"Anxiety about getting the vaccine is entirely understandable," said Dr Bartlett, a viral immunologist with Hunter Medical Research Institute.

"To help address this, I would remind people that these vaccines have been rigorously tested for safety. The TGA [Therapeutic Goods Administration] would not have approved them if they were not safe."

Since mid-December, millions of doses of the vaccines have been administered worldwide.

"Many people have had two doses. If there were safety issues it would be apparent by now," he said.

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"Vaccination might be a personal choice, but the impact of that choice is not limited to one person. Unvaccinated people provide opportunity for the virus to persist, mutate and spread and that affects everybody.

"The more people who vaccinate, the less opportunity the virus has to cause outbreaks and the quicker we can return to something resembling normal."

People who decide against being vaccinated against COVID-19 could face restrictions in their lives, as well as being susceptible to the virus.

Some employers could make vaccination mandatory and cease to employ those who refuse vaccination.

"If you do a job with a high risk exposure and that risk cannot be mitigated via other measures such as social distancing, then the employer has a duty of care to minimise risk to co-workers and the public," Dr Bartlett said.

Another area of life expected to be affected is travel.

"There may be restrictions on being able to fly and other countries might impose vaccination requirements for entry," he said.

It has been a year since the first COVID-19 case in the Hunter Region. Dr Bartlett said vaccines will "lead us out of this pandemic and save millions of lives".

"The fact that we have multiple safe, highly effective vaccines rolling out across the globe within a year of COVID-19 being declared a pandemic is a truly astonishing feat of medical science.

"They are not a silver bullet that is going to instantaneously eradicate the virus from the face of the Earth overnight. Vaccines and vaccination have limitations.

"But that does not detract from the monumental achievement they represent. And vaccines will be supported by other treatments that are currently being developed and will provide additional levels of protection that will ensure that we are protected from COVID-19 indefinitely."

Despite the quality of vaccines, some experts believe herd immunity may be difficult to achieve. While the vaccines prevent disease, they may not entirely stop transmission of the virus.

Given this, immunity may wane over time and be worn down by new COVID variants that have been emerging around the world.

This is one reason why other treatments will be crucial. An example of this is the nasal spray that Dr Bartlett has been researching. The drug, known as INNA-X, has shown great promise as a new way to protect people from diseases caused by common respiratory viruses such as rhinovirus. It has also been shown to reduce the level of SARS-CoV-2 [the virus that causes COVID-19] in the respiratory tract.

Dr Bartlett said the next 12 months would be "very much determined by national and international vaccination programs".

"The biggest risk to Australia will continue to be SARS-CoV2 coming into the country while we roll out our national vaccination program," he said.

"While the majority of the country remains unvaccinated, we are vulnerable. So the next 12 months is about getting the country vaccinated, whilst protecting the community from virus brought in from abroad."

He said Australia's international borders should not open until "the majority of Aussies are vaccinated".

"And then it may depend for a time on which country you are talking about."

Australia's borders could be opened to countries with "high levels of vaccine uptake and low case numbers".

"In countries where there is low-level vaccination and ongoing high case numbers, the concern is there may be viral variants that are not well inhibited by current vaccines."

As such, Australia should be reluctant to have open borders with these countries. This problem highlights the need for "international vaccine equity".

As the pandemic is a global phenomenon, ending it depends on "how quickly all countries can vaccinate".

A key factor will be wealthier countries that have bought and/or manufactured vaccines having the capacity to supply other countries that would "otherwise be unable to meet population demand in a timely manner".

The past year has been a big learning curve.

Dr Bartlett said the pandemic experience had shown that "we need more investment in infrastructure and systems in place that enable decisions and processes to happen more quickly".

"This is linked to the high speed at which data can now come from international clinical trials," he said.

"The value of this information is time sensitive and very much dependent on the capacity to efficiently adjust our [Australia's] response according to the latest, most reliable data as soon as it comes to hand."

The need to support basic research in virology, immunology and molecular biology had been underlined, along with its value.

This research was needed to "understand the virus and diseases it causes, as well as produce the treatments and vaccines necessary to bring the pandemic to a timely end".

"Take mRNA for example. It was first identified in 1961. The proposed role of mRNA in regulating gene expression has been rightfully described as a feat of the imagination.

"At the time, researchers were understandably focused on deciphering how your DNA code spells out the protein building blocks of life, rather than thinking about harnessing mRNA molecules to make a vaccine for a pandemic virus.

"But that is the nature of imagination-driven basic research - it often takes decades before it can be translated into a vital medicine."

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