A Novel COVID-19 Program, Delivering Vaccines Throughout Rural and Remote Australia

Background: The Royal Flying Doctor Service of Australia (RFDS) established a unique SARS-CoV-2 vaccination program. This paper describes the preparation and response phases.Methods: This study includes vaccinations conducted by the RFDS from June 1 2021 until December 31 2021. Prior to each clinic, we conducted community consultation to determine site requirements, patient characteristics, expected vaccination numbers, and community transmission rates.Findings: Ninety-five organisations requested support. The majority (n=60; 63·2%) came from Aboriginal Community Controlled Health Organisations. Following consultation, 360 communities were approved for support. Actual vaccinations exceeded expectations (n=70827 vs. 49407), with a concordance correlation coefficient of 0·88 (95% CI: 0·83, 0·93). The areas of Moree – Narrabri (23·6% vs. 31.5%), Broken Hill and Far West (20·0% vs. 35·7%), Beswick (20·7% vs. 31·6%), Far North (10·2% vs. 19·7%), and East Arnhem (7·1% vs. 11·6%) had the highest population proportion difference between expected and actual vaccinations. These areas identified healthcare workforce shortages during the preparation phase. The areas of Outback – South (20·5% vs. 17·9%), Barkly (13·1% vs. 12·5%), Katherine (9 . 4% vs. 8 . 2%), and Goldfields (4·85% vs. 4·4%) had fewer vaccinations than expected. These areas identified vaccine hesitancy during the preparation phase. Vaccination rates increased with positive polymerase chain reaction cases (r (41) = .35, p = .021).Interpretation: Engagement with community leaders prior to clinic deployment was essential to provide a tailored response based on community expectations.Funding Information: The RFDS COVID-19 response was funded by the Commonwealth Government of Australia.Declaration of Interests: No competing interests to declare Full publication consent was given by the RFDS Clinical and Health Services Research Committee (CHSRC).Ethics Approval Statement: This project was deemed a low-risk quality assurance project by the RFDS Clinical and Health Services Research Committee (CHSRC), which provides oversight for RFDS research projects, on 12 June 2020. All methods were carried out in accordance with Australian HREC guidelines and regulations.