sMater - RSV, long COVID and influenza | Prof Paul Griffin

This week on sMater, Mater Director of Infectious Diseases Prof Paul Griffin joins us to talk about RSV, COVID and influenza.

He shares invaluable insights on vaccination rates, evolving virus strains and what the future holds. 

GP Education activity log:  

- Podcast title - sMater: RSV, long COVID and influenza
- Provider - Mater Misericordiae Ltd  
- Date published – 30 May 2025

Certificate of completion: http://www.mater.org.au/files/group/documents/smater-certificate-of-participation-rsv-long-covid.pdf 

#healtheducation #healthcare #covid #RSV #influenza #vaccination #smater #mater

To learn more about Mater, visit https://www.mater.org.au/

To learn more about Mater, visit https://www.mater.org.au/

Transcript

Hello and welcome to this episode of SMater, a podcast by clinicians for clinicians,

brought to you by Mater, an Australian leader in health care for more than a

century. My name is Jillian Whiting and I'm your host, coming to you from Meanjin,

the land on which this podcast is being recorded. And I'm Dr Maria Boulton, GP

specialist and former president of AMA Queensland. Today we're joined by Professor

Paul Griffin, Mater's director of infectious diseases. Paul is a leading infectious

diseases physician and clinical microbiologist who became a trusted authority on

vaccine education and advocacy during the COVID -19 pandemic. We are Mater.

We are Mater. We are Mater. This is SMater.

Paul welcome to SMater. Thanks very much for having me. We're keen to tackle quite

a few topics today including long COVID and the flu but can we start with RSV and

what we're seeing so far this year? Look it's interesting we're seeing quite a lot

from a number of respiratory viruses but RSV in particular we are seeing quite a

lot of cases already and unfortunately quite a few hospitalisations but of course the

biggest thing that's changed with RSV is we now have a lot we can do about it so

that's really the message we're trying to get out there right now. Why is its

prevention so complicated? Look for a few reasons it was a real challenge to make

an RSV vaccine so we discovered RSV in the 50s and it's not like we only just

thought up making a vaccine in the last few years. The first vaccines very crude

caused some problems so that set RSV vaccination back a long way and we needed

quite sophisticated sort of molecular biology techniques to make the kind of really

clever, highly effective vaccine that we now have. But all those things have happened

and we now have a number of different interventions, but at the moment the uptake's

been a little bit slow, so we want to get the message out there. In February we

welcomed the inclusion of the RSV vaccine at Brisbane, the NIP for pregnant women.

It's early days, but are we seeing the desired immunological response in newborns and

what are the long -term benefits of the vaccine? You're too early to see a direct

impact of the the rollout that started. I mean, we were so happy that that

announcement came. We've had these vaccines for a little while, but until that

announcement in February, none of them were funded. So that was a big barrier to

their uptake. So very welcome announcement. We're seeing some reasonable uptake but

not where we want it to be. And in terms of actually translating that into

outcomes, It's a bit early, but we certainly anticipate that will be the case. In

addition to this, we've had the monoclonal antibody treatment, Nosevimab, that's also

been made available for babies and infants at risk of RSV, and Marder, as well as

the other hospitals have been offering to newborns since last April. What do we know

about the impact this is having on RSV cases and admissions to hospital? We know

it's had a huge impact. So us and others are measuring what we've seen and there

was some information put out by the government early on in the season last year

that there'd still been 90 babies admitted to hospital with RSV, but not one had

received a seven MAB. And so that was a reduction of nearly 50 % on what was

expected compared to previous years. So truly having an amazing impact, we've had a

bit of a look at some of the information around the uptake and it's not been as

high as we'd like with that either. And now one of the big challenges is it's a

really complicated system with a sort of national NIP funded vaccine and a state

based funded antibody and who gets what. So, you know, I think we need to do a

lot more to educate everybody about these preventative measures and where they all

fit in. But yeah, when we look at the impact of Necevimab, it's been huge. And so

it's really great that now most states have access to that. Are there any

limitations on stock? My understanding is that there were some challenges early on,

but at the moment, not really. So I think the biggest challenge is knowing who's

giving it and when. We looked at some of the data and some people missed out early

