to the community. So I would just make that point. I think we’re all at less risk if we bring the risk down as low as possible. And that’s not just about the vaccine it’s about access to PPE. It’s about the environment that we’re working in. It’s about all of those settings. It’s the daily testing that they’re all doing. These really are heroes, as a healthcare worker in the hospitals, during the second wave here in Victoria the community was really behind us and really we all all my colleagues felt so hugely supported by Victoria but the frontline of the battle now really is in a hotel quarantine. And can I also say providing care to the people who are in the quarantine hotels, those residents who are under extreme pressure and also have been through some pretty terrible circumstances overseas often. And so if we can look after the people looking after those very, very vulnerable Victorians then we’re protecting ourselves, all of us.

– Thank you. I’ve got quite a few questions coming through about different aspects of the immunisation process. One is, can my employer make me get vaccinated? Just sort of the flip side of many the questions you’ve been answering I guess the demand as well.

– So, and again, answering this in a couple of ways and I’d be interested. I mean, Jade might have other sort of aspects you’d like to bring in here. So neither Jade nor I are industrial law experts. So let me get that again, declared the outset unless Jade’s got a degree obviously that I wasn’t aware of. No. Okay. So from a public health perspective, so from the Chief Health Officer from public health authorities in Victoria, interstate other jurisdictions and indeed Commonwealth, there is no mandatory vaccinations. So from a public health perspective there is no compulsory vaccination for anyone in Australia. Now this that’s not the question you asked, however, the question you asked is what about employers and their ability to require as a condition of employment that their staff be vaccinated? Now, I’m not able to answer that categorically because I’m not an industrial lawyer and I’m not a industrial relations expert. I am unaware of any example currently in the nation where that is occurring. I also think there’s a significant downside and this is probably something I’d really like to get Jade’s perspective on. There’s a real downside in compelling something and you lose a lot of goodwill. And if you can do the engagement answering people’s questions giving them time to think things through giving them all the information that they can. I think that’s a, so much more effective way of influencing people’s behaviour in a health protective way than telling me you have to do this, or you’ve lost a job but I’d be interested to hear what Jade’s thoughts are on that aspect.

– Yeah, I guess upfront, really do recognise that 2020 was a really scary time. So the task ahead for us and really thinking about the vaccine is that a kind of a positive and a step forward we’d say that engagement messaging would be really framed around that trust and confidence and also the element that we all have in terms of collective responsibility. So what’s the role of sort of 6 million Victorians in this question outside of that mandating labour that we’d want to use as the last resort.

– Yeah. Thank you. And I think as well, that’s probably, as you say which some of these are sort of more industrial questions I just wanted to flag we’ve got other questions that have been asked around if you’re in a blended, the responsibilities of an employer if you’ve got some people who are vaccinated in a workplace place, some people who are not from what you’re saying, you’re not in a sort of position to be able to answer those questions. So there are things that we’ll probably need to get some legal advice around and share that information separately as well. One of the other questions which I think is a great one around for us as a community sector, as well as what do you think is the best way for us as community service organisations, I guess, to build trust in the vaccine program and to really, to counter some of the misinformation that’s out there as well?

– So I’d say it simply is have a conversation about the vaccine and to have some simple key messages to inform that and to also be clear around what are the other sort of trusted sources of information that we can draw upon to help community in practise. I think it’s as simple as having a conversation about the vaccine and making sure that there’s clarity about the convenience of the process for when people are invited to participate.

– I think as well too, it’s going to be the matter of us continually working together as also any messages you’ve got. We can look at how we put that out there working more broadly across the membership. So almost wherever someone goes they’re able to get accurate, clear information. And then obviously very personalised information from that the health practitioners that they work with wherever they might be situated.

– Yep. We can’t wait to work with you on that.

– And that individualised approach is so important. We know that people respond to evidence. Well, people think about evidence in different ways let alone responding to it in different ways. And there’s different types of evidence. And I think picking up on something that Jade said, I think for engagement, especially in this space where you’ve got people with hesitancy or uncertainty or might have beliefs that we wouldn’t share the first part is listening and actually listening to why people feel the way they do. And not just assuming that by communicating evidence and numbers and facts and statistics that you’re going to get everyone across the line because we clearly know that’s not the case.

