Anu: Thank you Ange, and thank you everybody for joining us today. It's really good that people from Sydney and people from Melbourne have taken the time to join us here, and we are hoping that we'd have a good opportunity to make sure all our COVID vaccine and COVID questions are either heard, answered or perhaps put on a file for later answering. But before we start, I would like to do a quick Acknowledgement of Country where all of us join from. So I am joining from the traditional lands of the Wurundjeri people of the Kulin nation. Really like to pay my respects to Elders past, present and emerging, and just acknowledge that this land has made many generations of migrants like myself welcome, and sovereignty has never been ceded and the longest continuous civilization on the planet 60,000 years. So really blessed to be here. I'm also really very, very fortunate to have a fantastic mix of people here today with us virtually over zoom. So we've got the mix from the western and northern suburbs of Melbourne, a representation of the Indian community. So I'd really like to thank all of you for taking part in the project and through the WhatsApp chat answering some of the questions. So like we said before in the chat, the purpose of the Burnet project is to actually create some awareness around the kinds of questions that are in people's minds while they're making decisions about taking the COVID-19 vaccines, and also just generally, acknowledging that there is a lot of anxiety around what's in the future, the vaccines itself and the safety aspect that all of us are concerned about. So we really wanted to see if we could get reliable, trustworthy and accurate information, especially when we are so bombarded by social media and all the other news that comes through. And while I think there's a recognition that many of us might be mandated to take the vaccine. It's always better if we make that choice freely. So really, really, really pleased to have a fantastic panel with us today, with people who've got experience in health, vaccine epidemiology and forms around some of these questions. First, I'd like to just acknowledge Stephanie Fletcher-Lartey, who's with the Burnet Institute. She has over 24 years' experience in public health and done a lot of work in infectious diseases, surveillance, environmental health and emergency response. So welcome Steph. Also extremely lucky to have Doctor Naru Paul. And Doctor Paul is sorry, I just completely mispronounced your name, my apologies. Doctor Naru Paul. Doctor Paul is the director and senior staff specialist at the South Western Sydney Public Health Unit at Liverpool in Sydney, and as all of us would have seen unfold on our TVs, it was definitely the epicenter of the pandemic in New South Wales and indeed in Sydney. Doctor Paul has successfully managed more than 21,000 cases, along with teams. He's conducted several orientation programs for COVID-19 vaccination for doctors, nurses and healthcare workers across southwestern Sydney, and we have definitely seen that unprecedented rates of vaccine take up in that part of the world. It's a testament to the work that Doctor Paul and his teams have done. He's taken lead roles in the implementation of childhood and adult vaccination programs throughout his career. In in the last 38 years, over Australia and overseas, the fellow of the Australasian Faculty of Public Health Medicine, Fellow of the Royal Australian College of Rural and Remote Medicine, and fellow of the Australasian College of Health Service Management. Wow. Fantastic. So, so, so lucky to have him here. Last but not the least, our MC for the day, Nayna Bhandari. People in Melbourne might know Nayna, but let me just do a quick introduction. Nayna is an activist, a producer, a community developer, a social worker, a tireless volunteer and a co-founder of the Oorja Foundation, which was founded in 2014. It's a community based organization which works at grassroot level, particularly in the northern and western suburbs in the cities of Hume, Whittlesea and Wyndham. She's done a lot of work with the family violence and but over the last 18 months, a lot of grassroots work in community, helping people with COVID-19 and more recently, in trying to dispel myths around the vaccine uptake. Now this is my queue to shut up and hand over to Nayna. So over to you, Nayna.

Nayna Bhandari: Thank you. Anu, thank you so much. And welcome everyone to this session. And I hope that it will go the way we all are hoping it to be. Um. Ah, my name is Nayna Bhandari, and I'm a social worker by profession, and I'll be hosting the session today and asking the questions that were developed through the conversation that have been happening in your Whatsapp group in past few weeks. So in case, if you have any other additional questions, you can chat, put that in a chat box, or you can even raise your hand to the reaction icon. And there might be some time in the end, which is especially being kept so that you can ask any further questions, if you have got and just a bit of housekeeping that if you can, please put yourself on mute, which you already have done that will help everyone to like, you know, have a very clear and nice session. So moving on to the agenda, there will be, first, we'll have some questions about COVID and the vaccine work and what the side effects are. Then we'll have some questions about the long term effectiveness of vaccines, and if we'll need boosters, or if we need new vaccine will be developed, what will they do? Then we'll wrap up with some questions about what's next and what the next few years might look like, in which I'm actually personally very much interested in, and I'm actually really looking forward to hear some of these answers as well, because like most of you, I'm also a migrant, and I really, really want to travel as well. So that is why I've got a special interest for this particular session. The important thing is tonight about asking all the questions you have ever wondered about these topics. Our panel is ready to answer any question you can think of, and you can either jump in or ask the panel and add questions, and in the end, we will open up again for more questions. So this is about the agenda for tonight, and let's move on to the introductory question. So I think Mamta had a question. So shall we take that question first before we formally start? Yeah, I think so let's hear that question that we don't want to miss it. Yeah. I

ah, Mamta, you on mute?

Mamta: Yes, I do, actually. Now I'm pretty scared to ask.

Nayna Bhandari: Why is that?

Mamta: I don't know. Just I had my I had my first step now, more than two weeks after I you know, I chat on our WhatsApp group. I was like before that I was very dire. I thought that I'm the only one maybe who hold that many things in my brain. You know, I'm a single mom, as I mentioned in the group, I'm mother of 2, 8 and 10, and they are old enough to know the side effects of these things. And they saw social media like TikTok, stuff like that, isn't it? So they always worried about my health. They think that if something happened to me, because we don't know the side effect, long time side effect of this vaccine. Yeah, I got my Pfizer anyway. I just want to let you guys know and by the like, don't you think that like, like, the kids that kind of face should be, you know, like, should be add like they they should do the government should do to make them comfortable. Something, you know, is there have a way to, you know, like, I don't know what I trying to say. I hope you guys understand.

Nayna Bhandari: So is it in regards to the vaccination for children, so that they should be safer? 

Mamta: Yeah. 

Nayna Bhandari: Okay, alright, okay, yeah. 

Anu: Can I just, I think I just want to ask something, Mamta [question in another language]?

