Speaking on the importance of immunisation

On 11 June this year Australia's Chief Scientist, Professor Ian Chubb, made a statement in relation to vaccination. He said that Australia has a proud record in advancing the science of vaccination and making sure it is available throughout the community. 


We have one of the highest rates of vaccination in the world and, unlike previous generations, Australians do not grow up in the shadow of polio and diphtheria. He went on to observe that on an annual basis between two million and three million deaths are avoided worldwide due to vaccination. So the power of vaccinations is very well known. They harness the capacity of our immune system to protect against pathogens.

Although our awareness of immunisation can be traced back to ancient Greece, it was the pioneering work of Edward Jenner in the 18th century that led to the modern era of the vaccination. In what became a famous anecdote shared in classrooms around the world, he noticed that milkmaids who suffered from skin infections from cowpox were resistant to the dreaded smallpox. In the decades that have followed, with the widespread introduction of vaccination, deaths from diphtheria, whooping cough, tetanus, polio and measles have fallen to close to zero in countries like Australia.

A vital component of any efficient vaccination scheme is a structured immunisation register. Registers are a key tool in improving the performance of immunisation programs. They do this by collecting data on the vaccinations that have been given; generating notices and prompting people to have their next vaccination, booster shots and the like; providing certificates of vaccination; and monitoring vaccine coverage, including hotspots across the entire population. Registers allow us to identify deficiencies and to adapt and respond to new and emerging threats.

The Australian Immunisation Register Bill 2015, currently before the House, creates a new, consolidated framework for the two existing immunisation registers. These are the Australian Childhood Immunisation Register and the National HPV—human papillomavirus—Vaccination Program Register. The first of these, the ACIR, which currently records vaccinations for children aged seven and under, will be expanded to collect and record vaccinations given to young individuals under the age of 20. This enables the transfer of data necessary to implement the government's No Jab, No Pay social security measure. From the September 2016 the register will be expanded even further. This will enable the register to cover every single vaccination from birth to death given through GPs and community clinics. For the first time we will have the framework for a comprehensive national immunisation register.

The HPV register will be replaced with the Australian Schools Vaccination Register. This new register will be able to capture data to assist vaccination providers to boost coverage rates. This is a common sense change and one that is supported by the Labor opposition. Currently the HPV register only catches administration of the HPV vaccine. But there are other adolescent vaccinations out there given through school programs that would now be captured. These include chickenpox and the diphtheria, tetanus and whooping cough booster. The changes are needed.

We often seem to think that vaccinations only apply to children, but this, of course, is not the case. There are a large number of vaccinations out there recommended for adolescents and young adults. In fact, the number of vaccinations is increasing each year. In addition to the ones that I have mentioned there is also the influenza vaccination, pneumococcal, whooping cough for pregnant mothers and, more recently, shingles for older Australians. This is the very reason why clinicians and public health workers have long advocated for this change. It is to have some information available for adolescents and adults and children.

How will this help health experts stay on top of the diseases that threaten the health and welfare of all Australians?

The answer is that unexpected disease outbreaks still occur. Recently there has been an outbreak of whooping cough, particularly in northern New South Wales, and this has had tragic implications for newborn babies. There is also the prospect of measles returning to Australia, as has occurred recently in the United States. Comprehensive immunisation registers will help determine whether it is due to low vaccine coverage and will enable a better and more targeted response.

The bill enables the transfer of data to Centrelink. This is necessary because it enables the government to effect the No Jab, No Pay measure that encourages parents to have their children immunised. I note that in the budget papers the government is booking in excess of $500 million worth of savings to the No Jab, No Pay initiative. I sincerely hope that those savings are not realised—not because I do not want the government to be making budget savings but because I want parents to immunise their children. If parents are immunising their children at the rates that are necessary, these savings will dwindle. I would also argue that the government would make up for those lost savings in other areas of health expenditure.

