One town and a gaping vaccination chasm. How did it happen?
Janeiqua Cedric is vaccinated on the beach in South Yarrabah, Far North Queensland, where local health officials are racing to increase COVID-19 vaccination rates. (Background Briefing: Mayeta Clark)
"Anyone want a COVID vaccine?" calls Sue Andrews down a long driveway, where a young girl is cooling herself with a garden hose.
It's early afternoon on a steaming hot mid-October day in Yarrabah, Far North Queensland.
Sue Andrews, the CEO of Yarrabah's Aboriginal medical service Gurriny Yealamucka, is going door-to-door on day two of an urgent vaccination drive.
With COVID cases still mounting in the southern states, it's a race against time to get Yarrabah vaccinated before the Queensland border opens and the virus finds its way here.
An elderly man walks out onto the verandah.
"Hey, brother Blake, you want to get vaccinated?" she asks.
"Not today," says Blake Davidson.
Sue Andrews, CEO of the Gurriny Yealamucka health clinic, chats with Yarrabah resident Blake Davidson during a door-to-door vaccination drive. (Background Briefing: Mayeta Clark)
He's heard stories about blood clots and is nervous about getting the jab.
Ms Andrews pauses for a moment, then tells him she's scared about what could happen when visitors return to Yarrabah, a 45-minute drive from the tourist mecca of Cairns.
She can barely suppress her relief when Blake finally agrees to get his first Pfizer dose.
Mr Davidson inhales sharply. "Only a little pinch," says the vaccinating nurse.
As metropolitan Sydney's double-dose vaccination rate soars above 70 per cent, Yarrabah's doctors say their latest figures indicate just 28 per cent of locals here have had two doses.
As one of Australia's most vulnerable communities, Yarrabah should have been towards the front of the queue for vaccination under the federal government's rollout plan.
But over six months since the rollout began, health workers are still fighting an uphill battle.
At the other end of the street, Dr Jason King feels the same sense of urgency as Ms Andrews, his boss at the Gurriny clinic.
An added incentive to get the Yarrabah community to turn out for the vaccination drive — kids line up at an ice cream van hired by the Gurriny clinic. (Background Briefing: Mayeta Clark)
Dr King's small team of health workers are lugging eskies of Pfizer door-to-door in the sticky 33-degree heat.
The clinic has hired an ice cream van for extra incentive, which is playing Greensleeves on a loop.
"When people start travelling around Australia, the virus will follow them," Dr King says, like a "smallpox-riddled blanket".
With a population of 3,500, Dr King fears that if COVID comes to an unvaccinated Yarrabah, 250 people could die in a year.
"I don't think devastating is the right word," he says. "It would destroy a community of this size in many respects."
So how did a gap in vaccination rates become a yawning chasm here? The ABC's Background Briefing visited Yarrabah over several weeks to find out why.
The answer starts at the beginning of the vaccine rollout, over six months earlier.
The rollout flatlines
The road to Yarrabah winds through sugarcane fields, along azure coastline, then climbs up a thickly forested mountain range.
On the other side, it emerges from rainforest into a town that hugs the edge of the Coral Sea.
The view over the town of Yarrabah, Queensland. (Background Briefing: Mayeta Clark)
Clifton and Dianne Burns and their son Thorne enjoy their holiday shack by the sea in South Yarrabah. (Background Briefing: Mayeta Clark)
Dr Jason King, a Yued Noongar man from Western Australia, first made the drive over the ranges after moving to Cairns, and instantly fell in love.
He has been head doctor at Gurriny Yealamucka — "place of good healing" in the local Gunggandji language — for three years.
"I always say we don't trade in medicine and pills, we trade in trust," says Dr King of Gurriny's work.
That trust has been built up over the decades since the community-owned and operated clinic was first founded as a small medical outpost in the 1980s.
Dr King says through the clinic's childhood vaccination program, almost 100 per cent of children in Yarrabah get fully immunised by age five.
"It shows the community understands ... the benefit of the vaccine and they happily engage with it," he says.
"We just need to understand how to apply that to a very much more controversial environment."
Yarrabah's vaccine rollout hit an early hurdle when the town's aged care facility failed to get vaccines during the phase 1A rollout due to delays.
Head doctor at Gurriny Yealamucka, Dr Jason King (right) talks to Clayton Abreu from the First Nations Team at Cairns Tropical Public Health Unit. (Background Briefing: Mayeta Clark)
It left some of the community's most vulnerable members at risk, until the Gurriny clinic stepped in and vaccinated residents with its own stock.
But there were some promising signs too.
In late March, as Gurriny received its first batch of Astrazeneca doses, a steady stream of residents were ready to roll up their sleeves.
Then, two weeks later, the Prime Minister made a devastating late-night announcement, recommending Astrazeneca be used with caution for people under 50 due to a rare blood-clotting condition.
The vaccine rollout in Yarrabah flatlined overnight.