– Yeah, absolutely. A couple more questions here around the vaccinations in terms of one being whether the Pfizer and Astra vaccines are safe for use in pregnant women or women trying to get pregnant and also for women who are breastfeeding as well.

– Yep. I’m happy to speak to that. So people, women who are trying to get pregnant, safe no effect on fertility, no need to delay vaccination if you’re trying to get pregnant. So women who are breastfeeding, safe. ATAGI have come out with guidelines saying that breastfeeding that the vaccines have no impact on breastfeeding women or their infants and as a consequence, breastfeeding or vaccination should not be deferred on the basis of breastfeeding. For pregnant women we’re currently not recommending routine vaccination and that’s not because we know there’s a problem. It’s because we just don’t have enough evidence to categorically state that there’s no impact of the vaccines in the setting of pregnancy. Now, overseas vaccines have been given to pregnant women. That’s sometimes because of the risk of COVID-19. Again, the tragic scenes we’re seeing overseas the risk of COVID-19 is extreme in many settings. And so that individualised approach to risk and benefit was taken and the vaccine was given and we are yet, or I am yet to hear of any evidence that suggested is a problem in the setting of pregnancy, but we just don’t have enough evidence yet. So to be clear, breastfeeding, no problems with vaccination. Planning pregnancy or trying to get pregnant, no problems with vaccination. For people, for women who are pregnant we’re not recommending routine vaccination at this time.

– Thank you. That’s brilliant. We had a few questions coming in around that as well. One other question, which comes to eligibility is around with the people who are on temporary protection, visas and foreign nationals who are living in Australia at the moment whether they will be eligible for the vaccine as well?

– So the Commonwealth statements in this place, they’ve said that the vaccine is free for all Australian citizens, permanent residents and temporary visa holders. So if someone’s in Australia on any visa, we believe that means that the Commonwealth has taken the position that they are eligible for free vaccine. So as long as someone’s got any sort of visa, then they’re eligible.

– Thank you. And in terms of will people have I think this has been a question that’s been playing out quite publicly around whether the people will have a choice of vaccine or will it be different at different distribution centres will all doses be the same type? If you’re able to talk to that that would be really helpful. We’ve had a few questions coming in around that as well.

– So I’m sorry. There’s no choice involved. So you can’t go along and go around your, go on the shelf and see which vaccine looks matches best with your preferred sort of vaccination appearance, et cetera. No, there’s no choice. It’s one vaccine or the other. And in fact, the vast majority of us are going to get AstraZeneca just for the reasons that Jade mentioned. There’s five times as many doses of that have been purchased by Australia in the first instance in the next few months, and indeed the Novavax vaccine which we haven’t spoken about much, cause we’ve yet to get it approved or obviously available. There’s another 50 million of doses of that one in the wings as well. So most people will get AstraZeneca. You can’t mix and match. You’ve got to have the same vaccine both times cause we don’t know if mixing and matching works. And most places will have AstraZeneca only. The Pfizer vaccine as I mentioned previously you need to store it at negative 70.It’s only going to be through those hospital immunisation hubs, those hubs through agreements between the Commonwealth and the manufacturer can’t have AstraZeneca vaccine through the same hub. So know that there’ll be one vaccine or the other.

– Thank you. And just as well to, I think there’s a few questions coming through around the references and guides that, that Ben yourself and Jade sharing and referencing today. We just want to let people know that we will send out all of those links. So don’t feel like you’ve kind of rapidly got to write it down, et cetera. We’ll send that out that out to you and make it available on our website as well. In terms of looking at as well with the vaccine should only another question I’ve had is which I think leads from your last question around choice, but around should the most vulnerable get the most efficient vaccine rather than the one that’s 67% effective?