Mamta: Yeah, that's, that's what I mean. And also like, right now they are talking about 5 to 5 to 8 year old kids can get vaccination. It's not like really happening yet, but it will soon, yeah, but my, my, both of them are really scared. They don't want to have it, but they are scared also they they cannot meet friends and go to school. Those kind of things, you know, those things are not good for kids' mental health, you know what I mean? And that make me scared as well as a mom. So I felt like they need, like government should provide something, you know? Yeah. Age group, that age group, you know.

Nayna Bhandari: Well I think you have really a nice collection of questions and and they are very, very I can say symbolic, or I can say relate in relation to the present situation and being myself as a mom, I can relate very well with you, because I'm also in the same boat. So let's get started, because I think let's get start from the start that what exactly COVID is and what does it do to the body. Because from, I think from that way, the your questions can flow as well into the discussion. So Steph, would you like to share your views around this question?

Stephanie Fletcher-Lartey: Thank you Nayna and Mamta. Thank you for that really very well thought out question. And I believe that today we will be able to answer your question as we go along. So COVID-19 has been around for a while and just a little bit of a basic reminder of what COVID-19 is. So COVID is caused by a virus, which is a type of respiratory virus that is part of a bigger family of viruses that are called the coronavirus. And these usually cause respiratory type infections. Now these infections can range from a common cold like symptom to very serious diseases. Now this new coronavirus that causes the disease that we have seen that as is responsible for the pandemic is called the severe acute respiratory syndrome coronavirus number 2. Now, we had a previous SARS COVID many years ago, and this is like a new version of it that we that has caused the coronavirus disease that we call COVID-19. Now, how does the virus affect you? Usually, people inhale the virus particles when other people who are infected have coughed or sneezed or spoken loudly or sung, and the virus particles are suspended in the air in your saliva, and sometimes these can fall onto surfaces that people touch. But most people will inhale these virus particles directly through their lungs or through their mouth, and some of it could even catch your eyes. So the virus, when it gets inside of your body, it multiplies itself, and then it begins to spread to different organs in your body. Right now, when the virus enters your body, that is how it begins to cause symptoms. So you will some someone who is infected may begin to start to have a mild fever, or a few days later, they might start to develop a dry cough, shortness of breath, fatigue, and as the virus begins to develop more and multiplies more in your body. It begins to get more serious depending on the person's immune system's ability to fight off the virus. And so that is how the virus infects the body. Now, as the virus gets through the body, as I said, the symptoms begin to develop, and you will begin to see, maybe the cough begins to get worse, the shortness of breath begins to develop, and what most people, they will have a very mild infection with the virus, just like a common cold, you can take over the counter medication, and it just goes away. Other people will have a bit more moderate type illness where the short shortness of breath comes and even with basic home remedies, some of these people will recover well. Very small percentage, or less than 5% of people who become infected with COVID develop the more severe symptoms and require, you know, us, to go into the intensive care unit in hospital where they have to be put on mechanical oxygen and so forth. Alright? So that is pretty much just, you know, let's get back to this is the disease we're talking about. As I said, the vast majority of people will have a very mild response to the virus, and usually after a person gets infected, it will take some people will develop symptoms within a day or 2, but on average it is between 5 to 7 days, people will begin to come down with symptoms. But there are a few people who may not see symptoms even after 14 to 21 days. And you may recall for for those people in Sydney and in some other states, people have finished their 14 days quarantine, but later on, after they have left quarantine, they were responsible for the outbreak, the outbreak in Sydney it was actually caused by someone who finished their 14 days quarantine. But the it's very rare. It happens rarely, but it is very much possible, alright? So I leave it at that for now.

Nayna Bhandari: Thank you so much, Steph, because this is such a important point to understand that the virus can stay up to 21 days, because most of the time we believe that by 14th day the virus will be gone and and I remember that even in Melbourne, we have heard few cases where the person has finished up with their quarantine, and then they have to, like, you know, they were considered as spreader of the virus. So that's really a very good, I can say, like, you know, answer for us and and to build our understanding about COVID. My next question is for Doctor Naru that, why do we need to be vaccinated? Because there are, like, you know, there are many viruses all always existing in the environment, and we never, like, you know, get vaccine for all of those viruses. But in this situation, why there is so much focus on get your jab done, get vaccinated, and what happens in our body when we get this vaccine?

Naru Paul: Thank you, Nayna and good evening. Thanks, Mamta and everyone. Okay, I would be clear and honest. You can ask me any questions. I would try my best from my knowledge, skills and competencies. So coming back, Nayna to your question, as we all know, prevention is better than cure, okay, and this coronavirus, this COVID-19, as Stephanie mentioned coronavirus, is a member of a large group of viruses, but COVID-19 is a new virus, so there is no treatment. So as that there is no treatment. And we are observing many deaths, even in Australia, although the deaths rate or the numbers are low, but still it is a major concern for everyone. So there is no treatment, no effective treatment. There is only supportive treatment. So then you have to protect our community members who are getting very sick. So then the question comes, if we can't treat, how we can prevent? And vaccination program is a prevention program. So what does the vaccines actually do? They help our body to develop an immunity. The antibody is the defense. Through our defense mechanism, like military force, a country has a military force. Our body system has a military force called immune system. So the vaccines, they had stimulus to produce that antibody that is the weapons to fight off those bugs. So it, in this case, the virus, it can be bacteria. So there are multiple vaccines as Mamta, your children 5 and 8, so they have got all those childhood vaccinations, starting from polio, diphtheria, tetanus, whooping cough, hepatitis B, haemophilus influenzae B, so 5 years old they are, they will soon be part of the school program as well. So I'm sure they have got all those vaccines. Is that right, Mamta?

Mamta: Yes, they do already.

Naru Paul: Yeah, so you, did you have any concerns about those childhood vaccinations?

Mamta: Never. They are okay, yeah.

