Queensland's mining belt remains one of the worst regions in the state for vaccination rates less than a month before the borders reopen to COVID-19 hotspots.
The local government areas of Isaac, Central Highlands and Banana, home to some of the largest mining communities in the state, are all below 80 per cent first dose and 63 per cent double dose.
In the Isaac region alone, which includes the communities of Moranbah, Clermont, Dysart, Middlemount and Coppabella, 37 per cent of residents are not vaccinated at all, making it one of the worst in Australia.
Eighty per cent of the Isaac region's workforce is employed in mining, so there's a lot at stake.
Infectious disease epidemiologist at Griffith University Paul Van Buynder says there is an "enormous" risk of outbreaks in mining communities.
"We've seen from overseas that we need to get people triple vaccinated to really protect them strongly, and yet, we've got places in Queensland that haven't had any vaccine at all to a significant extent."
Preparing to live with COVID
Isaac Mayor Anne Baker admits she's "worried about the whole impact" on the region when the border wall comes down when the state average vaccination rate hits 80 per cent, expected between December 6 to 12.
"This region has not seen a lockdown since April 2020. We have not seen or lived through any community transmission," Cr Baker said.
"We must be prepared and protected for that."
The neighbouring shire of Central Highlands, which includes Emerald and Blackwater has about a quarter of the population unvaccinated with Banana Shire, which covers Moura and Theodore sitting at 23.4 per cent with no vaccination.
Misinformation an issue
However, regional councils are increasingly speaking out against the state government's mandate, including Isaac and nearby Livingstone.
Cr Baker said her council had taken a pro-choice stance, including on vaccinations, and that it had been "extremely disappointing" to witness misinformation spreading in the community.
Ian Macfarlane, the chief executive of the Queensland Resources Council (QRC), agreed.
"If you're not vaccinated, then you will catch the virus and you will get sick and you may die.
"They are the facts and the facts are that the immunisation program is easily the best protection by a long way."
Mandate begins to influence uptake
Vanguard Health is contracted by the Mackay Hospital and Health Service to deliver vaccines to the Isaac region.
Clinical operations manager Sue Farrell admitted there had not been a "great uptake", but more people were coming forward since the state government announced unvaccinated Queenslanders would soon be banned from a raft of venues, including pubs, clubs, restaurants, cinemas and theme parks.
'As ready as it can be'
There is no blanket vaccine mandate for Queensland mine sites, however, BHP has introduced mandates for its workers nationwide.
Ian Macfarlane said the QRC was working with the Queensland government for clarity around mine outbreak guidelines, but the industry had been preparing for it for almost two years.
The QRC has been running a media campaign urging workers and their families to get vaccinated, while some mining companies are incentivising vaccination with gift vouchers.
"I think the industry is as ready as it can be, but the only thing that we can do more of is to get more people vaccinated."
Mr Macfarlane said FIFO workers from south-east Queensland had higher rates of vaccination compared to drive-in drive-out (DIDO) workers.
Professor Van Buynder said the widespread travel of people between mining communities and areas in south-east Queensland, as well as low vaccination rates would increase the risk to the sector.
"Shared accommodation is particularly risky … if you're in shared accommodation everybody else is going to get it (COVID-19) as well," Professor Van Buynder said.
He noted that many mining communities are near Indigenous communities, which also have very low rates of vaccination.
Vaccine hesitancy influences
The agricultural regions of Charters Towers, Mareeba and North Burnett, and the Indigenous communities of Yarrabah and Cherbourg are also recording first dose vaccination rates below 80 per cent.
There is no official data collected on a region-by-region basis on the underlying reasons behind low vaccination rates.
The University of Melbourne's Professor Anthony Scott is studying vaccine hesitancy at a state level.
He said people in New South Wales and Victoria, who've had more exposure to the virus, are more likely to be vaccinated, and that mandates have had a positive influence.
"Queensland, particularly in regional areas, people are pretty resilient and they kind of take care of themselves … so their contact with health services is often less than people in cities," Professor Scott said.
"That influences their propensity to go and get vaccinated because they're not usually at the doctors anyway.
"Our research has also shown that those people who are more dissatisfied with government policies, both state and federal around COVID are less likely to get vaccinated."
Mandate creates staffing issues
Businesses in the region are preparing for the worst as the border opening nears and the Queensland government's vaccine mandate comes into effect from December 17.
Moranbah Restaurant owner Forrest Egan said it had been a challenge to get enough staff, even without the new rule.
Mr Egan said 75 per cent of his workforce had not received a COVID-19 vaccine.
"I'll have to see what happens, whether they lift the mandate, whether we'll be able to continue trading within the hospitality area," he said.
"Apart from that, I'll just go and get a day job somewhere."
Mr Egan said he was frustrated the goalposts for businesses to operate during the COVID-19 pandemic had changed continuously over the past 18 months.