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What this new government immunisation policy means to our NSM community

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Recently, the topic of immunisation reared its controversial head again as prime minister Tony Abbott announced his ‘No Jab, No Play. No Jab, No Pay’ policy, linking child immunisation to child support. From 1 January 2016 ‘conscientious objection’ to immunisation will be struck out as an exemption category for childcare payments (Child Care Benefit and Child Care Rebate) and the Family Tax Benefit Part A end-of-year supplement.

There has been a lot of debate on the NSM Facebook group page about this policy change, from supporting it wholeheartedly to saying the government shouldn’t be telling parents how to raise their children. So we thought we’d invite some members of our NSM community – from a doctor to a nurse and midwife, to a childcare worker and an everyday mum – to have their say on the subject.

This new policy will apply to the 14,869 children nationally aged one, two and five years with a conscientious objection recorded, and any parents who haven’t recorded their objection or just haven’t gotten around to immunising their children. There were in fact 75,002 children who were not fully immunised in Australia in 2012-13. This is worth $7500 to many of these families each year, and up to $15,000 per child for many more. In plain terms, the government is hitting families in their hip pocket in order to coerce them to immunise their children.

All of the people below were in favour of the policy, but if you’d like to share an opposing opinion, you are welcome to in the comments section below.

Edwina Sharrock, registered rurse and midwife

No Jab, No play. No Jab, No Pay. What does this all mean?

The ‘conscientious objection’ exemption was for parents who formally registered as objectors to immunisation and were, therefore, still entitled to benefits such as childcare rebates.

The reason the government has given for making this change is that it believes parents who vaccinate their children should have the confidence to take their children to child care without the fear their children will be at risk of contracting a serious or potentially life-threatening illness because of the conscientious objections of others. 

This is the point. In health we have worked hard for years to decrease and, in some cases such as polio, eradicate these devastating illnesses. Research shows that making the choice not to immunise your child weakens what is called the ‘herd immunity’ – a form of indirect protection from infectious diseases that occurs when a large percentage of the population has become immune to an infection, providing a measure of protection for individuals who aren’t immune.

As an emergency nurse, a midwife and a mother, I feel very passionately about this very hot topic of immunisation. I believe each parent has a right to parent and raise children without judgement and without peer pressure. Where I draw the line is if those choices will have the potential to affect the health of other children in their community.

Here are two interesting facts for North Shore Mums.

  • The National Health Performance Authority reports only abut 80% of five year olds in suburbs, such as Manly, are fully immunised against contagious diseases.
  • In 2014 there were 350 formally listed objectors to immunisations in the North Shore and Northern Beaches districts.

This means those 350 children will not be entitled to taxpayer funded benefits as of 1 January 2016.

I can assure you from personal experience, once you have looked after a newborn struggling for each breath while waiting to be intubated, a small needle is obviously the kinder choice.

I believe immunisation is one of Public Health’s greatest gifts.

Kate Parker, NSM

After having a child that was immunosuppressed and brought home as a newborn in the midst of a whooping cough epidemic, I became a passionate supporter of vaccination. Frighteningly, other people’s parenting decisions became a matter of life and death for her, and it was difficult for me to watch the anti-vaccination lobby compelling other parents not to vaccinate, leaving their child and mine susceptible to potentially fatal illnesses. Now, although my daughter has fully recovered, I have an acute understanding of how this debate can affect individual children.

Tony Abbott’s policy is important because vaccination protects the entire community. In particular, herd immunity protects the sick, the young, the old and those that medically cannot be protected through vaccination. It is the reason we have no more small pox and very few cases of polio worldwide.

Herd immunity requires of 90-95% of the community to be vaccinated depending on the disease. Vaccination rates hover around 90% in this country (though they vary for each disease, age group and geographic location). We are on a knife’s edge that leaves our community inadequately defended against preventable disease and the most vulnerable will be the ones to suffer.

This policy attaches a consequence to a parenting decision. Financial incentivisation has worked in the past. While only an estimated 1.77% of all children are registered as conscientious objectors, there are still around eight per cent of children that are not fully immunised. Vaccinating these children could be the difference between life and death for some of their peers. This policy could convince those parents that are unsure or have been exposed to convincing but, in my opinion, incorrect pseudo-science.

Upper North Shore GP

Three years ago I  was telling my patients that the current level of immunisation in Australia could certainly be improved, given the level of whooping cough outbreaks. When there were 1500 cases in the country, and then a year later 1500 cases on average was reported in just NSW alone, I remember telling my patients to just wait and see…

Now, there are just so many cases of whooping cough that doctors like me are no longer being updated on how many outbreak cases there truly are.

Initially, cocooning vaccination was started for family members and grandparents for whooping cough (‘cocooning’ aims to protect newborn infants from becoming infected with whooping cough by administering a booster vaccine – in combination with diphtheria and tetanus – to mothers, family members and any individuals who would come into regular contact with the newborn infant), but this has now been scrapped due to lack of government funding, and only pregnant women can get the whooping cough vaccination in the third trimester.

Overall, things are going to get a lot worse in this country unless our politicians put more money into vaccinations and broadening the eligibility criteria for those who can have them. The ‘no jab, no pay’ is a good start – so many of my patients need to get the vaccination status of their children updated or payment would be withheld for child care anyway. Many parents go through this, and policies such as this will just force people to get their child vaccinated in time. I also find a good number of parents who haven’t vaccinated their children aren’t necessarily against vaccination, they simply haven’t gotten around to doing it. Hence, this ‘no jab no pay’ policy is not too draconian.

Our current national vaccinations guideline is set up for the masses – it’s a population policy – so there will always be somebody who misses out or wants more. But you do have the option to provide extra vaccinations to your children if you want to. You just need to find the right GP to advise you.

For example, I believe the chickenpox vaccine should be given earlier, not at 18 months, but preferably after 12 months of age, as I have had a few patients getting chickenpox before they reach 18 months. Also, not many mums realise that one jab at 18 months only gives you about 85% protection, so that’s also why there are so many chickenpox outbreaks. To gain greater protection, you just need to visit your GP privately to get a second jab.

With regards to the anti-vaccinators, I usually find more than 80% of them have made up their minds not to vaccinate before even discussing with their GP the pros and cons of vaccinations. The GP doesn’t really have the opportunity to educate and provide information. For example, there is a small group worrying about the measles/mumps/rubella vaccination causing autism, but to alleviate their concern this can be given in later years once the brain is fully mature.

I think in this society we should all do our part – we should vaccinate our kids to protect them and others. No matter what, we should not put at risk other people’s children, period.

Laura Hale, registered nurse, childcare worker and nanny

I am completely for the new government change being implemented in relation to immunisations and continue to be astounded by a parent’s choice not to immunise their child. To me, it is as simple as being asked if your child would like oxygen when they are unable to breathe themselves. I have seen the devastation that a loss of a child can cause a family, friends and the entire community due to unfortunate circumstances and would push any efforts to remove the risk of anyone I come across placing themselves in that situation. The government is doing its part to reduce the percentage of childhood deaths in an effort to abide to worldwide health goals, and it has been proven that vaccinations have been the most effective way of doing this, and has been the most successful way of reducing morbidity even when compared to the introduction of antibiotics. In my opinion, it’s as simple as this: if you care for your children, get them immunised. 

Of course, the above opinions are only a broad example of those within the community. If you would like to add your say, please do so respectfully in the comments section below.

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