on and then we weren't sure if they got it later on. Are we any closer to having

a vaccine that is approved for babies and infants? Yeah, look, that's a bit of a

tricky one. So, you know, given we have maternal vaccination, now we seven ab and

that's so safe and effective. I think the momentum for developing vaccines for

younger babies is probably slowed down a little bit. So there's nothing imminent as

far as I'm aware. I mean maternal vaccination is such a good strategy because you

kind of get a three or four for one. You protect mum, you protect the baby

directly, it's a bit of cocooning so baby won't get it from mum and then even

maybe some transfer of immunity through breastfeeding. So it's such an effective

strategy that then trying to additionally vaccinate the babies, there's probably a

little bit less momentum to have to do that in addition. Let's talk about trials

and Mater's also part of a first in human trial using an experimental mRNA vaccine

designed to prevent RSV in participants aged 60 to 75.

What can you tell us? How's the trial progressing? In terms of some of our vaccine

work, you know, it's always hard to comment too much until the trial is completed

and the data is analysed and that can take up to 12 months after, so make sure we

rigorously put all that together. But our vaccine studies, including that one, are

going really well. We've got a community that's supportive, so we recruit lots of

eager people into our studies and obviously carefully monitor them. So a bit too

early to report on results, but it's looking promising. Older Australians are at risk

of severe disease when it comes to RSV. There is a vaccine available but the cost

is really prohibitive. Is there any moves to fund it? The biggest change with one

of the RSV vaccines is that they were initially both approved for over 60s and

about two and a half weeks ago, one of those was expanded to be available for

people 50 to 59 with risk factors. But in Australia we've got this complex system,

they get approved by the TGA so they're available, they get kind of recommended by

another group, and that adds a layer of complexity. And then the funding piece is

very separate. And there's always a lag. So they never happen one straight after the

other. So to get something funded, there has to be a really detailed, robust

evaluation of cost -effectiveness. And even though we know the vaccine's safe and

effective, it's not always determined that it's cost -effective in that group. So

we're still waiting on that. There's lots of people lobbying really hard to get it

funded because we know that especially at the moment with costs of living etc that

you know the cost of that vaccine is a real challenge but in some of the

discussions we've had around that it's been really interesting some of the anecdotes

so one of the best tips I think I had from a GP was don't you know tell people

not to assume people can't afford it because if they've seen a young baby with RSV

or they've had up themselves or a family member sometimes people who probably can't

afford it will still want to pay for that vaccine so I think still recommending it,

making sure people know that it's out there and how it fits in and how significant

RSV can be is still really important. And Queensland does seem to be ahead of the

game when it comes to funding vaccines, right? Like we fund the flu vaccine for

everyone? Yeah, look it's been incredible and you know shout out to everyone involved

and to the government for doing that and you know we have big meetings where we're

talking about funding of these vaccines in other states and you know they're really

jealous of our situation here at the moment. The flu vaccine as you say funding

that for everyone is amazing. Manager Cockle is another great vaccine funding story

here and of course we were the second state to roll out the antibodies for RSV. So

we're very lucky here in Queensland and I just hope that it continues and we have

certainty about those things moving forward. - On vaccines, what are the current

challenges in developing a universal RSV vaccine? - It's great, we've got three

options. So two options approved in Australia, there is another option approved in

the US that might come here in time. It's like a lot of vaccines, we're really

lucky to have those but there's a big shopping list of additional properties that we

would like potentially so a lot of work still continuing. I think at the moment

what we've got is probably what we're going to have for some time. There's probably

not a lot of movement there other than maybe combination vaccines that I'm sure

we'll get to in a moment. I think just to be aware that the vaccine options we

have now are safe and effective. Biggest barrier, of course, is cost, but we're

really lucky that they're working really well.

RSV became a reportable virus to the National Notifiable Disease Surveillance System

in July 2021, more than a year after COVID -19 was listed on the same register.

RSV's addition to the list was driven by a combination of enhanced surveillance

capacity, greater recognition of its health burden and the emergence of new

preventative strategies, all of which gained momentum in the wake of COVID -19.

