WEBVTT - The killer disease you thought was gone

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<v Speaker 1>From the Australian. Here's what's on the front. I'm Claire Harvey.

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<v Speaker 1>It's Wednesday, May twenty seven, twenty twenty six. A huge

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<v Speaker 1>shakeup is coming for people on the doll with the

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<v Speaker 1>Albanese government saying the existing system isn't helping get welfare

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<v Speaker 1>recipients into work. That story is live now at the

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<v Speaker 1>Australian dot com dot AU. One patient is dead and

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<v Speaker 1>scores of Australians are infected with diptheria, a disease that

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<v Speaker 1>haunted humanity for thousands of years and killed millions of children.

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<v Speaker 1>Vaccines all but eliminated diphtheria, but now an outbreak is

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<v Speaker 1>spreading from remote Aboriginal communities and seriously worrying experts. So

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<v Speaker 1>what's causing it and how do we fight back?

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<v Speaker 2>This buy is not expected to live. He was not immunite.

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<v Speaker 2>Every twenty minutes a child is taken ill with diphia.

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<v Speaker 2>Every three hours a child dies from deferia. Mother, have

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<v Speaker 2>you forgotten to protect your child?

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<v Speaker 1>Natasha Robinson is The Australian's Health editor and Natasha, this

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<v Speaker 1>is a question I wouldn't have had to ask you

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<v Speaker 1>in generations past. You and I are both parents and

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<v Speaker 1>once upon a time parents were absolutely terrified of diphia.

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<v Speaker 3>What is diperia, well, Diphtheria is a bacterial disease that

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<v Speaker 3>has two iterations. It can be cutaneous, as in it

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<v Speaker 3>affects a skin, or it can be respiratory, which is

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<v Speaker 3>a more serious and potentially fatal version of the disease.

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<v Speaker 3>It's a horrendous disease and it is very understandable why

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<v Speaker 3>such a fear of this terrible disease when it was

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<v Speaker 3>endemic in the community. The respiratory version results in the

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<v Speaker 3>sort of coating over the throat that eventually makes it

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<v Speaker 3>incredibly difficult to breathe, and it can lead to heart

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<v Speaker 3>attacks and severe respiratory problems, which in years gone by

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<v Speaker 3>had death rates almost as high as one in ten.

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<v Speaker 3>The kachaneous version that has been the predominant strain that's

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<v Speaker 3>been spreading around Remote Australia causes really horrendous skin source.

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<v Speaker 3>But the real concern is when we started to see

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<v Speaker 3>higher and higher rates of the respiratory version of this

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<v Speaker 3>disease in Remote Australia, which has been occurring more recently

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<v Speaker 3>as the spread has gotten larger and larger.

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<v Speaker 2>We've done everything we can another young life wasted on

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<v Speaker 2>necessarily because well meeting parents delayed time, maybe taking on

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<v Speaker 2>towards tragedy in your home.

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<v Speaker 3>Governments across the country are racing to contain the largest

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<v Speaker 3>dip theoria outbreak since records began in Australia.

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<v Speaker 1>A dip theoria outbreak in the Northern Territory has now

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<v Speaker 1>spread to Western Australia, South Australia and Queensland. The government

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<v Speaker 1>is preparing to roll out an emergency support package. With

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<v Speaker 1>more than two hundred and twenty cases of diphtheria reported.

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<v Speaker 3>There was a general understanding or belief that this was

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<v Speaker 3>virtually an eradicated disease in Australia. In fact, it has

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<v Speaker 3>been popping up, particularly in the past few years. We've

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<v Speaker 3>seen a cluster of outbreaks in Queensland, and in fact

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<v Speaker 3>the genomic analysis, at least without being definitively epidemiological evidence,

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<v Speaker 3>indicates that this current outbreak has emanated from that Queensland

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<v Speaker 3>outbreak which was bubbling along up until about twenty twenty

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<v Speaker 3>three but apparently was not fully stamped out.

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<v Speaker 1>I have thought that the diffory vaccine that you get

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<v Speaker 1>as a child and the childhood immunization program gives you

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<v Speaker 1>lifelong immunity. Is that still what scientists think or not?

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<v Speaker 3>No, it's not the case. The immunity from dip theoria

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<v Speaker 3>childhood vaccinations do wane over time in around about midlife.

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<v Speaker 3>It's sort of from the age of fifty. People in

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<v Speaker 3>order to have immunity will need to be boosted. So

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<v Speaker 3>over the age of fifty, if you haven't been boosted,

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<v Speaker 3>and a lot of people, not a lot of people,

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<v Speaker 3>but some people, if you've had a cush or you've

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<v Speaker 3>been exposed to tetanus, will have been boosted for dip theoria.

