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Community Affairs Legislation Committee

BEATTIE, Mr Greg, Member, Australian Vaccination-skeptics Network Inc.

DOREY Ms Meryl, Private capacity

KEMP, Mrs Debbie Patricia, Member of Delegation, Citizens Concerned with Vaccination Legislation and Safety

SMITH, Mr Brett, Member of Delegation, Citizens Concerned with Vaccination Legislation and Safety

TOMLJENOVIC, Dr Lucija, Guest Speaker, Australian Vaccination-skeptics Network Inc.

Evidence from Dr Tomljenovic was taken via teleconference—

Committee met at 09:06

CHAIR ( Senator Seselja ): Good morning. Do we have Senator Di Natale on the line?

Senator DI NATALE: You do.

CHAIR: Great. I declare open this public hearing for the committee's inquiry into the Social Services Legislation Amendment (No Jab, No Pay) Bill 2015 and welcome everyone here today. I thank everyone who has made a submission to this inquiry. This is a public hearing and a Hansard transcript of the proceedings is being made. The audio of this public hearing is also being broadcast via the internet.

Before the committee starts taking evidence, I remind all present here today that this hearing is a proceeding of parliament and attracts the same privileges and immunities as parliament itself. It is my role as chair to ensure that witnesses participating in the hearing are able to give evidence freely and honestly, without fear of recrimination and without interjections from members of the public. I remind everyone that, in giving evidence to the committee, witnesses are protected by parliamentary privilege. It is unlawful for anyone to threaten or disadvantage a witness on account of evidence given to the committee. Such action may be treated by the Senate as a contempt. It is also a contempt to give false or misleading evidence to the committee. The committee prefers all evidence to be given in public, but, under the Senate's resolutions, witnesses have the right to request to be heard in private session. It is important that witnesses give the committee notice if they intend to ask to give evidence in private. If you are a witness today and you intend to request to give evidence in private, please speak to the secretariat staff.

The committee has scheduled two 25-minute sessions today, at 10.45 am and 1 pm, for people who are not listed as witnesses on the program to make a short statement to the committee. There will be a strict two-minute limit on these statements. To participate in these sessions, I ask that you register with the secretariat. The secretariat will provide you with a copy of information on parliamentary privilege and the protection of witnesses and evidence and will ask you to complete a Hansard witness form. The order for speaking will be on a first come, first served basis.

I remind witnesses and senators that parliamentary privilege does not apply to countries or persons outside of Australia. I understand you are coming to us internationally, Dr Tomljenovic.

Dr Tomljenovic : Yes, from Canada.

CHAIR: Would witnesses like to state anything about the capacity in which you appear?

Dr Tomljenovic : I am a senior research scientist at the University of British Columbia. I work in the school of medicine.

Ms Dorey : I was the founder of the Australian vaccination network and I am just a concerned citizen testifying today.

Mr Beattie : I was past president of the Australian vaccination network.

CHAIR: The committee has received your submissions. I would now invite you to make an opening statement and at the conclusion of your remarks I will open it to the committee for questions.

Mr Beattie : As I said, I am a past president of the AVN and I am the author of two books on this issue. We are dealing with a belief system. We frequently hear that the science is settled, that science has spoken and that the consensus is in but, although science is involved, the truth is that it is a belief system. People repeatedly refer to 'the science', but they cite no relevant scientific studies; instead they quote each other, claiming that 'the science' supports them. Such claims have value only as a rhetorical device, known as appeal to authority. By contrast our submissions are referenced with dozens of high-quality peer reviewed studies.

So let me challenge you to ask yourself: why do you believe in vaccines? Do you have the evidence for their protectiveness in the field and for their long-term safety? Can you use that to build a robust case that will stand up to scrutiny? If you do not, then your belief is not science based; it is based on faith. You have faith that those telling you that vaccine save lives are speaking the truth. We are all familiar with belief systems. We are entitled to buy into them, if we feel compelled to do so, but the role of government is limited to facilitating them. Only in dictatorships do belief systems get imposed on others by mandate. This does not happen in a democracy. As senators, your responsibility must surely be to protect the integrity of our democracy by not allowing such a impositions to take place. So the question for you is: do you want to take the leap from democracy to dictatorship—from facilitating a belief system to mandating it?