I don't need to tell you this but COVID arrived five years ago, I don't know

whether it feels like yesterday or a lifetime ago, what about you? Look in some

ways it feels like we've been doing it forever and in some ways it feels like

we're just getting started and you know the discussion around COVID is fascinating, I

mean it's really clear, so many people describe it as post -pandemic or post -COVID

but it's not going to go away and it's going to keep being a problem forever and

I think that's really the mindset change that we have to bring in now is that we

want people just to incorporate this into what they do sensibly and practically to

keep themselves and everyone safe every year just like we've been encouraging people

to do for the flu and now we're doing for RSV as well. So much has changed really

in that five years and including the variants presenting. So what's the next variant

that we're keeping an eye on? How does it present differently to those that we're

seeing at the moment? It's funny, I think for most people they don't need to know

what variant we're talking about. We can encourage people to leave that for a small

number of people who are responsible for coming up with recommendations because this

virus is going to keep changing. There's thousands of Omicron sub variants. Now The

latest one, LP 8 .1 is dominant globally, not yet dominant in Australia, but will

be. And the same discussion we've had probably 50 times now, we don't know whether

that's gonna mean we get a rise in cases from that sub variant or one in the

future. But what we do know, inevitably COVID will increase again. We're probably at

the lowest numbers of COVID right now that we've seen, which is great, but that's

not zero. And that's not gonna stay that way forever. So COVID will keep coming and

we've got great interventions but they're just being so dramatically underutilised.

What are the latest insights into how long COVID presents and presents differently

across different demographics? Yeah that's a really challenging one and you know I

think in the end we'll discover there's lots of different types of long COVID and

basically it's different for individuals. You know if you look at sources in the

literature they'll say there's 200 or 250 symptoms of long COVID, but basically it's

anything. I think that the commonest ones are sort of general things like fatigue

and lethargy, and it's people that just can't do what they used to do. They're

fatigued. Like running a marathon would have been before. Daily activities, fatigue

them and leave them washed out. And then there's a lot of different organ systems

involved. I think probably the next common ones, and it depends on which source you

use, respiratory, want us a breath even on doing things that wouldn't have been

considered activity before talking or walking, cardiovascular, chest pain, fast heart

rate is really common, neurological things and I think everyone's familiar with brain

fog but you know that means different things to different people and then from there

it's anything. Some people can have musculoskeletal things, other neurological things

and even gastrointestinal things so changes in bowels is something as well. Has there

been a shift in how long COVID presents? Because it seems that at the beginning, at

the start of the pandemic, we're getting a lot of people with chest pain and

shortness of breath, whereas now we get more the fatigue and the gut issues. Yeah,

I think so. Part of it's also a recognition thing as well, and the types of people

we're seeing. And, you know, obviously, and, you know, certainly not suggesting COVID

is not a problem, as we've already said, but the risk from COVID has declined. The

number of people in hospital and dying is less, which is fantastic. So how we're

talking about and thinking about COVID is a little bit different. So I think part

of that is, you know, maybe we're not finding a lot of them these days as well.

And for so many, it's hard for them, you know, we don't have the long COVID

clinics like we did. It's not talked about as much. So there's probably an under

recognition which might be skewing some of those presentations. So yeah, it's

complicated. - What are the current evidence -based guidelines for treating long COVID?

Because we know that I mean these patients they'll try anything but where is the

evidence? Yeah look at a tricky one and you know it's great there's a lot of

research happening in long COVID I'm part of the group assessing a whole lot of

grants that are coming through for for all sorts of different things with long

COVID. I mean what we really need we need to understand the mechanism better we

need to be able to diagnose it better and of course what we want that to translate

into is better management and at the moment we're really wanting in all of those

areas. So, you know, I think in terms of what's causing it, there's probably a

whole host of different things. And maybe, you know, a lot of it is an

immunological thing, maybe a bit of an exaggerated immune response. And part of it

is probably also a direct viral thing. So we're still working on it there. But in

terms of approved therapies, basically we don't have any. There's emerging evidence