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<v Speaker 3>Because the tetanus vaccine contains potassis and diphtheria. It's a

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<v Speaker 3>triple vaccine, so that sort of has given some people

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<v Speaker 3>immunity without them necessarily even knowing if they have been

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<v Speaker 3>boosted for tetanus. But no one virtually in Australia is

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<v Speaker 3>being told by their GP at this stage, Oh, you're

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<v Speaker 3>over fifty, you haven't had a booster for diptheria in

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<v Speaker 3>the past ten years, we'd better boost you for dips theira.

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<v Speaker 3>And that's simply because the disease has not been in

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<v Speaker 3>our community. But certainly if you're over fifty and you

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<v Speaker 3>haven't received a booster in the last ten years, your

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<v Speaker 3>immunity to dip through will have waned significantly.

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<v Speaker 1>There's two big things happening, I suppose in vaccination. Looking

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<v Speaker 1>at it from the outside, I'm not an expert like you,

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<v Speaker 1>but it seems as though childhood vaccinations for some conditions

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<v Speaker 1>are on the way back down again after some significant

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<v Speaker 1>reforms led by US here at News Corp Australia which

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<v Speaker 1>resulted in a huge uptake in childhood vaccines. That was

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<v Speaker 1>the no Jab No Play campaign. Parents will only be

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<v Speaker 1>allowed to send their children to childcare if they're vaccinated.

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<v Speaker 3>It would be an absolute crime to not use the

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<v Speaker 3>vaccines we already have.

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<v Speaker 1>The no Jab no Play legislation was passed by Parliament

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<v Speaker 1>last night. And there's some hesitancy to vaccines among adults

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<v Speaker 1>that we're seeing after COVID. Are either of those Do

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<v Speaker 1>you think at play in the defior outbreak that we're

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<v Speaker 1>seeing now.

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<v Speaker 3>I think we have to assume that they are. But

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<v Speaker 3>there's a lot of nuance here because this is an

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<v Speaker 3>outbreak affecting Remote Australia and in general Remote Australia, Aboriginal communities,

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<v Speaker 3>Aboriginal controlled health services do extremely well with childhood vaccination,

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<v Speaker 3>and the national rates of childhood vaccination for Indigenous children

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<v Speaker 3>sit higher than the national rates for all five year olds,

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<v Speaker 3>for instance, by about one percentage points.

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<v Speaker 1>Quite significant.

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<v Speaker 3>Why are we seeing a spread of such an ancient

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<v Speaker 3>disease across remote Australia and that boils down to the

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<v Speaker 3>same reasons in terms of endemic disadvantage, living conditions, vulnerability

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<v Speaker 3>of health. Are the same reasons that we have rheumatic

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<v Speaker 3>heart disease in Remote Australia, the same reasons we still

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<v Speaker 3>see cases of leprosy in the Northern Territory. So this

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<v Speaker 3>is a very vulnerable population and I think this is

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<v Speaker 3>something that is going to require some policy shifts in

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<v Speaker 3>terms of vaccination schedules once we get this outbreak under control,

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<v Speaker 3>to make sure that we don't see something like this

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<v Speaker 3>occur again.

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<v Speaker 1>Do you mean potentially boosters for adults of recommended as

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<v Speaker 1>part of adult healthcare?

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<v Speaker 3>Yeah, I do. I think that there has to be

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<v Speaker 3>serious consideration that when we're looking at the advice in

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<v Speaker 3>the National Numnization Handbook, that we have some explicit advice

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<v Speaker 3>perhaps that Aboriginal Torres Strait Islander people should be boosted

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<v Speaker 3>after the age of fifty if they haven't had a

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<v Speaker 3>booster in the past ten years. In the wake of

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<v Speaker 3>this outbreaker, I think surely that's something that has to

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<v Speaker 3>be on the table.

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<v Speaker 1>It's always seemed to me as though vaccinations, the vaccine

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<v Speaker 1>program was almost a victim of its own success in

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<v Speaker 1>those parts of Australia where there is increasing hesitancy. Nobody

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<v Speaker 1>my generation has really heard of polio. They don't understand

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<v Speaker 1>why the polio vaccine was this game changer that saved

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<v Speaker 1>hundreds of thousands of people's lives. Similar to hooping cough.

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<v Speaker 1>They've never seen a child suffering from hooping coff and

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<v Speaker 1>don't necessarily know why they should have to get their

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<v Speaker 1>child vaccinated because it's horrible to take a baby to

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<v Speaker 1>get a vaccine.

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<v Speaker 2>Cry you feel awful.