Naru Paul: Very good. Thank you. So, basically so, could be any new things is a matter of worry for everyone. Any new. If you go to a new place, you don't know, even if it's a journey of 1000 miles, start with a single step. So the this vaccine, when that past case reported back in 2020, I think the Melbourne first case of COVID-19 was reported on, I think 23rd of January or something, the New South Wales got on 26th January. So at that time, vaccines were not there. So since then, there has been lot of discussion, a lot of efforts. Billions of dollars have been poured in. And governments, 193 countries, most of them have worked together, who all have worked together. And now there are about 200 vaccines in the pipeline, although few are already in the market. Like Australia, we have 3 vaccines now. One is the Pfizer vaccines, but you got another one is AstraZeneca vaccine, and another one is the Moderna vaccines that there will be few more that will come to Australia, but there are other vaccines in many other countries. I even in India they develop. India is the one of the major producers of vaccines. So they have produced Covaxin, the indigenous vaccine, and AstraZeneca. There's a Bharat Biotech. They are also producers. So when this vaccines, a Pfizer vaccine you have got, you can stop me when I need to stop so Angela, or you can manage

Nayna Bhandari: I just as you just sharing so much information, Doctor Naru, I've just got a question out of what you have just shared that there are so many vaccines are coming up in the world, and they all are trying to help, like, you know, the world with this COVID-19, but there is so many doubts in everyone's mind, especially laymen like you know, which vaccine to believe. I remember, as you mentioned, Covishield, and as I like you know, as most of us are from Indian background, we had a huge discussion and issue around that some countries, they are not considering Covishield as a safe vaccine. So as a layman, it becomes really tricky for us to understand whether this vaccination has developed in such a short period of time is it safe to be taken? We should, like, you know, take it or not. So would you like to explain some thoughts around this?

Naru Paul: Yeah, Covishield basically AstraZeneca vaccine. So I think the lot of us have lot of misunderstanding and false belief. Okay, so we have a human beings have a tendency to see this minor risk as a bigger one. It is called sort of cognitive bias. So when they our brain developed. So we used to fight and flight that sort of from the time of development of our brain. So when you find a small risk, unless we have the right knowledge, we get biased, and we think it is a bigger risk, although it is not so the risk in this case, vaccines, vaccines save lives. Vaccines have saved millions of lives all over the world. I'm not I'm coming to the COVID-19 soon, but I'm talking about the sort of in general, the contribution of vaccines in the world of medicine. So vaccines are one of the best public health interventions in the history of medicines. No other medicines have saved so many, so many lives, other than antibiotics, only one other public health interventions have saved so many lives that is safe drinking water. So after safe drinking water, in terms of saving lives, comes the vaccines. Now coming to the COVID-19 vaccines, yes, generally, vaccines take about 10, 15, 20 years time to be developed. So how the vaccines could be developed so soon? Okay, so that is the sort of, say, for example, we all are adults, so if you ask a question, you can answer some of the questions in your facility very quickly, because you have the knowledge, you have the experience. So this vaccine development, those government agencies, medical doctors, scientists, epidemiologists, that cumulative knowledge, okay, so that knowledge have been applied to develop that vaccine. Now, Pfizer vaccine is a mRNA vaccine. This is a new technology, but that although the technology was successful, to develop the vaccine for the first time, but the technology is there for the last 40, 1015, years, mRNA technology and scientists who are developed trying to develop vaccines, and they have trial with the mRNA vaccines for influenza, it was not successful. Ebola virus, it could be it was other coronavirus, that sort of stuff. So mRNA technology is already there, number 1. Number 2, there have been lot of resources. So billions of dollars have been poured in now when one company, say, Pfizer, company, used to develop a vaccine against, say, for example, influenza, only their contribution, their shareholders contribution, so only probably a billion dollar. Now there are billions, hundreds of billions of dollar have been poured in and WHO has joined in. So, so monetary resource was not an issue. And then lot of, no, there are several steps in a vaccine development, like pre clinical trial that has been done before in the lab, then clinical trial, generally 3 steps trial, 3 phases trial. So instead of generally what happens, say, step A finished, then the step B begins, step B ends, then the step C. So it takes a lot of time, but what has happened this time? A, B, C, most of the steps have been trial in parallel, at the same time. Say, for example, particularly to Mamta. Say, for example, you want to cook for your children. So you can cook for your 2 children very quickly, within 1 hour. Now you want to invite 100 people. What you do? You call your friends, you you order some foods. So multiple people cook at the same time, and they can produce the food very quickly. Similarly, lot of countries, lot of scientists, lot of money, lot of processes in parallel. So that's why the vaccine has been developed so quickly. So it is we should be thankful to those scientists, to those companies. Yes, no, no one does business for free. Yes, so the companies are making money, but people have taken, invested their money, invested their knowledge, invested their skills, and that's why the vaccines have been developed so quickly. Now these vaccines are safe and very effective. About COVID-19 vaccines, the Pfizer is your 95% effective to prevent particularly severe disease, like hospitalization and against death. It also prevents symptomatic infection and asymptomatic infection, not that at great level, but it it does also prevent that getting infection as well. So my advice would be, where from you get the information? The source. Source is very important. For safe drinking water, you know the source. If the lot of councils in Melbourne, New South Australia, water is, you get water from the the tap water system, the in Sydney, Sydney Water System available, whatever the water agency. So you know that source is safe. So in your case, where from you are getting the information? TikTok, that sort of stuff, I will go to the government website. [Yeah] Government, Victorian Government website or Australian Government website, and ask questions to the health professionals, then you will get the right, right answer and judge yourself. Don't be persuaded by misbelief and the false belief or missing permission.

Nayna Bhandari: That's a very valid point, doctor, because I know, like, what happened with most of the migrant and refugee communities, because we always force lot of knowledge and a lot of news, lot of information from overseas, and that actually sometimes interfere with the local news forces, and that interference is often help us to believe, like you know, that this is right or this is wrong, and just adding, like, you know, more into it. My next question will be for you, Steph, that there is so many concerns around, like, you know, the short term effect and the long term effects of vaccines and and that's actually adding a lot of fear. And I've been often approached by so many moms like Mamta in community that, like you know, who think about what going to happen to their health, and similarly, some of the males, some of the men who are in community, they also asked about it that it will going to affect their immunity or their strength, or even with females, with their reproduction. So would you like to let us know more information around the short term and the long term effects of vaccine?