that if people get met foreman early on in their COVID, it probably reduces the

chance of getting long COVID. But again, there's some controversy around that, so not

suggesting we prescribe that. I guess the simple answer there is keep an eye out

for guidelines when they come, when we do have approved therapies. But at the

moment, no pharmacological therapies. But I think there's been a whole host of things

that can help in my experience. And I think, first of all, having an understanding

and appreciation that it's real because a lot of these patients bounce between

different people getting told there's nothing wrong with you and I think that

frustration and that need to be validated and have someone who can just listen to

them is really important. I think making sure there's not something else going on,

not just assuming that's long COVID, you know, because we don't want to miss things

like PEs or thyroid issues, diabetes for example, but then there's a whole host of

multidisciplinary people that really help, whether it's exercise, physiology,

physiotherapists, et cetera, there's a whole host of people that can help. And I

think involving as many of those as possible, ideally with a long COVID clinic, but

they're so hard to get into. But just making sure that you understand and listen to

those patients and do as much as you can to help them. Is there any evidence for

vitamins and supplements?

Obviously, if you're deficient in something, it will make a difference. So we

certainly want to make sure people aren't B12 for later on. Deficient, for example,

but if you're not deficient taking all of those things, unfortunately, doesn't have a

role necessarily. Are we getting any closer to an effective long COVID treatment?

Look, I think we will get something, but I think because long COVID is probably so

many different things, we might have treatments that work for some people and not

others. And part of that will be working out who's got what type of long COVID or

what's driving there long COVID to be able to address it more specifically. So I

think we will get some therapies. But at the moment, nothing that's approved. I

guess the one thing I will remind everybody is there's really good evidence that if

you're vaccinated, you're less likely to have long COVID. It obviously changes the

acute presentation. They're likely to getting more severe disease in the short term,

but it also has really good evidence for reducing your chance of long COVID. And,

you know, we know as So, severity indicator, for example, if you're hospitalised with

COVID and get long COVID, you're likely to have long COVID longer, so probably nine

or 10 months. If you're not, then your long COVID is likely to be shorter, so on

average maybe four or five months. So, again, the benefits of vaccination are really

clear there, too. Is there any research going into the use of monoclonal antibodies

in the treatment of long COVID? There's lots of things, and if we look at

potentially having an immunological mechanism. We've got so many great ways of

modulating the immune response with monoclonals now and there's some work specifically

looking at all types of monoclonals there. Again it's relatively early though and I

think one of the things we need to do is be able to diagnose it better, maybe

classify it into certain types and then look at more specific interventions there and

you know there's lots of great work happening in Australia as well as elsewhere into

a lot of those things. hopefully we'll have some progress soon. - You mentioned

before that COVID numbers are down currently. Does that translate to the chance of

developing long COVID? Were we seeing more people developing long COVID early on in

the pandemic than we do now? - Yeah, it's a bit complicated. So, you know, it's

fascinating. We talk about our case numbers now, but we know we're probably only

scratching the surface with the real numbers that are out there. So you know one of

the ways we look at that is the proportion of tests that are positive and we used

to freak out when I got to sort of six or seven before because that told us we

were missing a lot of cases and it's you know usually 10 to 14 at the moment so

we know we're only finding a small proportion so you know while we've had you know

60 odd thousand cases across the country this year it's probably many times that and

then the proportion that go on to long COVID is very different depending on how you

define it and what source of data you use. So, you know, most people would suggest

it's probably around six to ten percent of acute COVID goes on to long COVID. But

if we're not finding a lot of the acute COVID, it's very hard to know. So, you

know, the actual prevalence of long COVID is really hard to determine. What advice

can we give patients who have symptoms of long COVID? Well, I think the first one

is to just provide reassurance that you will get better. Most people get better from

long COVID. most people it's within a matter of months and for the vast majority

it's within a year. So be optimistic about recovery. There's some work coming out

about some other ways of approaching long COVID and it's the the three P's which is

pace, plan and prioritise which really is about not overdoing it.