The policy achieves its objective by removing conscientious objection as grounds for people being able to refuse vaccinations while still being able to claim family tax benefits and other social security benefits. It is not going to be popular with everyone, but it is a necessary initiative. In fact, it is an initiative that Labor took to the last election. We did it for a very simple reason. I know there have been complaints. I have received many emails from anti-vaccination campaigners throughout my electorate and throughout the country. I am sure the member for Lingiari, who is at the table, would have received similar complaints from around his electorate. The member for Lingiari and I know that it is unreasonable for those people to expect the collective benefits of welfare payments if they are not themselves contributing to the collective wellbeing of the population as a whole by having themselves and their children vaccinated against preventable diseases. It is for this reason that Labor wholeheartedly supports these changes. It is important that we improve vaccination rates across the country.

As I said at the outset, vaccination rates in Australia have been amongst the best in the world, but we cannot rest on our laurels. Vaccinations are vital to the welfare of all citizens. It is not just about protecting yourself or your child; herd immunity relies on everyone doing the right thing. As the assistant minister mentioned earlier, we rely on quite high percentages of the population being immunised to obtain what scientists call herd immunity rates. For diphtheria the rate is up to 85 per cent; for measles, between 83 and 94 per cent; for mumps, around 75 to 86 per cent; for polio, between 80 and 86 per cent; and for smallpox and rubella, somewhere between 80 and 85 per cent. Against this background it is of deep concern to all opposition members to know that the number of people claiming to be conscientious objectors to vaccination is increasing. Last year, according to the Department of Health, nearly 40,000 Australians had registered as conscientious objectors to vaccinations.

There are some towns throughout the country where immunisation rates are some of the lowest in the world. I am advised that the town of Mullumbimby has vaccination rates of below 50 per cent of the population. This is deeply concerning. At the very same time that we are providing resources to Garvan, along with other international aid organisations, to ensure developing countries throughout our region have access to the benefits of vaccination, we have towns and regions within Australia where vaccination rates are below those of some of the countries we are providing overseas aid to. This cannot be allowed to continue. It is not only irresponsible for the parents of those children; it is collectively irresponsible because it downgrades the capacity of the entire population to resist the outbreaks of certain diseases. So we think it is absolutely critical.

I have mentioned one town in northern New South Wales, but there are others where the rate of unvaccinated children is as high as 60 to 70 per cent. This is unacceptable. There are also other areas where this occurs, and we cannot blame low levels of education, as sometimes people are quick to retort, saying, 'If only we could educate the parents, we could improve vaccination rates.' It might surprise many to know that some of the lowest vaccination rates are in suburbs throughout northern Sydney, in areas like Mosman and Manly, and in the inner city and the eastern suburbs. We all, as public leaders, have a responsibility to talk about this and to ensure that we get vaccination rates up to where they need to be for the good of everyone.

It is important that we have preventative health measures such as these in place, but it is also important to ensure that we wrap around them health resourcing which ensures we are dealing with all areas of health policy. When we are talking about health policy, I cannot remain silent on the lacklustre policy of this government for the last two years when it comes to areas of health policy. We have seen absolutely disastrous attempts to make changes in the area of primary care, not only with the eradication of Medicare Locals and the black hole that existed for many months when people did not know how they were going to be replaced or where they were going to be replaced. We have seen the disaster in terms of the war the government has attempted to launch against GPs in this country, with the GP tax versions 1, 2 and 3 and the freeze on Medicare rebates which is, in effect, another GP tax. It is an attempt to get GPs to pass on a tax that the parliament itself has refused to pass.

These are other areas of health policy that are in drastic need of repair. The Abbott government was fundamentally incompetent at the task. The challenge remains for the newly installed Prime Minister to see whether he is up to the challenge. To date, he has had precious little to say about health policy, but the country is crying out for some certainty around hospital funding and the future of Medicare. These are initiatives that a government is judged on.

While we offer the government full-throated support in its initiatives to improve our levels of vaccination, for the benefit of the entire country, we are deeply critical about other areas of the government's health policy. I commend the bill to the House