"Nobody came," recalls Dr King.
"We asked people. 'No, I don't want the vaccine anymore,'" was the response from many.
Suddenly, Yarrabah had no viable COVID vaccine for the majority of its young adult population, a significant number of whom have underlying health conditions.
"Even the over-50s who had access to the vaccine, they were also similarly affected by that change in that and the confusion that that created," Dr King says.
It took another three months for a supply of Pfizer to reach Yarrabah, with state and federal health departments offering a litany of reasons for the delay.
In the meantime, social media disinformation had been wreaking havoc with Gurriny's vaccination messaging.
Plagued by disinformation
Father Les Baird and Father Wayne Connelly sit in a cool corridor at the end of the pews after a Sunday church service in Yarrabah.
Father Wayne has just delivered a pro-vaccination sermon urging parishioners to get the jab for "our people, for our community, for our families", because "we need to be ready".
These days Father Wayne might be singing from the same song sheet as Gurriny, but that wasn't always the case.
Father Leslie Baird and Father Wayne Connelly, pastors at Yarrabah's Anglican church, after a Sunday service. (Background Briefing: Mayeta Clark)
He was once unsure whether getting vaccinated was the right thing for a Christian to do.
"I was looking at the Bible and asking God to show me, through the power of the Holy Spirit, and to give us directions, you know?" he says.
And the Bible wasn't the only thing he was looking at.
As Yarrabah's spiritual leaders relax in the pews, they discuss the social media videos that have spread through the community.
In one video, a woman can be seen sticking a key on her partner's shoulder where he has supposedly received his COVID shot, to demonstrate the spot has become "magnetic".
In another, a popular Aboriginal filmmaker and activist exhorts people to turn their passionate distrust of police towards their health service.
Many of the videos flying around social media have a Christian bent, touching on the apocalyptic "End Times" themes from the New Testament book of Revelations.
Queensland Health pharmacist Rebecca Wilkins prepares syringes with Pfizer vaccine in preparation for the door-to-door vaccination drive in Yarrabah in October. (Background Briefing: Mayeta Clark)
"We had fears because there were Christians saying things as well, that if you take the vaccine, you're taking the mark of the beast," says Father Les, who is also the chairperson of Gurriny.
The pair talked at length with their families and decided they had to set an example for their community.
They got their first Astrazeneca shots in July.
"There were seven of us that had made a decision and we all got vaccinated," says Father Les. "One after another, like a rolling effect, a ripple effect."
But pockets of resistance to the vaccine remain, even among the well-informed.
In Yarrabah, making vaccination converts is a process that can take time.
Local knowledge
Her face shaded by a short-brimmed felt hat, Sue Andrews stands in the streets of Yarrabah with her deputy Dr Jason King, strategising about where to send the vaccination teams next.
They're a dynamic duo and their memory for which areas covered and households missed is forensic.
At the start of the pandemic, Yarrabah's leaders agreed that as heads of the Gurriny health service, they should steer the community through the crisis.
Such is the position of trust they hold.
Sue Andrews looks through a patient list during a door-to-door vaccination drive along the beaches in South Yarrabah. (Background Briefing: Mayeta Clark)
Nurse Katie Barron, Dr Joy Linton and Sue Andrews throw ice creams into eskies in preparation for the final afternoon of door-to-door vaccinations. (Background Briefing: Mayeta Clark)
Ms Andrews is a Bunaba Jaru woman from the northern Kimberley region of Western Australia but grew up in Yarrabah and, despite leaving a few times, has always found her way back.
"Yarrabah is described as paradise by the sea," she says. "It's absolutely gorgeous."
Her affection for the town is coupled with a deep understanding of its people and how medical services need to be delivered here.
Unlike metropolitan medical centres, where GP appointments are run in set timeslots, consultations at Gurriny last as long as they need to.
Back in August, Gurriny held a "super vaccination week" with music, games and lunch to encourage locals to come in for their first shot.
Out of the 186 people who attended, four got vaccinated on the spot, no questions asked, while four said they needed to think about it further.
Gurriny doctor Peter Roach consults with Michael Lilly through a car window. (Background Briefing: Mayeta Clark)
The remaining 178 needed a 20-minute conversation with a nurse or doctor before they felt comfortable enough to proceed.
"If they have any chronic illness, they're not going to just come in and get the shot," Ms Andrews says.
"This is what the state and federal government don't understand.
"You can see in Sydney and all that where they're lining up? But here in a community like ours, our mob are going to be asking these questions."
Back in the Gurriny clinic, she passes one of two as-yet unvaccinated health workers in the hallway.
Gurriny Yealamucka health clinic in Yarrabah was established as a small medical outpost in the 1980s. Today, it's a fully-fledged health service owned and operated by the community. (Background Briefing: Mayeta Clark)
A billboard encouraging vaccination in Yarrabah. (Background Briefing: Mayeta Clark)
Ms Andrews says that despite all the information available, the health worker is still fearful of the "government-forced things" that happened to First Nations people in the past.