Today we have a scientist with internationally recognised expertise here by teleconference. Dr Lucija Tomljenovic has published extensively on the subject of vaccine harm. She serves as a peer reviewer for several journals and is one of the editors of the immunology textbook, Vaccines and Auto-immunity. That means that she probably has few peers in the world in relation to expertise on that subject. She has graciously offered her time today to give evidence concerning vaccine safety. Please take the opportunity to ask her about some of the research that has led parents to question vaccination.

Dr Tomljenovic : I would first like to make it clear that there are many in the scientific community who do not question at all the idea that vaccines can cause adverse events. The only thing they question is how often these events occur. The idea of imposing financial sanctions on parents who refuse to vaccinate their children according to the official vaccinations schedule, as prescribed by the Australian government to health authorities, is flawed of scientifically and ethically. And I will explain why.

Again like all other drugs, vaccines can cause adverse events but, unlike conventional drugs, which are only prescribed to people who are ill, vaccines are administered to healthy individuals for preventative measures. So the tolerance for adverse events in this case is much narrower than for conventional drugs. Most side-effects attributed to vaccines are mild and transient, but reactions such as anaphylaxis and induction of autoimmunity can occur although with much lesser frequency. These can be rather severe and, in some cases, fatal. The occurrences of such serious events, despite what has sometimes been promulgated, are quite extensively described in the scientific literature. In many cases, direct causal links have been established between vaccination and the adverse events. These are, again, not fables; these are facts. Given that vaccines are delivered to billions of people without preliminary screening for underlying susceptibilities, it is of concern. As we all know, vaccines are given to many people and, yet, not so many have serious adverse effects. However, it is, again, naive to believe that all humans are alike. It is known that autoimmune diseases have a certain genetic basis. Thus, certain genes can create a genetic predisposition which can bias someone toward developing an autoimmune disease.

Typically, in these cases, an environmental trigger is required to precipitate the manifestation of the autoimmune state. Examples of such environmental triggers commonly associated with development of autoimmunity are viral infections and vaccinations. The reason for this is that the mechanism for which the host immune system responds to vaccination resembles the mechanisms by which the response against the immune infectious agent can precipitate an autoimmune disease. This will be clear in a specific example. For example, one well-known mechanism by which infections or a vaccination can initiate and exacerbate autoimmune diseases is molecular mimicry, where a foreign antigen shares a structural similarity with a particular host antigen. Because of this, host antibodies which are raised in response to vaccination or infection—whatever the case may be—will recognise and attack not only the particular foreign antigen but also the host antigen which is structurally similar to it.

A well-known example of molecular mimicry is found in the archaeology of the antiphospholipid syndrome, which is a serious autoimmune multisystemic disease associated with recurrent foetal loss thromboembolic phenomena and neurological cardiac and dermatological adverse manifestation. Antiphospholipid syndrome is characterised by the presence of pathogenic autoantibodies against the molecule known as beta-2 glycoprotein. The infectious triggers of antiphospholipid syndrome have been identified—such as syphilis and leprosy and varicella infections. Tetanus vaccination can also trigger APS, or antiphospholipid syndrome, by producing antibodies which target both the tetanus toxoid and the beta-2 glycoprotein 1 due to structural similarity between these two molecules. This is only one of the many examples of molecular mimicry phenomena which shows that overly vigorous or aberrant immune responses to either infections or vaccinations can, while protective, also be detrimental to the host. It is obvious, again, that many people are vaccinated and, yet, relatively few show such aberrant immune responses. Unfortunately, the scientific research aimed at identifying such vulnerable individuals is still in its infancy.

In this context, imposing financial sanctions on families who refuse to comply to vaccinate their children—and, thus, forcing them to do so—will put such vulnerable but otherwise healthy individuals at risk of serious adverse reactions to vaccination. It is important to note that even those in the scientific community who are strong proponents of vaccination have come to question the scientific legitimacy of one-size-fits-all vaccination practices. One such individual is Gregory Poland, a professor of medicine at the Mayo Clinic and also editor-in-chief of one of the most respectable journals in the field of vaccination, Vaccine. Poland is also co-author of the article entitled, The age-old struggle against the antivaccinationists. So one can hardly label Poland as being an antivaxxer.