Stephanie Fletcher-Lartey: Thanks, Nayna. And I'll, I'll, I'll have a go, and I'll also ask Naru to jump in as well. So most, well, the vaccine is a chemical that is being introduced into our bodies, right? So like anything else that gets into our bodies, our bodies will make a reaction, right? For almost every vaccine, a majority of people will have very mild side effects, like, you know, a little bit of redness or swelling at the place where the injection went into the body, right? Most of us are familiar with that when we have taken our other shots before, it's quite similar. So most of the side effects that follow a COVID-19 jab for are quite similar to that, you know, a bit of redness or swelling at the point some people may have a mild, feverish type illness. They will feel like they are having a very light fever. Some people may have chills or headache or tiredness. What happens is that the vaccine is working in your body to produce your immune response. Or, as Naru, Naru said, when the vaccine, when the soldiers come in, they are trying to build up their weapons. And so tomorrow, it's just as if you were doing some physical activity. As you begin to put your stockpile together, you become tired. You know your body is working to produce the weapons, and you start feeling the strain of the labor that you're doing. And that's pretty much what's happening. However, that will disappear after about 24 to 48 hours. In the vast majority of cases, there might be some what we call more general type symptoms, and like the tiredness and for a few people, that might last for a few days, but generally speaking, those very mild symptoms will disappear after the first 24 hours. And if you've had vaccines, you would have experienced that as well. Now there are a few persons, persons who will experience some more serious reactions, like an allergic reaction to vaccines, and that is mainly due to certain of the ingredients that they use to help the vaccine to score through the body. Some people might be allergic to some of these ingredients that they use to produce the vaccine. And the vaccine companies, they are aware of this, and they make it known. For example, your doctor will say to you, because of a history of this kind of allergic type reaction to this particular ingredient, you shouldn't take the vaccine. Now, there are some people who have had what we call a anaphylactic response, where their body begins to shut up and they have tightness of the throat and those kinds of symptoms, which is a more severe form of allergic reaction to to the ingredients from the vaccine. And that is why people are encouraged to seek medical attention when it comes to taking the vaccine, but these are very, very rare, and so the vast majority of people who are vaccinated will never, ever come down with these symptoms. And before I ask Naru to talk a bit about some of the more long term or more severe side effects, like the the thrombocytopenia and some of the the the more blood related conditions, the there's one point I want to reiterate, which is about the monitoring of vaccines. So at this stage that the vaccine production is all the vaccines that have been approved in the Australian market and overseas, they actually go through what we call post-market surveillance, which is a very rigorous system that is in place throughout many countries across the world to ensure that all these side effects of vaccines are monitored and recorded, and that is how we are able to know of the total number millions of people that have been vaccinated, that the side effects are very rare, because we are able to calculate, calculate, you know, the proportion of persons who have been impacted by the vaccines. So Naru, the question is about the long term side effects. I don't know if you can help with that. How do we know that the vaccines basically the potential long term effects of COVID and how do we know that they are safe in the market?

Naru Paul: Okay, so particularly vaccine, the Pfizer vaccine, there is a mRNA technology. So the vaccine actually you get mRNA particle in a lipid coating, sort of basically, so that teaches our body cells to produce more proteins. So basically, it's a protein particle, and it teaches our body to produce sort of immune response and defense against that spike protein that so the one protein, but the particularly four proteins are important for the coronavirus: spike protein, membrane protein, envelope protein and so on. So there is a spike protein is the main target. So the mRNA vaccine, basically mRNA messenger RNA vaccine. So that is inserted into the injection so that enters the cell. It teaches our cells to produce sort of spike protein. So the spike protein, then it is a foreign body. So our body, our our military system inside the body, then starts weapons so build against and so that is called antibody. So, so anytime in the future, if there is a coronavirus attack, that antibody immediately attacks that virus. And what we are finding, that's why the Sydney case numbers are coming down. We have got here in my district, the south west Sydney, that is basically Bankstown, Liverpool, Fairfield, Campbelltown Bardwell, 1 million plus people. Three, four weeks ago, we used to get 550 cases a day. Now yesterday, we got 60 cases. So basically, people behavior is the same. Basically, see, they don't sort of manage, they can't maintain that distance, or can't maintain that hygiene. But is the vaccination even our most disadvantaged areas people, they have got that vaccination rate is about 88% first dose, no no 91% first dose, and 88% two dose vaccines. So that is come bringing down the infection rate. So the long term effect, so that in the messenger RNA vaccines inside the body, as soon as that produces spike protein in our body, then our our body cells actually destroys that, that foreign body inserted through the injection, so that got destroyed, so there is no tears of it, so that has produced now antibody. So it is a total transform, like you are cooking. You are cooking rice. You cook the the rice from the shop. It produces actual rice, what you eat or, or a vegetable is transformed, or a egg is transformed into omelet, that sort of stuff. So there is no, no taste of the raw egg, no, no trace of that. They think, what was in sudden? Okay. Now there are some controversy, because there are lots of theorists. They are very intelligent people that, oh, you get infertility. Now I will tell you the story. What happens with the infertility, the the placenta, the the when the mothers, the in the room that the new the fetus, the placenta, is connected with the uterus, so that is connected with the protein, that is also called spike protein, that is the called syncing protein, sensitive one. And this is a called spike protein. There's different one. So different protein, different functions. So there is no way it can interface with your fertility. And during the trial population, in US, about 30 people pregnant women were in the trial population. So they produce, they they get birth to their babies quite safely, or an empty mother is one mother got sick, and that was found because you use a trial, you know, randomized control trial, some somebody gets the placebo, somebody gets the vaccine. You know that that is a the sort of the basic principles of randomized control trial. So the one mother who got sick actually didn't get the vaccine. It was the principles, but she got so there is no way. Ah, if anyone has any doubt, just don't believe all those social media. It is a toxic social media. And when you get toxic, your children are sort of basic- basically, children learn from their parents. When the mother or the father or the parents, senior family members are stressed, they get the vibe and they get stressed as as well. So first thing what you have to do, you need to have the confidence. How you can get get confidence. You can get confidence to the knowledge. You get confidence, gain confidence through your training, so that those are the empowerment tools, empowerment models and to get the right knowledge, right knowledge, every departments of health has a website. They give the right information, if you don't trust say, for example, Victorian Government website. So New South Wales is different. Government is also different, Labor Government, Liberal Government. So look at the match the information does the information match? So that sort of things you could look that does WHO information match? So if you read all those information, basically the same information, so there is no long term effect as of now and for the future, you can guess what is going to happen. Say, for example, the vaccines. Say measles vaccine. Measles vaccines is one of the best vaccines so far has been developed. One vaccine give protection to about 95% of people, 95% of children, and two vaccines give 99% so one person, they never get protected. Okay, no vaccine is under 100% effective, and no vaccines or no medicine is 100% safe, even if you go to if you go for walking, chance of getting road accident is about 8 in a million people. That chance of getting death or dying is about 2 in a million people from the thunder lightning. So there is always a risk, okay? So that you have to assess, so that that will not that should not stop your life. Life should move on. Her life should move on positively. Okay? And you should make a change. We should change for betterment. So there is no such thing that the future is going to be bad to do COVID vaccines, that we should acknowledge. We should be grateful that this sort of good vaccines have come in New South Sydney, there used to be 10, 15, people have died per day. Now the death has come about 5 deaths, but not even 5 deaths, and most of the deaths are happening over the age of 70, not even 70 over the age of 80 years. So what is happening in Australia every year, how many deaths happen? Do you know? 170,000 deaths happen every year? Now, some of the people are getting vaccines before that death. So there is no association linking between the vaccines and death. This is just a coincidence. Okay, so, so, so my advice would be, be confident, be empowered with the right knowledge, definite knowledge, don't trust the social media. Social media is ruining people's life. Did I answer about- did I miss anything? Or was there any other parts of the question, Stephanie?

