The working group welcomes the announcement that NSW is working towards opening up the state, however, cautions against relaxing current behavioural control measures (physical distancing, mask wearing, handwashing/sanitising and lockdown/isolation/quarantine to reduce transmission) or opening too soon before the safety of all population groups in the state are met.
Aboriginal and Torres Strait Islander people (hereafter, respectfully Aboriginal) in NSW are currently being vaccinated at a rate that is about 20 per cent lower than for the general population. The risk for Aboriginal people in the proposed opening date is therefore greater than for the general population. The currently proposed ‘roadmap to freedom’ 70 per cent target does not appear to consider the younger Aboriginal population age distribution nor the greater risk factors experienced by Aboriginal people and Aboriginal children.
The extensive efforts by Federal and NSW governments as well as Aboriginal community-controlled health organisations (ACCHOs) to improve vaccination rates across the state is acknowledged by the working group. This includes the work by the Australian Medical Assistance Teams who are working with ACCHOs within Aboriginal communities identifying and assisting those with access issues and in need to get vaccinated has been shown to be effective in improving vaccination rates in outer regional and remote NSW to date. Targeted, comprehensive and accurate information on vaccination in Aboriginal communities also supports vaccine uptake.
The requirement for individual vaccination ‘passports’ illuminates known challenges for Aboriginal and Torres Strait Islander people without identification, with limited internet access or without autonomy over their own decision making. For instance, many Aboriginal and Torres Strait Islander people do not have access to their birth certificate which will impact identification and access issues to the myGOV website. There is an assumption in the ‘road to freedom’ that all people will have the hardware and services to be able to access the vaccine passports. This may not be true for people in the lowest socioeconomic groups and in outer regional and remote areas in NSW without internet services. Additionally, there are highly vulnerable groups including children in foster care, people with disabilities in full time care and individuals leaving prisons, many of whom will be unable to access these details.
To ensure ‘No One Left Behind’, the working group recommends the following:
- Aboriginal communities are required to have a higher proportion (estimated at between 85-95 percent) vaccinated against COVID-19 than that modelled for the rest of the population before opening up in order to prevent community outbreaks that could cause significant illness and death.
- COVID-19 vaccines and necessary resources are to be urgently provided to ACCHOs and support service teams in discrete communities to improve vaccination rates.
- Travel by fully vaccinated people should continue to be restricted to those regions with lower rates of vaccinations, including Aboriginal communities and regions.
- Remove known barriers to the ‘vaccine passport’, enabling Aboriginal people and other vulnerable populations access to their vaccination data.
- Improve the quality and availability of disaggregated Aboriginal data on COVID-19 infection and vaccination.
- Urgently develop a comprehensive promotion and education plan for Aboriginal people and communities to support vaccination goals.