A veterinary student who was denied free access to the Japanese encephalitis (JEV) vaccine, despite working directly with livestock, says the eligibility criteria should be expanded.
Ameika Brecko is studying veterinary science at a university in Wagga Wagga and was told she was ineligible for the vaccine when she contacted both her local GP and NSW Health.
"I called my GP … They said they didn't stock the vaccine at all but gave me the number for NSW Health," she said.
"[NSW Health] responded by saying, as I don't work at the piggery, I'm not eligible for the vaccine. I told them I'm a vet student living in Wagga and they still said that I wasn't eligible.
"I doubt the mosquitoes finish at the fence line of the piggery."
Ms Brecko — who is originally from Melbourne — said the response came as a shock, given a large percentage of the course involves hands-on work with animals.
"We've got a lot of animals on campus. Even this week I've been with the cattle.”
The NSW Department of Primary Industries states on its website that JEV can infect "a range of species including waterbirds, pigs, horses and donkeys, cattle, sheep, goats, water buffalo, chickens and others".
However, it notes that "few species play a significant role in transmission", with waterbirds and pigs the main contributors.
The ABC is aware of another student who booked an appointment for the vaccine but was told she did not fall under the eligibility criteria as a vet student and would be charged $300.
"It's completely unaffordable," Ms Brecko said.
Japanese encephalitis has recently been detected in southern parts of Australia for the first time.
There have been seven confirmed cases in NSW, eight in Victoria and eight in South Australia.
About 99 per cent of people who get infected will have very mild or no symptoms. However, for the small number who do develop severe encephalitis — an inflammation of the brain — it can be deadly.
Eligibility criteria blocking free access to JEV vaccine
The Communicable Disease Network Australia (CDNA) released an eligibility criteria guide, outlining priority groups with direct exposure or close proximity to pigs and mosquitoes could access the vaccine.
It states that the vaccine is recommended for “people who work at, reside at, or have a planned, non-deferrable visit to a piggery, including but not limited to farm workers and their families living at the piggery, transport workers, veterinarians and others involved in the care of pigs”.
In a statement, New South Wales Health said vaccination was recommended for veterinary students who have a non-deferrable visit to a piggery as per the CDNA guidelines.
"NSW Health will continue to work with GPs and other relevant stakeholders to ensure all those currently at highest risk of exposure to Japanese encephalitis are prioritised for access to [a] government-funded vaccine."
Ms Brecko said placements at piggeries have been suspended until further notice, as a precaution, to keep students safe.
However, with growing detections particularly in the region where she lives, Ms Brecko said the eligibility criteria should be revised.
"It's quite scary going out and living your life in an area where there have been cases," Ms Brecko said.
"They should increase the eligibility because, at the end of the day, everyone deserves the right to public health."
Vaccine availability forcing the prioritisation of high-risk groups
Greg Devine, who is the group leader of the mosquito control laboratory at QIMR Berghofer Medical Research Institute said it was sensible to focus on those working at piggeries due to the limited availability of vaccines.
"Our vaccine stocks are not sufficient to cover everybody who might now be at risk so they have to prioritise where it's going to go and so making a connection to an occupational hazard is very sensible at the moment," he said.
Dr Devine said pigs were very good at amplifying the virus, so when a mosquito bites them the viral load was large enough to transmit the virus on.
Other livestock such as sheep and cattle, as well as humans, were described as "dead-end hosts" because they did not amplify the virus to the same extent, he said.
"It's definitely sensible to focus on pigs," he said.
"It's domestic pigs and feral pigs, because we must remember that Australia has millions and millions of feral pigs."
Dr Devine said only about 1 in 200 people infected with JEV would show symptoms, so with around 20 confirmed cases so far, it was likely that at least 4,000 people had been infected.
He said anyone in the area surrounding a piggery was at risk.
"I've yet to read a report that suggests anybody has been infected in a piggery," he said.
"So absolutely there's an occupational hazard of working within a piggery or in a service industry for a piggery, but the mosquitoes that can transmit JEV from a pig to humans, they can fly very large distances so they're easily able to cover a couple of kilometres a day."
Virology experts this week told the ABC a strategy prioritising access for the highest-risk groups in the population made sense for now, but authorities should monitor the situation carefully in case that needed to be expanded.