So many times I get the story recounted that they feel really flat they have a

better day so they go to the gym, mow the lawns, do the shopping and then get off

the couch or out of bed for two days. So it's about pacing yourself, holding back

a little bit, planning your activities so that you can have breaks and spread things

out and prioritising. Just understanding that you have some limitations, you're not

going to be able to do everything. So pick the top things, get those done whilst

planning and pacing yourself and appreciating you can't do everything and just giving

yourself time to recover. Do you have any advice for people who want to return to

exercise, you know, particularly those people who are avid exercises like people who

do triathlons, etc. Yeah, the way I'll describe it to them is for a lot of those

people doing a normal thing that you used to do, a day -to -day activity, will be

like doing whatever event it was you used to do and just think about it that way.

So in essence, almost train to get back to having a full day, whether that's work

or just doing normal things, don't overdo it early 'cause that'll set you back just

like it would have when you started training for your marathon or your rowing event,

et cetera. So think of your daily activities almost as an event to train for and

have a long -term plan in terms of getting back to what level of function you had

before. - The thing that concerns me, Paul, is that it seems that people aren't

aware that there are antiviral treatments for COVID and particularly those people who

are high at risk. But it seems that people aren't Yeah, absolutely. And you know,

that that's a great question and a really important point. So first of all, testing

has become much harder to access. So early on, you know, I think it was great. It

was one of the big strengths of Australia's response was that we just let people

get tested without needing to see a GP first and waiting for the referral and then

paying extra for that, the drive -through clinics. They were great innovations that

made a huge difference. And of course, we've undone all of that now. So many people

recount to me that it's just really hard. You've got a CGP get a referral that

there's a bit of a delay and then there's a delay getting that test and you know

The single biggest determinant of how effective antivirals are is how quickly they're

initiated. So on that point I encourage high risk people to have a plan for how

they get tested and get access to the antivirals Head of their infection if they're

in that risk category that they might benefit from that because that way they can

do that quickly And it's going to make a huge difference. And the other thing about

testing is with, you know, laboratory based PCR, those no swabs we all can to know

and love that major eyes water, we can find all sorts of things at once. And we

have excellent antivirals for COVID, excellent antivirals for the flu again, if

they're started early in high risk people. And then we have antibiotics for some of

the bacterial things that can look similar, microplasma and whooping cough. All of

those things are indistinguishable early on. So you don't know what someone's got,

but we can do something about those. And then kind of a secondary gains. We also

know what's out there. We can do excellent surveillance. That's how we know what

subverance of COVID is circulating. That's how we know what type of flu is around.

So there's heaps of benefits to testing. And I think people have lost sight of a

lot of that as well. And just also on the rapid -angent test, just so people know,

there's actually combination rapid -angent tests as well, so they'll do COVID flu and

RSV so they're really helpful and especially if there's delays or people can't access

a laboratory the challenge with those is the sensitivity and when we've looked at

some of those for flu B for example sensitivity of those combo ones you do at home

it's probably 30 or 40 percent so the big message there is they're great do them

and if they're positive get your antivirus isolated etc but if they're negative don't

assume you find to go and visit your sick relative in a nursing home or go to a

hospital because you could still have COVID flu or RSV. - Yes, and I do have some

of those in my drawer. What we do at our clinic, and what some GPs do, is that

basically, if somebody's at risk of severe disease with COVID, we put it in the

comments section in the file. So if they ring up with respiratory symptoms, we know

that they need to be fitted in, we know that they need to be tested, and we know

that they need to be considered for the antiviral treatment as well. - Yeah, that's

great. And I think the other message there as well. And one of the things that's

probably contributing to the high numbers of all these things we're seeing is either

way, if people have symptoms, we want them to stay home. And that was a message

that was really effective during COVID. And people probably remember if you went on

a bus or in a public place and coughed or sneezed, everyone would look at you. And

so people were doing the right thing for a variety of reasons. But we used to say

this every year for the flu. And people think they're doing the right thing

soldiering on. But there's great evidence that doing that and spreading your COVID

flu or RSV in the workplace has a massive impact on productivity, so it's better if

you do the right thing, stay home till you're not shitting and potentially spreading

those things around and then go back to work.