Stephanie Fletcher-Lartey: I think you answered... Nayna? Did we-

Nayna Bhandari: Yes, yes, yeah. I believe that, yeah, that's right, because the long term effect definitely is a big question in everyone's mind, because short term anyone can see by having that syringe in your body, but long term no one can figure out. So before moving on to the next question, I would like other participants please feel free to ask any question if you have in your mind, because we have an expert sitting within us, and you won't get an opportunity like this where you can have a direct question and answer thing, and if you want to ask in Punjabi or Hindi, both Anu and I can translate for you. So please,

Naru Paul: yeah, and [in another language].

Nayna Bhandari: Okay, so that's good.

Anu: I actually just wanted to summarize that last bit because I think it has been a matter of chat conversation in our chats as well, particularly because we have a younger group of people, and these are important things that come up with the infertility, which I saw a lot of Indian social media chat around infertility, and they say Doctor Nashaya, it's because of a similarity of names. And there are different types of protein in the bodies, in our bodies, and there are many different types of spike protein. And because there was so much talk around the vac- the mRNA vaccines, particularly attacking a spike protein, people just conflated and said, "no, no, it's going to attack the spiral spike protein in the placenta as well." But like the Doctor explained, it's a similar name, not the same thing, and most of the trials have shown that it doesn't impact pregnancy or the effect on the children. In fact, one of the things that we found out because a number of our friends were in a similar situation, where, you know, they were in advance stages of pregnancy and whether or not they should take the vaccine, the recommendation is that they should, because if you don't, then the impact is even worse if you do fall sick. And I particularly like the reference you made to the thunderstorm Doctor Naru, because every time somebody dies of a lightning strike, it makes news. It's because it is so rare that it makes news. But [another language]. Of course, it makes news because it is quite rare. I just thought I'd say that and Nayna, please, please move on. Thank you.

Nayna Bhandari: Thank you. Thank you. I know it's so important to have that feedback in and considering the time-

Naru Paul: I would just like to add sure I think people are aware of that autism from measles vaccine, I think many people are aware, and that is in the media. So I'll just tell you a story very shortly. So some doctors from England, they did a publication association- associating measles vaccine with autism. Now, The Lancet that the one of the most reputed medical journal, they published that article, they later found that the the those doctors actually cheated to write that article, they they made up the story, and it was found that was false. So that article was taken off The Lancet magazine, and those doctors registration has been canceled in England, so there is no such association. So people make lot of associations, so you need to trust the right source. And knowledge is power.

Nayna Bhandari: That's so important and very, very rightly said that knowledge is power, and in all this COVID time, what I have observed that most of us, who are from the community, often we are unaware of finding the right source of information, and that wrong information drags us into the wrong side of making choices. Alright? So moving on to our next question.

Naru Paul: So why the interval has been shortened now? Is that right? Why the interval is from 6 weeks? Yeah, actually the interval for Pfizer vaccine, as per the manufacturers, the Pfizer company, Pfizer, biotech, biotech, the duration is 3 to 6 weeks, actually. So you can give the second dose up to up to 42 days from the first dose. Now, if it is 3 weeks, actually, the idea is to vaccinate more people in a short time frame. So that is the whole idea. So but the immunity, antibody response, basically 3 to 6 weeks is more or less same for Pfizer vaccine. But in case of AstraZeneca vaccine, the gap is about 4 weeks to 12 weeks to one month to three months. And for AstraZeneca it has been found that if the interval is more so more than 8 weeks, 2 months, you develop better immunity, better antibody production. But Pfizer vaccine is more or less the same so long the interval is 3 to 6 weeks. But in case of AstraZeneca, it has been found that more the gap between the first and second dose, better the antibody level production. People are learning every day. So you learn, and you whatever you say based on evidence. So that is not enough data to tell you that it will it will not work. So possibly because the way that vaccines develop. So vaccines helps in the develop of antibody. And there are the two types of cell, B cell that may the the humoral antibody B cells, the blood cells from WBC lymphocytes, and the T cell memory cell. So the memory cells, whatever produce in the body, it never get lost. Okay? So whatever you give the vaccines, they catch up, they they wake up, otherwise they remain silent. So there should not be any problem.

Nayna Bhandari: Alright, so that means Doctor Naru, like the duration is safe if we cut down from 6 to 3 weeks of time and-

Naru Paul: For AstraZeneca? Pfizer vaccine 3 to 6 weeks.

Nayna Bhandari: Alright, okay. So in regards to the after vaccination journey, because again, there is so many news in the market about the booster shots and like you know, the immunity your body, how it feel, going to behave after taking COVID vaccine. So would you like to share some, some of the thoughts?

