Medical anti-vaxxers suffering serious cognitive dissonance

READERS who have been watching the news may have heard about the strong critique by Federal Health Minister Greg Hunt of a group of doctors who have been go-to providers of vaccination exemptions. One such provider came to light after speaking at a gathering organised by the anti-vaccination community in Melbourne earlier in August.

Since the Australian Health Practitioner Regulation Agency investigation commenced, the GP has agreed to stand down, his patient records have been seized, and a community funding campaign to defend him has started in the organised anti-vaccination community.

Vaccination exemptions have been tighter since the “No Jab, No Pay” legislation came into effect in January 2016. Access to the Child Care Benefit, Child Care Rebate and the Family Tax Benefit Part A end-of-year supplement is now limited to families who vaccinate to the schedule, or have a legitimate medical exemption. Families declaring conscientious objection no longer receive the supplementary payments. While there has been much discussion about the pros and cons of financial incentives, a large number of additional children have been fully vaccinated since the law change.

Many of us who have practised for some time will remember getting many of the vaccine-preventable infections ourselves in childhood, and also treating miserable children with measles, or rotavirus gastroenteritis or Haemophilus influenza type b epiglottitis. Thanks to vaccination – with no change in nutrition, lifestyle or sanitation – these diseases have been controlled. Not to mention, of course, smallpox, polio and tetanus. Most new graduates have never seen many of these conditions.

What, then, makes experienced medical practitioners question the effectiveness and safety of vaccination? We know that they aren’t 100% safe – no aspect of life is, let alone medical treatment. We also know that they aren’t 100% effective – which is why herd immunity is so important.

Anti-vaccination sentiment is quite widespread among some “alternative” health care providers, such as the subluxation-based chiropractors. Medical practitioners, though – and especially GPs – are at the frontline of both childhood infections and vaccination. It takes serious cognitive dissonance to distort the risk–benefit balance against vaccination.

Many people would construct this as a human rights argument: the right to refuse vaccination, and the right to practice medicine according to one’s judgement. In Australia, we retain the right to decline vaccination, although financial incentives may be foregone. Registered providers do not, however, have the automatic right to practice outside the accepted standards of our profession.

For those who want to make extraordinary claims about accepted treatment, extraordinary evidence is required. And yet, it is not the eminent vaccine researchers, paediatricians or infectious disease specialists who are questioning the safety and effectiveness of vaccination. What is it, then, that this small fringe of dissenting doctors think they know, that those with most expertise don’t know?

Dr Sue Ieraci is a specialist emergency physician with 30 years’ experience in the public hospital system. Her particular interests include policy development and health system design, and she has held roles in medical regulation and management. She is an executive member of Friends of Science in Medicine.

 

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