– Yeah. And I think I posted on this one on the chat as well. Not at all, not at all, just we’re in parallel Emma and that’s a good thing. So I think the first thing to remember is that that 67% sort of efficacy statement was for when you take all comers and all schedules, et cetera. The evidence from the AstraZeneca trials that have been released in the more recent evidence that’s been published but not yet peer reviewed in the Lancet is that if you delay the second dose of the AstraZeneca vaccine by 12 weeks, the efficacy increases to above 80%. Compared to less than 60% at a shorter time. Well then less than six weeks I think was the comparitor there. So ATAGI has actually recommended that we do that in Australia that we space the vaccine for AstraZeneca by 12 weeks. And we’ll hit that greater than 80% efficacy if that’s the case. The second point is again just emerged evidence from the UK, not yet peer reviewed. So we’ve got to take everything with a grain of salt, but that in terms of prevention of hospitalisation in the United Kingdom the AstraZeneca vaccine has had appears to be performing better than the Pfizer vaccine in terms of the percentage protection against hospitalisation for those who have been vaccinated. So again, we need to take all of that with a grain of salt but I don’t think it’s as clear cut as saying one’s 95 and one 60. It’s not bad at all. And we really not just Australia but every country is urgently trying to compile as much evidence as we can. And there’s a lot more evidence out there now that tens of millions of people have been vaccinated with these vaccines globally.

– It’s extraordinary, isn’t it? In terms of, I guess it’s your site in terms of the information that’s been gathered literally by the hour that’s influencing decisions that are being made. It’s nothing like working at pace. One of the questions I have here which again might be more of an industrial question. So apply which of these it is but one question that’s come through is what about clients refuse to be sorted by a non-vaccinated employee? Any thoughts that you’ve got around that?

– Yeah. Okay. So again, I think, I mean I dunno if Jade’s got a perspective, but choice of individuals regarding the healthcare or aged care whatever the, I guess the service provider that that is providing a service based on their vaccination status. I guess for me that again, as a non-expert that would bring up a lot of issues around confidentiality. So what is the privacy implications of an individual having their vaccination status known by the the people that provide a care to or even their colleagues. So there’s some privacy principles there I think that come in. There’s the other aspects that if someone has is unable to be vaccinated, for whatever reason there’s actually a very, very short list of those. But for instance, we spoke about pregnant women. So does that mean that a pregnant woman should be discriminated against on the basis of not being able to be vaccinated because we can’t recommend it at this point in time. So I think there’s some equity considerations there. I think this is a little bit of a fraught one. My gut feeling is that people would not be in a position to make that re to assert that choice but I am a completely uninformed individual in that space. And so it’s probably one that we need to take up with people who actually can give you a proper answer.

– Thank you. And I think it shows the that reality doesn’t in terms of the sort of the ethical lens through which number, so many decisions are having to be made and made at pace and worked through it pace as well. In terms of, a question that has come through as well as around how COVID the COVID vaccines relate to the flu vaccines and whether the sort of the waiting period between one and the other?

– Yep. I can take that one. Jade knows these answers as well but she likes the sound of my voice. That’s why she’s holding back. So with the flu vaccine, the precautionary advice from ATAGI at the moment is that you need to space the flu vac or in fact the COVID vaccines from any other vaccine including the flu vaccine by at least 14 days. so you can’t get them on the same day or you’re not supposed to, and it’s not recommended that they be given within 14 days of each other. That’s purely because we just don’t know what the effect is on efficacy of the COVID vaccine if you do that or indeed of the flu vaccine, if you do that. I suspect that as more evidence becomes available that will change and that time interval will drop and it may even be the case that they can be co-administered. I do understand that there’s some work being done internationally on development of combined flu and COVID vaccine actually but we’re a long way off that yet. So can’t be co-administered, should be spaced by 14 days or more. And interestingly, the AstraZeneca vaccine with that 12 week dose spacing does mean that our flu vaccine program might be able to go in between those doses because the flu vaccine will be available probably from early April. So the last thing we want to do is people wait having to wait for flu vaccine for five weeks because of they’ve been COVID backside against COVID. So I think some of the programmatic implications there’ll be eased by that 12 weeks spacing.

– And good I think to keep pointing out that we just keep learning on this front. So there’s some things that as we kind of catch up perhaps the future forums there’ll be some more information that we’re able to share that just isn’t knowing at the moment as well. In terms of, there’s a question here around what consideration and planning has occurred on how the state will partner with local government in standing up mass vaccination centres. So looking at current testing centres that are split between sort of retail, LGAs and properties, and I guess whether the state has figured out an ask for local government to support mass vaccinations as well?