Outside her office, Ms Andrews greets her assistant, who for a long time believed that finally, white Australia had found a way to get rid of Aboriginal people, and that the COVID vaccine was it.
She eventually changed her mind and got vaccinated.
Help from out of town
On a Monday afternoon in late September, Ms Andrews gets a call to inform her a federal government contractor is coming to vaccinate people in Yarrabah the following day.
She is floored and angry.
For months she has been asking for more funding so she can relieve staff who are juggling daily clinical needs with public health programs and the extra workload from the pandemic.
Despite their frenetic schedules, Ms Andrews and Dr King scramble. Notices go out on Facebook; a suitable location is found.
They have to spend most of the next morning explaining community protocols to the contractor.
He's confident that he and his team will vaccinate 500 people over the next few days.
On the first afternoon, the contractor vaccinates five people. On the second day, he jabs 12.
On the third day, the local supermarket tries to help by offering free fish and chips to anyone who gets the shot.
Anthony Fourmile declines to get vaccinated on the final afternoon of the door-to-door vaccination drive in Yarrabah. (Background Briefing: Mayeta Clark)
They get a handful more.
Later, Ms Andrews confesses she lost her temper on a conference call with the federal and state health departments and the National Aboriginal Community Controlled Health Organisation, or NACCHO.
"We've been asking for resources from the very beginning," she says. "For me to get up and grandstand and rant, I felt quite embarrassed by it."
But Ms Andrews's angry outburst got her funding for two vaccinating nurses, effective immediately.
Gurriny is not the only First Nations medical services provider spoken to by Background Briefing to raise a lack of funding for a proper vaccination rollout.
Brenda Garstone, CEO of Yura Yungi in Halls Creek, said the money they received equated to little more than "seed funding", arriving in blocks of tens of thousands of dollars at a time.
To run an effective vaccination program with four to six fully-funded positions, Ms Garstone says she needs between $300,000 and $600,000.
"We're at war. And it's a matter of time when a bomb is going to be dropped in our community," she says.
"What do we do to protect it, protect our mob from being impacted should it come tomorrow? I don't feel that sense of urgency."
The federal Department of Health says it has given more than $150 million to the pandemic health response for First Nations people.
Dawn Casey, deputy CEO of NACCHO, said federal funding to Aboriginal health services for the vaccine rollout was $29 million, and that it had been adequate.
She said no requests for funding had been turned down.
Leading by example
On the last day of the door-to-door event in Yarrabah, Queensland Premier Annastacia Palaszczuk announces the border will open to vaccinated travellers on December 17.
Sue Andrews is rattled.
"I was actually quite scared when I heard news that the borders were opening," she says.
"Our mob think we live in this protective environment in Yarrabah, it doesn't hit us."
The mobile vaccination van belonging to the First Nations team at the Cairns Tropical Public Health Unit and the ice cream truck hired for the vaccination drive parked outside a home on the outskirts of Yarrabah. (Background Briefing: Mayeta Clark)
The clinic car pulls up at a blue house and four small kids rush out laughing and surround the nurse.
"Where nana?" asks Ms Andrews.
Soon, Dorothea May, 70, wanders up to the front fence.
Ms Andrews explains that they're here vaccinating people door-to-door.
Dorothea hasn't had her vaccine yet. She really wants to, but her adult grandchildren, who live with her, are dead against it.
Dorothea remembers people suffering in iron lungs when she was small. She pulls up her right sleeve and shows her grandchildren the scars on her upper arm.
"See the little marks and that I've got here," she says. "That's when we were kids here, we had to get polio shot. We had to get everything."
"Are you happy to get it today?" asks the clinic's nurse.
"Yeah, I'll get it," says Dorothea.
"I'll get one with you then," says Dorothea's grandson, Neil.
Dorothea May receives her first COVID vaccination shot from Gurriny nurse Katie Barron while younger family members watch on. (Background Briefing: Mayeta Clark)
Dorothea's grandson Neil Narrier gets his first COVID vaccination. Neil had been reluctant to get vaccinated because of wild rumours he had heard about the vaccine. (Background Briefing: Mayeta Clark)
Within 10 minutes, Dorothea and three other young adults in her home have had their first jab of Pfizer.
Ms Andrews and her team move on and head towards the beach a few kilometres out of town, where some of the townspeople have holiday shacks and family blocks.
A white van is parked near an empty tent next to the beach.
She spots two young German men who have come to visit a friend in south Yarrabah.
"You want to have your COVID shot while you're here?" asks Ms Andrews. "We're doing door-to-door COVID shots with everybody."
"Not today," says the visitor.
Ms Andrews and her team say goodbye.
"There you go," she says. "People are here we don't even know and they're not vaccinated. What next?"
Listen to Background Briefing's podcast and subscribe for weekly updates.