The Australian Institute of Health and Welfare reports that from the limited data

available, current prevalence estimates of long COVID, defined as 12 weeks or greater,

in Australia range from 5 % to 10 % of COVID -19 cases.

- Focusing on the flu now, our vaccination rates have been described as dire. Our

flu case numbers are tracking above the average for the past five years. So what

does that mean for the flu season ahead and what should GPs be preparing for? - The

simple answer there in terms of what it means is worse than it should otherwise be.

So first of all, on the numbers. So we've seen about one and a half to two times

the number of cases we would see for January, February, March and April. So a

really big inter -seasonal period with flu. Now, a lot of people say, what does that

mean for the season? Simple answer is we don't know what the season is going to

bring until after and we can reflect and look back. But it is a bit concerning,

especially when you then factor in our vaccination rates. And, you know, we've

touched on how great our job Queensland has done in terms of funding flu vaccines

for everybody, unfortunately, that hasn't translated into an increase, which is what

we'd really like to see. And, you know, if we look at our highest risk groups, so

people over 65 and young children, we're tracking along on about a third of those

people being vaccinated, which is really concerning. And, you know, as I mentioned,

that means that whatever the flu season brings, the impact will be greater than it

should have been. we know flu vaccines aren't perfect, we know you can still get

the flu after you've had a flu vaccine but what we do know is that flu will be

different in terms of your trajectory. You'll be sicker probably for a shorter

period, you're less likely to go to hospital, less likely to die from the flu and

probably less likely to spread it as well. So if people want to know what the

benefits of those vaccines are it's really clear and the fact that people can still

get the flu is not a failure of those vaccines And I think people need to

understand that there's so much misinformation about flu vaccines and vaccines in

general that I think that's part of what's impacting those rates. I am concerned

that it's quite an early season, but also it seems that those patients who are

becoming sick with the flu who are unvaccinated are actually reporting really severe

symptoms and it's spreading quite easily amongst the family members, which is not

good. I was just wondering, when it comes to vaccines, is there any research on

what is best when combating misinformation about vaccines? We haven't solved this,

otherwise we'd have better vaccine rates. I think, you know, part of it is

understanding what people's concerns are. And you know, I think there's a, there are

those people that are what would have previously been labelled as true anti -vaxxism.

We probably can't change their opinion and that's fine because I think they're the,

they're actually the minority. But I think there's a lot of people that are a

little bit confused because it's really complicated. You know, we've got more vaccines

for the elderly now. I often say that for older adults, it's a bit like being in

the pediatrics space 'cause there's now a whole host of quite complicated vaccines

that we recommend for that group. Pediatrics, we know, has always been complicated.

And in pregnancy, there's now three vaccines we recommend for every pregnant woman.

So it's just more complicated. So for many people it's overwhelming I think that's

part of it. I think the amount of information that's out there is hard for a lot

of people to digest and I think for a lot of people they're probably sick of

talking about infections as well that and it gets called fatigue although some people

said we don't want to describe it as fatigue but it's just been too much maybe so

you know I think that's a role that a lot of people involved in this space can

really have in just reminding people telling them how important these things are and

you know our GPs do a great job of doing that every day, but we know that they're

busy and time poor, so it's hard to just rely on them. Pharmacists have a bigger

role these days, but I think everybody just needs to know how important these

vaccines are and do a better job of reminding people and encouraging them to get

them every year. - Well, we heard earlier this season about the risk of the

quodemic, RSV, COVID, influenza and Norovirus all striking at once,

is it still a risk and what are the implications of these co -infections? That's the

thing that makes every winter more challenging now is we used to have, you know, we

used to struggle with the flu season every year and we had a bit of a bad flu

season. That by itself was enough to make our hospitals more stretched than they are

at baseline, make it really hard for our GPs. We know that, you know, there's

millions of primary care presentations from the flu alone potentially every year. Then

we add RSV to that and now we've added COVID to that and every year COVID is

going to be something we consider in addition to the flu and RSV. But we're seeing

lots of other things. Norovirus is one. In the last couple of years we've seen a

lot of microplasma and whooping cough or pertussis as well. And now we've got

measles and all sorts of other things as well. So it's a really crowded space and

so that means in a resource constrained environment where we want people to come and

get advice about vaccines and get access to get tested etc it's really hard and so

you know we are in for a tricky winter I think. Speaking of combos is there any

progress being made on a combo vaccine you know COVID flu maybe COVID flu RSV.

