Issue 29 / 3 August 2015

HOW far should authorities go to encourage universal childhood vaccination?
 
The recent “Disneyland” measles outbreak in the US saw almost 200 people fall ill after an infected person visited the theme park. It prompted some tough medicine from Californian legislators.
 
Under new laws, children whose parents refuse to vaccinate them for non-medical reasons will from 2016‒2017 be unable to enroll in Californian schools or childcare facilities, leaving home schooling as their only option.
 
Opposition to the removal of vaccination exemptions on religious or philosophical grounds has been predictable, with various groups attacking the “pro-vaccine mafia”, alleging legislators were bribed by vaccine manufacturers, that truth tellers about vaccine risks have been silenced, and so on.
 
Unsurprisingly, public health experts have a different take.
 
“Other states should follow California’s common sense decision to protect the public’s health, understanding that the state’s interest in protecting children is a higher priority than the freedom of some,” argue the authors of a viewpoint article published last week by JAMA.
 
Although vaccination rates in the state are generally stable (around 92% for measles/mumps/rubella, for example), they are as low as 50% in some suburban areas, the authors write. More than a quarter of Californian schools have vaccination rates among school entrants below the 92%‒94% level recommended for herd immunity.
 
Australia faces similar challenges, with large variations in vaccination rates around the country. 
 
Rates for full vaccination at age 5 years range from an impressive 99% in Victoria’s Goulburn Valley to just 67% in the Byron Bay area of northern NSW, according to the most recent report from the National Health Performance Authority.
 
Pockets of low vaccination exist in areas popular with those seeking alternative lifestyles, such as Byron Bay, but also in many wealthy suburbs, including Melbourne’s South Yarra and the eastern suburbs of Sydney.
 
The federal government is seeking to boost vaccination rates by restricting access to some childcare rebates and family tax benefits for families of children not vaccinated from next year.
 
Under the proposed changes, “conscientious objection” will no longer be a valid reason for vaccination exemption in families seeking these benefits.
 
Removing financial benefits is one thing, but should our legislators take the further step of restricting access to education?
 
It will be interesting to see whether the Californian initiative does actually bring substantial improvements to vaccination rates.
 
If not, the move risks being seen as simply punitive, and likely to feed the already well developed sense of martyrdom felt by many vaccine opponents.
 
More importantly, it could drive vulnerable children out of the education system entirely, compounding risks to their future health and wellbeing.
 
We’ve established that the benefits of immunisation outweigh the risks. Now we need to be sure measures designed to boost vaccination rates pass the same test.
 
 
Jane McCredie is a Sydney-based science and medicine writer.
 

Poll

Do you support punitive measures, such as withholding welfare payments, to boost childhood vaccination rates?
  • Yes – it works (44%, 41 Votes)
  • No – no evidence it works (29%, 27 Votes)
  • Maybe – if nothing else works (27%, 25 Votes)

Total Voters: 93

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5 thoughts on “Jane McCredie: Punitive risks

  1. Sue Ieraci says:

    It’s common for many of the old anti-vax tropes to re-emerge in response to articles such as this. School exclusion is practised for multiple reasons – to protect both the unvaccinated children and the vaccinated who might not have sero-converted by limiting the pool for the pathogens to circulate. If parents are aware that their children are unable to sero-convert, they will generally want to exclude them from exposure to infective outbreaks. ONe may also conscientiously object to wearing seatbelts because they are not risk-free, but most agree that the compulsion is for the greater good.

     

  2. Joe Kosterich says:

    The need to use coercion suggests that the arguements in favour of immunisation are not strong enough to convince people. Plus once a principle of coercion is established it is eaier to use it again. And next time it may not be for such a worthwhile purpose.

  3. kryan says:

    Would Milly West kindly explain how smallpox was eradicated from the world?

  4. John Tay says:

    And one of the reasons that many more people, such as myself, are questioning not so much the effectiveness, but the safety of vaccines, is that the medical profession and media take little note of serious questions that are raised.

    The video linked below is from just last week: Congressman Posey talking about how the CDC has hidden evidence of harm from vaccines.
    The response by the media and/or medical establishment? zip

    http://www.c-span.org/video/?c4546443/posey-cspan-72915

  5. Millicent West says:

    The choice to refuse a medical procedure carrying the risk of death, disability, or chronic disease is to be preserved at all costs. That there is even a debate around the merits of medical consent, free of coercion, is concerning to say the least.  In any case, medical consent is invalidated in the presence of coercion.

    The state already has wide-ranging powers, under existing public health laws, to exclude children from schools in the event of outbreaks of so-called vaccine-preventable disease.  There is absolutely no evidence that extending these powers to exclude healthy unvaccinated children will serve to enhance the health of the public.

    The general public should be very suspicious of the current and unprecedented wave of coercive vaccine policies sweeping the world.  In the case of Australia, overall mmunisation rates increased from a low of  53% in 1986 to 91.2% in 2013., the highest rate ever.  For some reason though, the medical profession is actively cultivating a belief that immunisation rates and conscientious objection are an issue of concern.   The push to vaccine mandates or effective mandates has the strong reek of lobbying by vested interests, which includes the pharmaceutical and medical industries.

    If the medical profession is unable to convince vaccine sceptics like myself, then they need to make better arguments, and not attempt to suppress my scepticism via mandates.  The narrative of vaccines as the single biggest contributor to improved health, after clean drinking water, just doesn’t stack up.  Vaccines have not reduced the overall disease burden.  Australia has a very sick population. 

       

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