The top four agenda items for the PM’s COVID vaccine war cabinet

By Stephen Duckett

Tuesday April 20, 2021

The PM announced major changes to Australia’s vaccination rollout and quarantine system following a late-night national cabinet meeting. (AAP Image/Dan Himbrechts)

If the newly announced, twice-weekly vaccine meeting of the prime minister, premiers and chief ministers is to be anything other than a talk fest and blame shielding opportunity for the prime minister, then it needs to have a clear agenda and timeline.

It also needs to be accompanied by a work program for the Health Chief Executives’ Forum to ensure that the first ministers come to the national cabinet meetings well prepared, so their time is used efficiently.

The so-called ‘war cabinet’ has the potential to change dramatically Australia’s approach to the COVID-19 vaccination rollout, to iron out the current mess, and set a clear strategy for a way forward. It should usher in a new era of transparency and cooperation.

Four key issues should dominate the agenda of the meetings, the first two mainly operational and others strategic.

Issue 1: Fixing the vaccine rollout to the over-50s

The first agenda item here should be to publish the production schedule for the AstraZeneca vaccine – how many will come off the CSL production line each week? Targets should then be set about how many of those should be in arms within a week. It may be that the commonwealth’s preferred, ‘bespoke’, GP and pharmacy strategy could be made to work for this group. At least, the commonwealth might take responsibility to get it to work, with the aim of having all over-50s vaccinated by the end of July. There should be fortnightly public reporting of progress against targets, both of vaccine production and vaccinations.

Issue 2: Developing a new vaccine roll-out strategy for the under-50s

Because the preferred vaccine for the under-50s, Pfizer, has more complicated storage requirements than AstraZeneca, the under-50s strategy will be quite different from the over-50s and will rely on mass vaccination centres. States should be tasked with setting these up, but they should be integrated into the existing system and we shouldn’t have a separate website for commonwealth GP locations and state centres, as we do now. Where GPs have the capacity to manage Pfizer vaccines, they should be part of the mix, but the roll-out should not rely solely on GPs and pharmacies. As new vaccines, such as Novavax, become available, the under-50s roll-out strategy should be revised.

Again, there should be transparency about how many doses of the Pfizer vaccine will arrive each week, how many will go to each state, and what the target is for vaccines into arms. And again, there should be fortnightly reporting of progress against targets.

Issue 3: Overcoming vaccine hesitancy

Between 25% and 30% of Australians are reported to be ‘vaccine hesitant’. That figure may be even higher given the shemozzle over the past week. Addressing vaccine hesitancy requires first identifying and segmenting the various groups. The strategies to address vaccine hesitancy among young women will be quite different from the strategies to address hesitancy among populations who are from culturally and linguistically diverse backgrounds. The Health Chief Executives’ Forum should be tasked to develop a vaccine hesitancy strategy which can be rolled out from mid-year, when pent-up demand from those who are keen to be vaccinated begins to taper. The first ministers should receive fortnightly reports on the vaccine hesitancy strategies.

Issue 4: Whole-of-government considerations

A top-level war cabinet allows consideration of the impacts of the pandemic across the whole of government. This includes consideration of the criteria for reopening borders and helping to restore the economy by re-introducing international tourism and international students. The first ministers should also consider whether there should be an interim change to the hotel quarantine arrangements for people who arrive in the country with a verified vaccination record. Perhaps the heads of premiers’ and the prime minister’s departments could be charged with producing a paper on these whole-of-government issues.

Rather than each war cabinet meeting considering each of these issues, perhaps the first meeting of each alternate week could deal with the strategic issues, and the second meeting of each alternate week deal with the operational matters of tracking progress and tweaking policies to ensure that the published target are being met.

The creation of the war cabinet provides an opportunity to reset the vaccination strategy, involve the states, and rebuild public confidence. But public confidence will only be restored if there is a new, high level of transparency. Australians need to be confident that targets are more than thought bubbles for media consumption, and that there is solid bureaucratic work behind the targets that links the aspiration and the delivery.


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