People with disability are an at-risk group in the COVID-19 pandemic for a range of clinical and socioeconomic reasons. In recognition of this, Australians with disability and those who work with them were prioritized in access to vaccination, but the vaccination targets were not met. In this paper, we analyze qualitative data generated from a survey with 368 disability support workers to identify drivers of COVID-19 vaccination hesitancy and why the implementation of this policy may have experienced challenges. We identify a range of themes within these data but ultimately argue that a major driver of vaccine hesitancy in this group is a mistrust of government and an erosion of employment terms and conditions. Drawing on the policy capacity literature, we argue that the “Achilles’ heel” for the Australian government in this case is the critical policy capacity of political legitimacy. This finding has important implications for where the government needs to increase/build policy capacity, strengthening its efforts and better relating to organizations that can be helpful in terms of developing public health messaging for disability support workers.

中文翻译：

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政治合法性和疫苗犹豫：澳大利亚的残疾支持工作者

由于一系列临床和社会经济原因，残疾人是 COVID-19 大流行中的高危人群。认识到这一点，澳大利亚残障人士和与他们一起工作的人被优先接种疫苗，但没有达到疫苗接种目标。在本文中，我们分析了对 368 名残疾支持工作者进行的调查所产生的定性数据，以确定 COVID-19 疫苗接种犹豫的驱动因素以及该政策的实施可能遇到挑战的原因。我们在这些数据中确定了一系列主题，但最终认为，这一群体对疫苗犹豫不决的一个主要驱动因素是对政府的不信任以及就业条款和条件的侵蚀。借鉴政策能力文献，我们认为，在这种情况下，澳大利亚政府的“阿喀琉斯之踵”是政治合法性的关键政策能力。这一发现对于政府需要在哪些方面增加/建设政策能力、加强其努力以及更好地与有助于为残疾支持工作者开发公共卫生信息的组织建立联系具有重要意义。