– So the work ahead of us is to think about how the AstraZeneca product will be rolled out. And so that’s where we’re working with the Commonwealth around one of the kind of points of distribution that are allowable in terms of the AstraZeneca product. That will give us a bit of a steer around the points that are allowable or the maximum number of points it may be allowable within the Victorian context from which questions of how do we make this work are really important to us. So we’re getting a bit of a sense and you refer to the general practice expression of interest process a little bit earlier, but a sense of, what’s the work that’s like likely to be done with the sort of general practice community pharmacy echoed GP respiratory clinic that gives us a base for breadth of access. And I guess what we’re trying to do is what is work together around sort of consortium that will enable us to deal with a surge response within communities. So we’re working through some of those processes at the moment and keen to leverage the expertise that exists across the system to do this.

– Fantastic. And I guess when we look at some of the local government immunisation programs that happen for some, infants, for example that there’s some models, et cetera that I imagine can be leveraged off considerably as well.

– [Jade] Yeah, definitely.

– Thank you. We’re getting some questions as well. I’m mindful that they’re quite individual questions in terms of whether someone has, so one question is is it safe for a person with HIV and a current but stable case of cancer to get the vaccine? I’m wondering whether you’re in a position to answer that question today whether that’s something you’d encourage someone to speak with their health professional about?

– So yes, to both Emma, everyone should always speak to their health professional if they’ve got questions because there’s no way that a forum like this can adequately address all the individual concerns and parameters, but in general principles, I can answer. And that is that we have no signal around these vaccines being unsafe in the setting of immunodeficiency whether that’s acquired immunodeficiency or otherwise. So no evidence that it’s unsafe. As is the case for any vaccine if someone has significant immunodeficiency then their response to the vaccine may be not as effective. And so as a consequence, they might not have the same degree of protection against COVID-19 as someone whose immune system was functioning normally. But we also know that people with immunodeficiency had significantly higher rates of severe COVID disease and mortality as well. So again, it’s a really key population we want to protect. We have no evidence of problems with the vaccine and there has been trials done specifically in South Africa of these vaccines in people living with HIV/AIDS. And there’ve been other people with immunodeficiency in some of those clinical trials elsewhere as well. So no reason to not get vaccinated but the efficacy is still open to question.

– Thank you. And perhaps one of our last questions I’m mindful, I think you and Jade have done an incredible job of answering all of the questions we’ve been throwing at you today. So I want to just ask for a little bit if it’s possibly more specific about the plans of vaccinations in prisons we spoke about it earlier in terms of saying that there’s particular cohorts that I know that you’re still working through at the moment around what that program might be. Do you have any detail around the plans for vaccinations in prisons at this stage? Or is it something that you were working through?

– Yes, so we are working with DJCS and Justice Health around models of service delivery that will enable us to sort of efficiently and effectively reach both staff and clients. So certainly strategies and conversations. Live at the moment and it’s actually, that’s my next meeting.

– Thank you. Look, I might wrap up with a couple of key comments. One is it’s really clear should we’ve had lots of sort of workforce and industrial relations issues come up throughout all of the questions as well. So I think it would be great if we can look at VCOSS is happy to commit to looking at who we can have come on with us to help sort of work through some of those issues as well. Ben and Jade, we certainly would look forward to holding more sessions with you both in terms of webinars more generally but also perhaps for some specific, sections of our membership as well. I think that would be incredibly helpful. I just can’t thank both of you enough. We’ve been throwing questions you’ve done your presentation. We’ve been throwing questions at you for an hour. You haven’t missed a beat. You’ve been really direct in responding to questions. Really, really appreciate that. The work that you’re doing, the work that the public health team is doing is just phenomenal. So any generosity and openness in terms of saying look how happy to do whatever you need us to. So we’re really looking forward to continuing to work with you. I want to say a very sincere thank you. I also really want to thank the VCOSS team who are working behind the scenes and we’ll call out Ryan and Amy in particular who have been dealing with multiple tech things or making everything look as smooth as it possibly can on the surface. I’d like to really thank the Auslan interpreters, who’ve been phenomenal today as always, it’s just so critical that we have you there. So a huge thank you to you. As I’ve said, we’ve recorded this today. It will be shared more broadly and it will also be captioned as well. We’re aware of how critically important it is to make this information fully accessible as well. So it’s my chance to as well, thank for all of you who’ve taken the time to join with us. We look forward to continuing to work with you over what is a time I think, to feel pretty optimistic on the back of 2020. So a huge thank you to all of you and look forward to seeing you again soon. Have a great afternoon.

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