Naru Paul: Based on the current information, because it is still in transit in the vaccine, COVID-19 vaccine. So based on the current evidence, it is, it is currently, it is believed that the protection remains up to 6 months. That's why you will see the government all those sort of information brochure, I think, similar in Victoria, what we have done here, because when someone gets COVID, they either end up in hospital, or most of them, as Stephanie mentioned, 80% remain in home. So once they are released from isolation, so they finish isolation, they get a letter, and we write in in New South Wales that you can wait up to 6 months if you want to get the vaccine, to talk to your doctor. But other recommendation is you can get the vaccine as soon as you recover. So current evidence that protection probably remains up to 6 months. So then what will happen after 6 months? So vaccines in Australia have started from February, 2 of February, it is something like that, yeah. So 22nd so the last week of February, so 6 months already gone. Some of the studies are coming out. Probably there is a reduction of antibody level, probably 20%, 30%, but still, that is protection. Okay, so on the- based on that information, and US, UK, they had started vaccination long before Australia, and they got lot, many more cases. So CDC, the CDC is a very renowned communicable disease control body, so they have recommended, as well as the Australia recently recommended booster dose only for severely immunocompromised people, say for someone has blood cancer, someone has severe say for required some transplant, bone marrow transplant, that sort of severe immunocompromising conditions, their response to those vaccines are not that great. It is not optimum. That's why they have been recommended to get the vaccine as of now. So it might change for the next month, three months time as because people are all are learning based on that evidence. So they are following people that they are doing the blood result. You can look at the blood result, antibody level, you can see that person got infection. We got, say, Today I got a case. The the person never got tested, but he told that he has been with the family members who were cases. So basically, if he had tested at that time he skipped the testing. Anyways, we don't know. We can't contact every people then, because he was scared of the sort of isolation, that's why he did not test it. Now, he got tested, we found that antibody level is there, but that is considered as a historical past infection. So he does not need any quarantine, because he is already protected. Now the question is, if someone is already protected, you have got the disease, do you get the vaccine? Yes, you need the vaccine. Vaccine will booster your immunity level, and it has been found that vaccine produces better immunity than the disease. I think everyone knows that you can get the immunity either from the natural infection or from the vaccination. So vaccination is a sort of copycat of the natural infection, but without many side effects. Natural infection might kill you. There's the COVID-19 is killing people. So 1% of people in Australia, dying, basically, but the vaccine escapes that sort of had very severe adverse reactions. Say, for example, from AstraZeneca, there have been 9 deaths for 13 million doses. So very small. Yeah, and severe reactions are also very, very less. Yeah. So vaccines ultimately works. It is safe and effective.

Nayna Bhandari: Great. Thank you so much. And I would move on to the last question, probably I'll ask Steph, would you be able to help us in predicting our next 3 years, or 1, 1-3 year of time, because I think most of us really, really want to understand how the future looks to us.

Stephanie Fletcher-Lartey: Thanks, Nayna. Um, look as as we've been speaking about COVID, one of the important things for us to all remember that it's just been a little bit under 2 years since this started. But that said we have made so many great achievements in that short period of time. And what we are doing is we are learning more and more every single day as as the the pandemic progresses. So what does the future look like? This will depend a lot on how well we are able to contain our outbreaks and our cases, and how well we as a community are able to follow the guidelines that have been put forth by the, the scientific and public health experts, and we've been speaking about vaccination, and Doctor Naru has reminded us that vaccines have been one of the most effective public health interventions for centuries, right? So the future will look like what the future will look like. So there are various things that I believe will happen based on what we already know and based out on our past knowledge of managing other diseases. For the immediate future, I think what will happen is that we will continue to push for a higher level of vaccination, because what we are coming to understand that the more people who become vaccinated is the better protected our community is, right? And it's important that as many of us as possible get vaccinated. And I want to quickly mention something about herd immunity here, because the more of us become vaccinated is the better we will be able to build up this protection around those few people in the community who may not be able to take a vaccine, like some people who have certain kinds of chronic diseases or underlying conditions that prohibit them from taking a vaccine, because the vaccine then is dangerous, like those people who have severe reactions and so on. The more of us who become vaccinated, the better we are able to protect those people, and that is generally, loosely called herd immunity, so we can protect those people in our communities. Alright. Now what the future will also look like is that certain measures will still be required as time goes by, depending on what happens when we open our borders, when we begin to go back out to work and so on and so forth. One of one of the things that you might be asking is, what's going to happen with our children? As we've had that question earlier. So chances are there will become enough evidence to to determine whether or not the vaccines are safe enough for children, and then we will see that they might expand vaccination to even younger children. We already saw very quickly that after certain trials, that we were able to include even younger children into the current vaccination program. And this happened a lot faster than we actually expected. Some of the other things that we should expect to see is that we will be required to continue to wear masks in indoor settings and and we might be able we- with outdoor settings. You know, they there might be some requirements to continue to wear mask at some point in time, but one of the big topic that might be on most people's mind is lockdowns. Some you might have heard about some of the modelling that we have done, and the University of Melbourne may- has done some of them as well. But what we do, and these models are using mathematical predictions to identify what may happen if we follow a certain scenario. And because we have so many cases, and we have so many people getting ill from COVID, we have been able to use real life information to plug into these mathematical models and put some measures in to say what will happen if x and y continues to happen. And our models tell us that if we continue, if we have a certain level of vaccination, and we begin to introduce people, for example, from outside, who may come in with disease, then there might be outbreaks that could occur. And so what has happened in the past is when we have those very sharp lockdowns, like you've had in Melbourne, for example, for a couple of days, those help to contain the spread and limit the numbers of people who become infected. But all of this works if we abide by the the requirements that have been outlined for us. The other thing that will you will see happen is around testing. Now, testing—and Doctor Naru and I have worked in public health for many years, you know—a surveillance system for these rare diseases are really strong. If we have good testing, the more people that are tested, the better the information we have to inform how we will put in the measures. So what will happen is that there will be, you will be required to continue to be tested, even after becoming vaccinated, because testing for COVID will help us to know how many people might have the virus, but may not necessarily be ill. What will happen as well you will see more of the rapid type of antigen testing begin to come- come up, because rapid antigen testing is a quick way of screening to see whether or not your body is producing those antibodies to the the virus, or to pick up the antigens, or those little flags that say that there is an intruder on board. And so once we are able to do the antibody the antigen testing to identify persons who are exposed to covid, then you can go on to have a confirmatory test, which is usually like a PCR, but those, those types of tests are really crucial for public health departments, like the one that noru leads so that they are able to understand what is the baseline level of disease in the community, even if people do not get sick, because with more people vaccinated, then fewer people will end up in hospital or will end up with symptoms. But we still need to know what's happening on the ground, so that for those small groups, for example, those younger children who are not yet eligible for vaccination, we will still need to know whether or not there's disease circulating that our kids could become infected as well. And I hope that's making sense, so testing will continue to be a requirement even after we have been vaccinated. And I believe that some of the big companies will begin to to to develop rapid tests that you can administer yourself at home or in the workplace very quickly. Alright, the check-ins will be the, you know, check-ins will continue, and in terms of social engagement, I believe, I believe that we will still be required then the vaccine passports will become I believe those will become commonplace. They will probably become like another identification card that we will need to carry now, I guess the big topic is about travel. Like most of you here, I am a migrant, and I also have concerns about traveling back home to see my family, so I probably I'm going to pause here and and ask Naru to jump in when it comes to travel. And you know what I would say, though, is that travel is happening. As you know, our premier mentioned that we will be opening up. But with travel, then there is the potential that people will begin to bring in, you know, infection into the country and, Naru?