In another article, entitled 'Vaccine immunogenetics', which was published in 2008, Poland and his colleagues ask whether, with the advances coming from the new biology and genetics of the 21st century, it is time to consider how much new genetic and molecular biology information may inform vaccination practices in future. In light of this question, Poland concludes that the one-size-fits-all approach for all vaccines and all persons should be abandoned. According to him, this conclusion applies to both vaccine efficacy and safety. Thus Poland's current data may have far broader implications for understanding vaccines, again, not only in terms of efficacy but also in terms of safety. Indeed, the vulnerable populations would neither have the same antibody response nor the same level of tolerance to adverse reactions as non-vulnerable populations.

Another point, which is important, is that it is likely that an increasing number of individuals, regardless of their genetic background, may react adversely if exposure to compounds with immune-adjuvant or immune-stimulating properties exceeds a certain threshold. This concept has been, in fact, clearly demonstrated by a team of Japanese researchers led by Dr Ken Tsumiyama, who, in 2009, showed that repeated immunisation causes systemic autoimmunity in mice otherwise not prone to spontaneous autoimmune diseases. It is true that people are exposed constantly to infectious agents in the environment. However, there is a vast difference between natural exposure and that which is induced by vaccinations. The reason for this is that the immune response induced by vaccination is greatly amplified owing to the addition of adjuvants with immune stimulating properties.

In summary, not all vaccines are safe for all people. In spite of this, most vaccination policies worldwide operate on this principle: one size fits all. Moreover, that serious adverse events following vaccination do occur is evident, in light of published evidence, to anyone who has some degree of intellectual honesty. Those concerns about vaccine safety have a valid scientific foundation, and, although it is popular to label those who express concerns over vaccine safety as anti vaccines or anti science or 'baby killers', such labels should not have a place in any civilised society—they are simply irrational, bigoted and unscientific. Now, in truth, those who employ such labels suffer from cognitive dissonance, which is a psychological discomfort that most people experience when their deeply-held beliefs are contradicted by new information that disproves their old beliefs. The hostile reaction against the bearer of this new information often takes the form of personal ad hominem attacks. Attacking the messenger of the unwelcome truth, rather than rationally dealing with the truth, is a common tactic when the new information cannot be refuted using sound logic.

Finally, modern medical bioethics has rejected the notion that we can treat individuals as a means to an end, regardless of how honourable that end may appear to be to some. The Nuremberg Code and the subsequent Declaration of Helsinki clearly reject the moral argument that the creation of the alleged benefit for the many, such as herd immunity, justifies the sacrifice of the few. It should also be noted that the proof of safety and efficacy of the product is the responsibility of regulatory agencies and drug producers, not the consumer, and now the former have been shown to be unreliable on many occasions, due to financial conflict of interest. To this day, there are very few vaccine safety reviews that are done by people who do not have any conflicts with the pharma. With this I would conclude, and I thank you for your patience and time.

CHAIR: Are there any other opening statements? In order to get to questions we will obviously need to keep them relatively short.

Mrs Kemp : Sure. Of course, I appear on behalf of Citizens Concerned with Vaccination Legislation and Safety. We are a group of concerned citizens who came together because we found ourselves concerned with various aspects of this legislation. We consist of an Aboriginal elder, who is in the room, Uncle Max Dulumunmun Harrison; two naturopaths who deal with vaccine injury on a daily basis; a teacher of primary-school children who was finding more and more learning issues in her classroom; a childcare centre owner who was confronted with more and more allergies; and, throughout our time visiting many members of parliament and senators, we have been joined by a pharmacologist, a lawyer, a medical secretary and the president of the AVN.

We have been, really, trying to raise awareness of the various issues. To try to summarise the main problems we see with this legislation, we think this issue is far too complex to say, 'Let's remove a conscientious objection and remove payments and carry on.' There are many people who are affected by vaccination in an adverse way and we need to have a good look at that. There is much good science—and the committee will have been made aware of much of that in the submissions—that says we need to be concerned with vaccine ingredients and with the schedule, and we need to have a really good look at that.

The legislation says that we will repeal certain subsections and be left with children meeting immunisation requirements if a GP has certified, in writing, that the immunisation of a child will be medically contraindicated, under the specifications set out in the Australian Immunisation Handbook. That handbook says:

True contraindications to vaccines are extremely rare (see relevant chapters), and include only anaphylaxis to any of the particular vaccine’s components, and anaphylaxis following a previous dose of that vaccine.

That is what our handbook is saying people can have a medical exemption for. We have a society and, perhaps, there are many members of parliament, who think that it is okay because the people who deserve to be protected are going to be protected by a medical exemption. But they are not.