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<v Speaker 1>What do you think about what's happening? More generally the

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<v Speaker 1>big picture, if we zoom out about vaccines in Australia.

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<v Speaker 3>I think that what we're clearly seeing, and this is

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<v Speaker 3>probably like a Canarian The coal mine in terms of

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<v Speaker 3>this dip theory or outbreak, is the re emergence of

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<v Speaker 3>diseases we thought were a thing of the past. We're

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<v Speaker 3>seeing it already with measles. I think, if we start

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<v Speaker 3>to see polio in our community, my god, what an

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<v Speaker 3>unbelievable state of affairs. I mean, I remember as a

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<v Speaker 3>school student having a science teacher, you know, who had

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<v Speaker 3>polio as a child, and the way I vividly remember

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<v Speaker 3>the way he woked. He wore a big shoe that

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<v Speaker 3>raised his foot. I remember the stories that I heard,

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<v Speaker 3>even though it wasn't really happening in my lifetime. And

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<v Speaker 3>I remember the stories of kids in iron lungs, and

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<v Speaker 3>those stories are not in the minds of young parents anymore.

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<v Speaker 3>We are seeing the tip of the iceberg here. I think,

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<v Speaker 3>in the wake of COVID, in terms of hesitancy and

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<v Speaker 3>dropping rates of vaccination, which are in years from now on,

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<v Speaker 3>are going to see an increasing reemergence of these diseases.

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<v Speaker 3>And I'm not quite sure how we get the message

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<v Speaker 3>across that these are absolutely terrible diseases.

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<v Speaker 1>Terrible diseases. The government doesn't really do a lot of

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<v Speaker 1>explicit messaging. I mean, I am more exposed to messaging

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<v Speaker 1>about how smoking is bad for me than I am

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<v Speaker 1>to why the measles vaccine is important and what Tennis

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<v Speaker 1>even is I mean you and I both used to

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<v Speaker 1>having tennis shots as soon as you fell over or

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<v Speaker 1>got bitten by a dog when you were a kid. Again,

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<v Speaker 1>I haven't been exposed to that as a parent in

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<v Speaker 1>the past decade and a bit of parenting. Yet.

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<v Speaker 3>We now have a Australian Center for Disease Control and

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<v Speaker 3>this is something that they're thinking a long and hard

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<v Speaker 3>about and they're in this leadership space now led by

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<v Speaker 3>Professor Zoe Wayner, and I think she's thinking very deeply

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<v Speaker 3>about how to get that message through. Coming back to

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<v Speaker 3>this outbreak itself of diphtherior, we know that there is

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<v Speaker 3>an incredibly effective network of Aboriginal community controlled health services

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<v Speaker 3>in across remote and regional Australia. They do a magnificent job.

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<v Speaker 3>They are highly trusted by the community. You know, in

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<v Speaker 3>some communities the health service is the center of community life.

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<v Speaker 1>The staff are from the.

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<v Speaker 3>Community quite often, and in COVID nineteen they did an

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<v Speaker 3>incredibly good job. There were a lot of fears that

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<v Speaker 3>Aboriginal communities in remote Australia were going to cop the

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<v Speaker 3>absolute brunt of COVID nineteen and they didn't, and that

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<v Speaker 3>was largely to do with the efforts of community controlled

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<v Speaker 3>aboriginal health organizations who were well resourced and the full

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<v Speaker 3>gamut vaccination, absolutely rigorous contact tracing, et cetera, et cetera.

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<v Speaker 3>That seems to have been slow to get off the

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<v Speaker 3>mark here with diptheria, and there's questions I think to

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<v Speaker 3>be asked about that was there a lack of resourcing?

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<v Speaker 3>Were these vaccines to boost adults distributed early and quickly?

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<v Speaker 3>Were contact tracing teams sent out to ring fence these

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<v Speaker 3>outbreaks in a timely manner? Why was it allowed to

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<v Speaker 3>bubble away this outbreak that has been building up since

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<v Speaker 3>October last year with the Commonwealth calling an emergency in May.

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<v Speaker 3>So I think these are all pertinent questions here. And

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<v Speaker 3>the vaccination issue is a wider issue and it's a

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<v Speaker 3>national issue. But we have a very vulnerable community here

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<v Speaker 3>that is being subject to an outbreak that is totally unprecedented,

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<v Speaker 3>and I think we've got some lessons to learn from this. Well.

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<v Speaker 1>I'll be booking my diptheria vaccination booster this afternoon. Thanks Natasha,

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<v Speaker 1>Thanks Claire. Natasha Robinson is The Australian's Health editor. You

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<v Speaker 1>can read all her work right now at the Australian

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<v Speaker 1>dot com, dot au