Naru Paul: Yeah, I think- thanks Stephanie. So basically, future, future is at your hand. Your health is at your hand. This is the Rotary Club of- International Rotary Club's Message. Hi, I'm a member, of course. So your health is at your hand, and your health based on your knowledge. So just before coming to the main question, whenever you get some sort of information through social media, your WhatsApp chat, ask that guy, ask that person, what is the source of that information? I am sure that they will say, though I got my friends told me that should be then look at the health department source. You can't corrupt everyone, okay, I can't be corrupted, right? I can't be so i I'll be honest and transparent. So similarly, lot of health professionals, maximum, the Departments of Health governments, they they are telling the truth based on the evidence number one. So the trouble, yes, you get will get infection, chance of infection probably what will happen? It will be like a influenza virus, like a flu, every year flu, the case numbers might increase. So the numbers will not matter. What will matter is how many people, what proportion of people are hospitalised? What proportion of people are getting moderate to severe disease? How many people are admitted in ICU? In Sydney in the last 6 weeks, say, 4 weeks ago, there are about 1200 plus hospitalised. Yesterday, I think hospitalisation number is 595 something, and it is vaccination that is working. So the prevention, there is a good hope, vaccine is very much effective. Now, on the treatment front, like, say, meningococcal disease, you get vaccines and you get treatment. So here treatment is also coming, some antivirals, there are some promising results. These are also coming, so treatment will be very successful. So in that way, human life will not be lost, and morbidity that is suffering will be minimised. So you might get the infection, it will be like a mild to influenza-like illnesses, but the but one of the issues all viruses, like we want to survive, they also want to survive. They want to- they want to make the life better. So they try to change themselves, to trick the human being. But human beings, who is more intelligent human being as a technology. So they also tweak, so the mRNA vaccine, it is easy to tweak the vaccine. So when the viruses change, they can tweak that mRNA easily than the traditional vaccines. So it so in that way, I believe, I am optimistic the future will be much, much better. So we have to make ourselves better. Don't get stressed. If you are stressed, who you are harming? You are harming yourself. You are damaging your body. When you get stressed, there is cortisol, adrenaline, noradrenaline, norepinephrine, that sort of hormones are sick are produced in the body, and that damages our cells, that damages our immune system. So you will see when you- before the exam, there is a tendency that you get more much more cold and cough because your immune system, because of your not good sleep, because of your stress, you you are more susceptible to those sort of common viral infections. So good night sleep, it has been found different studies, the good night's sleep is very be essential for for development of antibody through the vaccines. So be safe. Be confident, be optimistic.

Nayna Bhandari: Sorry, doctor, I'm interrupting- I'm interrupting. In between just being conscious of time, I think Anu has a question. She wants to add on something, and then Hak has also got a question. So please go ahead, Anu.

Anu: Thank you. Thank you so much. I think it's only because the question about travel came up. So we've got the vaccines. Yes, I've got the AstraZeneca. Others might have had the Pfizer or Moderna. Will the vaccines that we've had here protect us against the strains if we are travelling back to other places? I'm personally hoping to travel to India by the end of November, hopefully, fingers crossed. So would it protect me against whatever strain is over there?

Naru Paul: I think currently, or unfortunately, Delta strain came from India. Why it came from India? Because there are so many cases. So when there are many cases, viruses, they mutate, they change. So some viruses came from England, some from that strain from Africa. So there are different alpha, beta, gamma, delta. So this is the delta strain we are talking about. So these vaccines, particularly is, is much more effective for the Alpha strand as a fast virus that developed last year. But it is almost little bit of difference. It is also equally effective, very much effective, against the Delta strain. So even if you go back to India, it should be it should be alright, but you need to vaccines. Is not going to help alone. You need to maintain all those public health, your hand hygiene, your cough etiquette, your social distancing, that sort of stuff you have to maintain all the time.

That's so good to know and relaxing as well at the same time, because I think all of us might be planning to travel sooner or later.

Basically, both vaccines are effective and safe. So anyone you can choose. But what the Australian peak body there is the ATAGI – Australian, the advisory committee, Technical Committee on Immunisation. They have suggested Pfizer vaccines for under the age of 60 and AstraZeneca over the age of 60, but both are equally effective. Okay, probably few percentage the Pfizer is better efficacy than AstraZeneca, but every vaccine has some sort of side effects, so that is, but that is very, very rare, and the the benefits outweigh the risks. So for support, I got Pfizer vaccine as a healthcare worker, my wife got AstraZeneca. And different people have different body system. So from the technical point of view, anyone can choose any vaccines, but government suggested probably because of the thrombosis that from the AstraZeneca vaccines. That's why government, that big body, suggested Pfizer vaccine is better for the age groups below 60. But there is no other reason. So you can get whatever the vaccines you like, but the vaccines you start with, you should finish with that one only is not interchangeable. Where do you get the information? Just Google search. Say COVID-19 vaccine, comma, Victorian health, or Australian Health, Australian government health. Don't just search in the Google, all the newspaper report, all those sort of fake news will come up. Don't go to the YouTube that there are heaps of ocean of knowledge. You have to choose, okay? Now it's now we living in time, good or bad. It is your choice. You have to right- you have to choose rightly. So such, COVID-19 vaccine, comma, frequently asked questions or Australian government or COVID-19 vaccine, Victorian health department or New South Wales Health, and you just compare. So when you get time, you just compare one government website with the other. If there is difference, then talk to Burnet, talk to me, I'm happy happy to help.