I'd like to think there are some upsides from what we went through with COVID and

I think it has advanced a lot of vaccine development and so now there are heaps of

combination vaccines. And here at the Mata, we're trialing a few of those. So COVID

flu, COVID flu, RSV, and even some with human metonymivirus in it, where we haven't

had an approved vaccine. And that's probably the virus severity wise. It's just below

those other three. So it'd be great to have a vaccine for that. So yeah, there

will be combination vaccines. Like all these vaccines, we can't recommend them or say

they'll be available until we've got the data to approved that and they're approved

by our regulators so that's not the case yet whether it's this year or next year

or the year after it's hard to say but I think that'll make a big difference the

biggest thing of course and we'll be talking about that a lot at the time is it's

gonna be really hard to know when to recommend those because the seasonality of all

those things doesn't overlap exactly so yeah we're gonna have some interesting

conversations but yeah the combination vaccines will come. So much work being done in

this area. What about a universal flu vaccine? You know lots of really good work

being done and I think we're getting much more advanced in some of our techniques

with vaccines that you know that might be something we're getting closer to but

that's been tried for a long time. It's a really really difficult thing to do so I

don't know if we'll ever get a true universal vaccine. I think you know the next

big steps forward with flu is we're going to have combinations. We're probably going

to have very soon vaccines that don't need to be given by a needle and syringe so

patches things you can put on the skin which will be a big step forward and then

maybe an intranasal vaccine so we've kind of got one of those but that's going to

improve so again we can spray it rather than having to inject it so lots of great

work happening you know locally and here at the martyr even on a lot of these

things but you know for now the main focus I think has to be on recommending the

vaccines we have because they're already excellent but just underutilised. And that's

something that you've been doing very publicly for the past few years. We've been

talking about your public role and talking about all of this just from a personal

perspective. You do a lot of talking about it. How are you feeling about it and

how much work do you actually do sharing this message with the broader population?

Yeah, thanks. Look, there's so many important messages that I think aren't easy to

find for people and this is feedback that I get often is that you know there's a

lot of noise so I you know I guess my approach and whether I do this or not I

guess it's up for other people to to decide but I just try and get the what I

think are the important messages out there in a way that hopefully most people can

can understand and you know as I mentioned we've got great vaccines they are safe

and effective or we just can't use them in this country and the utilization of

these interventions has a direct impact on what we see, whether it's COVID flu,

measles, etc. And so we do have to try and combat a lot of the misinformation and

lack of information by trying to get good things out there. And I try and help in

a really small way in that regard. Well, thank you for all the work that you do.

And thank you so much for joining us on SMater Today. Before we go, though, we

have a little segment called The Checkup. So, surprise, we have five quick questions

to ask you and Maria will ask you and they're just questions about you to give us

an insight into the man you are, so are you ready to go? Let's go. Quick five.

Great. Alrighty. What was your first concert? Oh, probably Pearl Jam.

If you could impart one piece of knowledge on a medical medical student what would

it be. I think just to let them know it is a hard road ahead but it's a really

enjoyable one and if you put the work in it's an amazing career. Who was the last

person you FaceTimed? FaceTime? Oh I'm Android so I don't have FaceTime.

You Android. I guess Skype which now doesn't work but my parents my parents live

interstate so I virtual call them all the time. And what TV show best portrays your

profession? Look, it probably reflects a bit of my nerdy approach,

but I like Scrubs. That's a great show. What's your secret superpower? Oh,

gosh, secret superpower? I don't know. That's a hard one.

Never thought about it like that. Might Just like a rain check on that question,

I'm not sure. Yeah, to be discovered. To be discovered, yeah, exactly, exactly. Paul,

thanks again so much for joining us on SMater. It's a pleasure, thanks for having

me, guys. For our listeners at home or in the car or having a well -deserved break

between patients, thanks for tuning in. See you next time on SMater.