I have kids with compromised immune systems. My doctor has said, 'Yes, I gave you the conscientious objection because I believed there was an issue there. But I am not able to give you a medical exemption. Your kids are not eligible for that.' My kids do fall under this issue. I have an article, here, by Dr Yehuda Shoenfeld. I will read one paragraph from that. He is a clinician with 30 years study on autoimmunity and its relationship with vaccination.

He has written a paper called Predicting post-vaccination autoimmunity: who might be at risk? It predicts postvaccination autoimmunity and who might be at risk. It lists four categories of people:

1) those who have had a previous autoimmune reaction to a vaccine, 2) anyone with a medical history of autoimmunity, 3) patients with a history of allergic reactions, 4) anyone at high risk of developing autoimmune disease including anyone with a family history of autoimmunity, presence of autoantibodies which are detectable by blood tests and other factors including low vitamin D and smoking.

Autoimmunity is increasing in droves, in our society. Nowhere in our immunisation handbook does it state that this is an option for children to receive a medical exemption. In fact, our immunisation handbook says, on page 482:

Can too many vaccines overload or suppress the natural immune system?

No. Although the increase in the number of vaccines and vaccine doses given to children has led to concerns about the possibility of adverse effects of the aggregate vaccine exposure, especially on the developing immune system, there is not a problem.

It goes on:

Do childhood immunisations cause asthma?

There is no evidence that vaccination causes or worsens asthma.

What we are seeing, from some good evidence—and Lucija referred to the fact that Dr Yehuda Shoenfeld is the editor of that new textbook Vaccines & Autoimmunity—there are huge amounts of good science that say it is a concern. At the very least, we need to revisit the documentation that is our doctors' guidebook.

A section of the Australian Immunisation Handbook refers to adverse events following immunisation. To give one example, babies are given the hepatitis B vaccine when they are hours or minutes old. It says that the side-effects of this vaccine are localised pain, redness and swelling, occasionally an injection-site nodule and a low-grade fever. The vaccine insert from the manufacturer of the hepatitis B vaccine goes on to refer to the fact that adverse reactions reported relating to this vaccine include meningitis, thrombocytopenia, anaphylaxis, encephalopathy, encephalitis, neuritis, neuropathy, paralysis, convulsions, hypoesthesia, multiple sclerosis, Guillain-Barre syndrome, hypotension, vasculitis, angioneurotic oedema, lichen planus, arthritis, muscular weakness, abnormal liver function and bronchospasm.

I do not want to use up too much of the time with examples like that. Citizens Concerned with Vaccination Legislation and Safety have made a very proactive proposal to this inquiry. We have suggested a full public inquiry, independently done, to thoroughly look at ingredients, the schedule and the newer science—the science that says things other than 'Vaccines save lives.' It all needs to be looked at. This is not somewhere we can just continue to say, 'We think it has worked for a long time, so let's continue to do it.' We have to take a look at this. In the meantime, what we need to do is look at protecting those children I referred to a moment ago, who society thinks are protected by this medical exemption. We need to include autoimmunity, allergies and genetic and racial predisposition. What we do not want to end up with is a system that is making people sick. Unfortunately, it appears that we may already have a system like that.

Professor Peter Collignon, from Canberra Hospital, has talked a lot about our vaccination program and is actually a supporter of it, but he has grave concerns. He has said things such as:

To stop two or three children going to intensive care we had to immunise 600,000 people. We need to be very careful before we recommend universal vaccination against influenza—

and other things—

every year until we have better data. Otherwise we're talking about faith-based medicine, instead of evidence-based medicine.

He says that he is very aware of being in the bad books over his criticisms of vaccination. He says:

Like a lot of medical people, I believe vaccines are terrific—but it has come to the situation where it's almost like motherhood, that you cannot question it, especially in the public arena, for fear you'll undermine the vaccination program.

In conclusion, I want to reiterate that the decision made about this legislation in coming weeks cannot be the end of this. With all respect to the committee, I do not envy your position. You have had three weeks to look at 3,000 submissions and huge amounts of science. We need to look at a long-term solution and an interim solution. Thank you.

CHAIR: Thank you, Mrs Kemp. I will go to Ms Dorey and then we will try to have time for questions.

Ms Dorey : I appreciate that, Chair. I have come here today to explain why parents—not doctors or politicians—must always be the ones to make health decisions for their own families. I am the mother of four children and founder of the Australian Vaccination Network. I was that organisation's president for 18 years, and I am still a very proud and active member.