Nayna Bhandari: Oh, that's so good. Anyone has got further question or any doubts in your mind or anything which you would like to clarify? All good? Over to you, Anu.

Stephanie Fletcher-Lartey: Nayna, before Anu takes over, I guess I'd love to add one point about vaccines, you know, we- Doctor Naru spoke about the fact that some of these will not last for maybe more than 6 months. As we are seeing vaccines, they they wane over time the effectiveness, but work is already on the way to develop new vaccines that can also protect against those newer variants. And I did a little search research too to find out that there are 2 vaccines being developed right there in Melbourne, based on the mRNA, one based on mRNA technology, and there's another one that is based on the vector technology, so one that would be based on technology similar to Pfizer, and another one based on technology similar to AstraZeneca. So there is really a great big ray of hope that we will get vaccines that will protect us for much longer than the current ones in the future. And a lot of the work is already underway. And as you can see again, industry and a lot of governments are throwing their weight behind the vaccine development, making money available so that these kind of work can take place in a short period of time compared to what we are familiar with it historically. So again, it's a great, great news and great hope for us as a community that we will have better vaccines in the near future that will help us to tackle COVID going forward in the future. Thank you.

Anu: Thank you so much, Steph and thank you so much Doctor Naru, really, really, absolute wealth of information there. I'll just quickly summarize the key takeaway, so they kind of sit with us. So firstly, from Steph, just the understanding that COVID is a respiratory illness, which is comes from a family of diseases that have been around for a while, but this particular variant, largely can be a very mild illness which can be managed at home, but a very small percentage of people do fall extremely sick and sadly die. But the good news is that it is preventable, both through the hygiene measures that have been in place, and also through vaccines. So thank you for that Stephanie. As Doctor Naru, said that, outside of drinking water, vaccines are the single biggest reason that so many of us are alive in the world today. And I mean, we all come- a bunch of us come from India. So we know the power of vaccine. Like in my lifetime, I know that smallpox and polio have been eradicated. We've been vaccinated against many diseases, which unfortunately our parents would not have been. And I know stories in my family where you know, there was 10 or 11 children born, but only 5 survived to adulthood because of childhood diseases. So absolutely, vaccines do have the power of saving life and preventing serious illness. Again, as Doctor Naru said, from a very recent experience in Sydney, we have seen literally a real life situation where the high numbers turned around so quickly. And now, like in a place like western and southwestern Sydney, which was where a large number of cases came from, we are now seeing cases in double figures. And I know that you people live a lot of you live in the western and northern suburbs, where consistently we have seen high numbers, but the vaccination rates are absolutely phenomenal. So hopefully we will see that turn very quickly. I think a big question that many people had in the chat, as well as in the group here was, why is it that this particular vaccine has become ready so quickly. And I think if you look at all the conspiracy theories, there's a number of reasons for this. And I have seen news like, oh, the medical giants already had a vaccine built, and then they released this virus so that they could sell it to everybody and make millions of dollars. Maybe there's a Hollywood movie which is going to say that, or a book, but like Doctor Naru explained, there was a lot of work happening concurrently, and the technology to make the vaccine has been around for a long time. It was just that they needed to customize it to this particular virus, and which they were able to do again, because it was a global pandemic, governments and companies and people around the world just put money and worked together instead of working in silos, which is why we've got a number of really, really good vaccines. The other question that I think has been on all our minds is, how effective are the vaccines? Is the dosage interval? Is there an optimum dosage intervals. So really happy to hear that all the main vaccines used here in Australia, at least the AstraZeneca, the Pfizer and the Moderna, are all excellent vaccines. And the interval is what is recommended by the manufacturer for the AstraZeneca between 4 and 12 weeks, and for the Pfizer between 3 and 6 weeks. And I think the Moderna is like a month or something like that. I'm happy to hear that if you wait 12 weeks, the AstraZeneca has the best possible validity because I waited the full 12 weeks to the date. But good to hear that for the Pfizer, whether it's three or six, the difference in efficacy is not much. The one thing that I was quite keen on hearing is what's going to happen. With immunity over time, because are we going to need boosters and stuff like that? So good to know that even after 6 months, while there's a reduction in antibody production, the efficacy is still there. And I think one of the good things about the vaccine that we have heard is that it does prevent severe disease and definitely prevents death. So if you are healthy otherwise and don't have those underlying conditions, if you're vaccinated, then your outcomes are really good. I think what the future is going to look like, you're obviously going to have more research and more treatment options as well for people who fall sick, but it's really good to know that the vaccine development is going to continue and we probably have better vaccines, more efficient vaccines, etc, over time. The other thing also, I think, which was good to know is that travel is going to become easier, and I'm really, personally, quite happy to know that the vaccine I've had here is going to protect me if and when I get to India at the end of the year. I'm sorry I'm harping on about it, but I'm just so excited that in the last one week, we've heard we can actually travel, but I'm already mentally in Delhi. And I think one of the key takeaways for me from the session was that while vaccines are going to do a bulk of the heavy lifting in protecting us from disease, looks like some of the measures are here to stay, so the wearing of masks, hand hygiene, social distancing, cough etiquette, all of those things, I think, are things that we have to continue into the future. I'm glad that some of the questions around the side effects, long term and short term have been hopefully addressed, especially around like, you know, what happens? Do you get a fever? Do you become sick, etc? And we know that it was good to hear Steph, that it means that the it's actually doing its work when you have those little reactions. And that is something that I think most of us understand, that you are getting something that's going to make a reaction in your body. And also, really, I think it was good to hear the actual number, that out of 13 million vaccine of the AstraZeneca administered, they were 8 sad deaths. And we don't know if some of them had pre existing conditions. I mean, 8 deaths is 8 deaths, but when you see it in the larger scale of things, you know it is, it does put it into perspective. And I do agree with Mamta that it's good to- it would be good to have information for children so if they are concerned, we can find relatable language which makes them understand, because we don't want them to be stressed, and thinking about how their parents are going to be if they get this or if they get. The vaccine, so really take your point. So thank you for that.