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Punishing families not the way to boost vaccination rates

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The media has been rife recently with calls for the Government to deny conscientious objectors the Family Tax Benefits Part A Supplement.

The AMA does not believe that denying parents financial assistance for raising a family is the right approach to improving childhood immunisation rates. A more appropriate response is to identify and refer children who are behind in their immunisation for a program of catch-up vaccinations.

While I can certainly understand the frustration and anger caused by conscientious objectors who promulgate myths, misinformation and unmitigated paranoia about immunisation, punishing them will not alleviate the problem of the 60,000 or so children whose parents are not conscientious objectors, but who are left unprotected from very preventable diseases.

Action has already been taken against the network spreading anti-vaccination messages. They’ve been compelled to change their name to better clarify their purpose, and they have lost their charity status. This is something that can only be proclaimed as a win for common sense. 

The recently released National Health Performance Authority (NHPA) Health Communities: Immunisation rates for children in 2012-13 showed there had been a slight decrease in the number of children not fully immunised at one, two and five years of age. In addition, the report highlighted that the number of Medicare Local catchments where fewer than 90 per cent of children aged five years were fully immunised decreased from 23 in 2011-12 to 13 in 2012-13.

While immunisation rates, in general, are improving, there remain pockets where the rates are well below that required for herd immunity. In particular, in North Coast NSW among one- and two-year-olds and Eastern Sydney for five-year-olds, at 86.1 per cent, 89 per cent and 86.2 per cent respectively. In addition, the Medicare Local catchment areas with the greatest number of non-immunised children (across the three age groups) were Western Sydney, South Western Sydney, Greater Metro South Brisbane, Metro North Brisbane and Inner West Sydney.

What the data also showed was that majority of children who are not immunised are not of parents registered as conscientious objectors.

This highlights that there must be other factors restricting parents from fully protecting their children against preventable disease. These could include:

·        no experience or memory of the devastating impact of preventable diseases such as poliomyelitis measles, diptheira, tetanus, pertussis, rubella and mumps;

·        missed or forgotten immunisations due to busy lifestyles;

·        being part of a mobile or disadvantaged population group; and

·        concerns about the safety of immunisation following false and misleading representations made about it.

This is why the AMA supports universal and targeted measures that aim to increase the rates of infant and child immunisation in Australia.

We are right behind the proposed introduction of nationally-consistent requirements for immunisation documentation to be a compulsory aspect of school and preschool enrolment. Measures such as this enable the identification of children who are not fully immunised, and provide the opportunity to refer them on for a program of catch-up vaccinations.

Talking to parents about immuninisation has often been done opportunistically by GPs. Putting in place a defined checkpoint, such as the compulsory provision of immunisation documentation at school entry, will help ensure these conversations happen, and that parents make an informed choice.

With the weight of scientific evidence behind them, hopefully these conversations will ensure that those children who have missed out on some or all of their vaccinations are provided with the best opportunity for protection from preventable deadly and debilitating diseases.