Over 26 years ago my eldest son was born, and, like many parents, I believed strongly that vaccination was the way to keep him safe and healthy. I did no research, nor did my doctor give me any information to help me to make an informed decision. I simply had my son vaccinated without thought. Unfortunately, he had serious reactions to his first DPT and polio vaccines, and later to his MMR. These reactions have left him with lifelong health issues which only hard work with natural therapists and his own dedication to healthy lifestyles and diet have helped him to minimise and, for the most part, overcome. He taught me a very important lesson, and it is one that I have tried to share with others over the last 25 years: when it comes to your health and the health of your family, make informed choices. Whether worried about diseases or treatments, when a decision is made you and your child will be the ones living day-to-day with the positive or negative outcomes—not the doctor, and not the government. It is such a simple message and yet it is one that has gotten many people up in arms. How dare I suggest that parents take responsibility for their children's health? Apparently, that is the last thing the medical fraternity, media and some sectors of government want.

When my son was born in 1989, 18 doses of seven different vaccines were administered to children between birth and school age. He was injured by his first lot of vaccines at two months of age, and then again by his MMR at 18 months. Vaccine injuries and deaths can occur at any time to any vaccine, even to adults. The AVN's adverse reactions register contains thousands of stories of children and adults who know that firsthand.

Today, children receive 30 doses of 13 different vaccines by one year of age, more if they are of Aboriginal or Torres Strait Islander descent. With up to eight vaccines being administered at a single visit, there are over 250 new vaccines being developed and readied for licensing. What you do here and what you recommend the Senate does will have far-reaching effects not only on the health and freedom of today's children and adults but for those who will be targeted with those 250-plus new vaccines in the future. Be sure that you are aware of the implications of these policies before you threaten to take away our freedom to make the most personal and God-given choices available to us.

I am a strong supporter of every parent's right to vaccinate fully, selectively or not at all. I cannot support my own freedoms whilst trampling on yours. During my tenure as AVN president, I was involved with several delegations that lobbied both state and federal parliaments to enact legislation protecting individual health rights. These rights are inalienable, and no democracy can or should violate them.

Eighteen years ago, we successfully lobbied federal parliament to pass a conscientious objector clause. Many of those who supported us were medical doctors themselves, including Dr Bob Brown, then head of the Australian Greens, who introduced our amendment and defended parental rights so passionately in the Senate chamber. Dr Brown was and is adamantly pro-vaccination, but he had unanswered questions about safety and above all, he honoured parents' rights to make vaccine choices without coercion, penalty or discrimination. Those were proud days for the Greens, days when they fully lived up to the motto on their website, under the heading 'Social Justice': The key to social justice is recognition and action to support the rights of all people.

Today, the Greens seem to have taken a leaf out of the book Animal Farm, inferring that some people are more equal than others, and only those who agree to obey government health policy deserve to be protected and supported. Senator Richard Di Natale has even put forward a resolution demanding the AVN, a community health organisation representing thousands of disenfranchised parents and health professionals, disband. He publicly thanked Daniel Rafaelle, founder of the hate group Stop the AVN, for his hard work on this issue, whilst Daniel Rafaelle was under a police AVO instructing him not to come near me due to threats of violence he had made against me. The purported reason for this No Jab, No Pay legislation is to protect the fully vaccinated from the healthy unvaccinated. Think about that for a minute: if the vaccines do not protect you from infection, why would this legislation do it? Why, when our vaccination rate has increased by nearly 25 per cent over the last 30 years, is the rate of infection from diseases like whooping cough so much higher now than it was then? As democratically elected representatives of the citizens of Australia, I urge you to recommend that the Senate does not pass No Jab, No Pay. It is immoral and unethical legislation that is based on unfounded beliefs, not scientific fact. Thank you for your time.

CHAIR: Thank you.

Mr Smith : Can I just have two minutes? I promise it will be two minutes.

CHAIR: It will have to be brief.

Mr Smith : It will be very brief.

CHAIR: There are one or two senators who have questions.

Mr Smith : The problem with this issue is that, like most issues, especially those that the Murdoch media get involved with, it becomes a left versus right, anti-vax versus pro-vax issue. There are a lot of people in the middle with regard to this. A great example of that is that I have people in my clinic who fully support vaccination. They vaccinate their children. Why should those parents be penalised if they decide they do not want to vaccinate their child for hep B? That is the issue that this legislation has not looked at. It looks at the schedule as a whole. While you might be able to make a credibly statistical argument in relation to measles incidence and vaccination success, you cannot make the same argument for hep B, you cannot make the same argument for rotavirus, and the pertussis vaccine is a total disaster. Anyone who considers themselves a friend of science or a friend of medicine, please come forward and argue the benefits of those vaccines. Each vaccine on the schedule should be broken down and looked at on a risk, benefit or cost basis, because all vaccines are not equal.

The last point I would like to make on it is: if the rationale for this legislation is herd immunity, anyone who considers themselves a scientist, please step forward and tell me how herd immunity applies to a vaccine product that has waning immunity issues. The manufacturers of the vaccines themselves say they only work for two to10 years. If that is the case then how many people in this room right now are immune to whooping cough? It is all very well to be saying we have got to vaccinate all of our two-kilogram and three-kilogram infants, but all of the 100-kilogram adults and 70-kilogram adults sitting in this room right now have no immunity to pertussis if they have not had a booster shot in the last two to 10 years.

Senator DI NATALE: I might start with the AVN. You referred to yourself as the AVN on a number of occasions through your submission but my understanding was that you were instructed to change your name. Can you explain to me why you keep referring to yourselves as the Australian Vaccination Network.

Mr Beattie : I will respond to that by saying: what on earth relevance does this have to this inquiry?

Senator DI NATALE: I will get to that in a moment but I am interested in the reasons for the representation of yourselves as the Australian Vaccination Network when you have been instructed to change your name. I just want an understanding.

Mr Beattie : When I was president, it was called the Australian Vaccination Network. Chair, is this relevant?

CHAIR: The members are entitled to ask questions. We tend to have a fairly wide-ranging discussion. You are entitled to answer the question how you like but I am not going to rule out Senator Di Natale's questions. He is entitled to ask his questions.

Mr Beattie : I will answer it with this: I would like to know why you have not recused yourself from this panel, Senator Di Natale, given the fact that you very publicly have shown your derision for the people who this bill is going to most affect. Why have you not recused yourself? You should have nothing to do with this process whatsoever.

CHAIR: I would ask witnesses and people in the gallery to keep order as best we can. There is no need for applause and the like. I understand there are strong feelings but we will try and have a back-and-forth with questions. Senator Di Natale, continue.

Senator DI NATALE: I have asked a specific question. I am keen to get an answer. It is actually quite a serious issue because a ruling has been made and I am concerned that this organisation is representing itself in a capacity in which they are not able to do so. I think it is important that we understand the rationale for them representing themselves as a group, which they are not entitled to do. That is where I would like to start.

CHAIR: I made the name clear when I introduced them. I am not going to stop them from saying certain things. These things are on the record and you have now noted that so it will be on the Hansard record and people can read that.

Mr Smith : It is good to see, Senator Di Natale, that you are doing great work for the sceptics. I have been a member of the Greens since 2001 and I will have to tell you now, I think you are a disgrace to the green movement and you will end up like the Australian Democrats—your primary vote is going to be gutted like the democrats—so well done.

CHAIR: We will try and stick to answering questions if we could.

Senator DI NATALE: Again, I urge you, Chair, to ensure that the hearing is conducted in the spirit in which most of these hearings are conducted.

CHAIR: I am certainly doing my best, Senator Di Natale, and I am giving you the call. Obviously I cannot instruct witnesses how to answer but I would ask people to all be respectful to one another.

Mr Smith : We have limited time so I am hoping that we can actually concentrate on the issues here and not worry about what Rupert Murdoch and News Limited want you to say today at this hearing.

Senator DI NATALE: Given that today's hearing is not actually about the effectiveness of vaccines, I am more interested in the credibility of the witnesses here today. In terms of the evidence provided by the Australian Vaccination-skeptics Network, there was a ruling made by the Health Care Complaints Commission in New South Wales that the infrastructure they provide on vaccination is:

… misleading to the average reader because it is either incorrect, inaccurately represented or because it has been taken out of context.

What has the organisation done to correct the way in which they present that information? How is that different today compared with the manner in which they have presented information on this issue in the past?

Mr Smith : About the AVN, there are a lot of groups here that are not represented by the AVN. You are wasting a lot of our time. I know Mr Murdoch wants you to ask these questions.

Witnesses interjecting—

CHAIR: Order! It is going to be virtually impossible if people speak over one another. I cannot order Senator Di Natale. He is entitled to ask his questions and you can choose to answer them in whatever way you like. We are almost out of time and it is unhelpful. There was a question but I missed most of it. I am not going to instruct senators how to ask their questions; they are all entitled to ask their questions.

Witnesses interjecting—

CHAIR: We are virtually out of time. If somebody would like to address the question that Senator Di Natale has—

Ms Dorey : No, we do not want to address that question.

Witnesses interjecting—

CHAIR: Order! It is unhelpful when we have several people speaking at once. I would ask that we have one person speaking at a time.

Mrs Kemp : I just want to say for the sake of moving on, because it feels like there is a very definite strategy here to hijack our opportunity to speak, there is a committee that has been put in place by parliament. I can see on the paper here that Senator Di Natale is a participating member. I would like to give the committee the respect it deserves and accept that it has been able to choose the appropriate people to speak. I think we should move on and ask questions about the particular subject we are here for.

CHAIR: I think there is going to be an agreement to disagree between the witness and the senator. We are out of time. Senator Di Natale, do you have a final question before we move on to other witnesses?

Senator DI NATALE: No, that question was specifically about the AVN and it could have been answered very directly by the Australian Vaccination-sceptics Network. Obviously there have been a number of interjections. If they choose to ignore the question, that is their prerogative to do so. I am more than happy to discuss the matter but it is not the matter that the presentation was about. It was not about the effectiveness of vaccines but specifically about this legislation and its intent to increase vaccination rates. It may be a surprise to some of the witnesses here today but I indeed have some concerns, not around the effectiveness of vaccines but more around whether this legislation will achieve its intent, which is to increase vaccination rates. However, I have given the opportunity to the Australian Vaccination-skeptics Network to perhaps provide an account of the Health Care Complaints Commission ruling against them and they have chosen not to do that. They are absolutely entitled to do that.

CHAIR: If you have a question, I invite you to ask it. I would prefer if you did not engage in statements as well.

Senator DI NATALE: I am more than happy to hand the floor over to one of the other senators if they have got questions.

Ms Dorey : Since Senator Di Natale has hijacked almost the entire question time, may I ask if any of the other participating or full members of the committee have any questions regarding vaccination that they would like to ask us or ask the expert witness we have here.

CHAIR: We are out of time and I am trying to manage the time. A significant share of the time has been given to opening statements. Of the 45 minutes, the vast bulk was opening statements so I do not think there is an intent to stop anyone from speaking.

Senator MOORE: Mrs Kemp in her evidence touched on the issue of the medical exemption, which, from my understanding of the legislation, is really the only exemption under the proposed legislation. I would like to hear from any of the witnesses about what their understanding is of the medical exemption.

Mrs Kemp : I will happily speak to that. As I said, in the immunisation handbook the legislation actually refers to the fact that a GP can certify in writing that the immunisation of the child would be medically contraindicated under the specifications set out in the AustralianImmunisation Handbook. On page 477, it refers to anaphylaxis as the only true contraindication. What I do know from my personal experience is that I visited my doctor who I had previously consulted with in making a decision relating to vaccines. He had signed the conscientious objection form. I think there are many people out there who have a conscientious objection form who fall under the heading of people who for whatever reason do not want to vaccinate but they often do not vaccinate for medical reasons; they just do not fall under the medical exemption.

My doctor said to me: 'We are being told that unless the child has suffered a severe and immediate reaction to a vaccine, you are not eligible for a medical exemption.' I shared this information with a number of people that are interested in this space and they have been told the same thing by their doctor. I think although the medical exemption form is strict and limited, it does look like there might be a few other options, but what doctors are being told is something different and I think we have to take that into account.

Senator MOORE: We have got the AMA coming later and that is certainly a question I will be asking them what their understanding is.

Mrs Kemp : Great, I think that is very important. It is important that we look at the fact that some children are contraindicated to vaccination. Perhaps there are children whose parents know enough and have been educated enough that they do not want to risk a vaccine injury first, and we need to look at that being a valid option.

CHAIR: We will move on. I do appreciate the time. We have gone a little bit over time but I think it is about right. I appreciate all of the witnesses coming and giving their evidence. Thank you for making yourselves available today.

Mrs Kemp : Thank you for the opportunity.