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Monday, 23 November 2015
Page: 8556

Senator XENOPHON (South Australia) (10:41): The issue of immunisation of children is highly emotive because it relates to our most treasured loved ones—our children. It is true that Australia is seeing a drop—many consider it a worrying drop—in immunisation rates and the herd immunity that comes with them. Australia has a vaccination rate across the nation of a little over 90 per cent, but in some parts of the community it has dropped well below that.

From 1 January 2016—just five weeks away now—this bill will introduce a requirement that children have up-to-date immunisation shots in order for the family to receive childcare benefits, childcare rebate or the family tax benefit part A supplement. The vast majority of families that would be affected by this bill already meet the immunisation requirements for their children at the appropriate age points—it is about 97 per cent. Figures provided by the Department of Social Services show that this 3 per cent of families represents an additional 18,000 children who would be required to undergo immunisation shots from 1 January 2016. But, crucially, this bill would also apply to children of all ages who do not have up-to-date immunisation shots. The parents of these children would need to have them undergo catch-up shots to the appropriate level for their age in order to continue receiving the childcare and FTB-A payments.

The bill also scraps the conscientious objection exemption to children's vaccinations. Exemptions will only be granted for valid medical reasons, such as when a GP certifies that the child already possesses a natural immunity from, say, previously contracting the disease in question. At this point it is worth mentioning that the Australian Greens second reading amendment seems, on balance, a sensible way to go forward—to allow GPs to make a judgement in these cases. It is a second reading amendment and it is not binding on the parliament, but, from a policy framework perspective, I think it is important that we do not ignore or shut out GPs who are on the ground, know the families and children and can make a reasoned judgement based on the medical evidence as to what is the best and most appropriate course of action to take.

Although we are talking about a small percentage of families, when added to those needing so-called catch-up shots and those families for which exemptions no longer apply, this bill will affect many thousands of Australian children and their parents. The DSS estimates that more than 200,000 children aged from one to 19—although if you are 19 you are not really a child, but I am relying on the DSS estimates—would need to be immunised to some level in the current financial year. That is 3.4 per cent of the total population of 5.9 million Australians in that age bracket of between one and 19. This is a large number of children, the future health of whom should be a priority for all of us. The arguments that weigh both sides of this debate cannot be discounted. I think we need to respectfully consider both sides of the debate. On one side of the equation there are parents who believe that their children will be at risk of contracting diseases because another child in the classroom has not been immunised. They say that that is unfair, despite any conscientious objection. These could be classmates at school or playmates in child care, or just kids that kick around together in the neighbourhood. On the other side of the equation, we should not discount the concerns of parents who do not want to see what they regard as pharmaceuticals injected into their children, even for the best intents and purposes, because there has been a concern that occasionally—rarely—there are adverse health impacts. There is a school of thought that has linked immunisation to autism. However, as reported in the Journal of the American Medical Association, this year there was a massive study of 95,000 children which found that the measles-mumps-rubella vaccine did not affect autism rates in a known risk group—those with autistic siblings. But I do understand that there are also contrary views in respect of that. It is not for me or for the Senate to repudiate what parents have observed in their children stemming from immunisation; I think that parents know their children best. There have been instances and evidence suggesting that vaccines are not risk-free. That is something that even the most ardent proponents of vaccination acknowledge—that there are, occasionally and rarely, adverse outcomes.

This year, the journal Vaccine reported that mistakes made in making Fluvax in bioCSL's Melbourne laboratory had led to dangerous side effects in children. Fluvax remains banned for children aged five and younger. The risks of injury from immunisation are very small but very real. I think there is a place for a statutory compensation scheme to cover the very small number of families who face a tragic outcome. And I note that, going back a number of years now, there have been calls for a vaccination injury compensation scheme. These are from people who support vaccinations; these are from advocates of vaccination who acknowledge that, where there is an adverse outcome and where that adverse outcome is linked to the vaccination, there ought to be such a scheme. My understanding is that Canada has had such a scheme in place for a number of years. That is something that we need to look at. That would appear to be a best-practice model. I ask the minister—and I would be satisfied if this were taken on notice—whether the government has looked at the Canadian approach, where vaccination programs are very much in place and supported by the community and where, for those rare cases of adverse outcomes, there is a compensation scheme.

I note that, back in 2011, Associate Professor Heath Kelly of the Melbourne University School of Population Health told Fairfax Media:

… although it was rare for children to be seriously harmed by vaccines, it was unfair not to compensate the few affected when there were known risks.

He is an advocate for vaccination, and he also said:

There is no doubt that the benefits of immunisation far outweigh the risks. However, on the very rare occasions that there is a serious complication, despite proper manufacture and administration of a vaccine, it is only fair that the community should provide for the individual suffering ... as there is a community benefit from as many people as possible being vaccinated.

That seems to be a measured view, which I think we ought to consider. But we also ought not to dismiss those who are critical of vaccinations; their views should be heard, and not derided.

We also need to ensure that the risks posed by future vaccines are closely monitored. Earlier this year, researchers writing in the PLOS Biology journal outlined the risks that vaccines against some of humanity's deadliest diseases, including HIV, Ebola and bird flu, can be 'leaky' and can lead to so-called 'super-bugs'.

For all the claims and counterclaims around this debate, I understand that this piece of legislation is about the risk of contracting diseases that have previously been eradicated, or largely eradicated, in Australia. I understand the government's argument about herd immunity, and that is a concern. But I also think it is important that we acknowledge the concerns of those who have said, 'we are worried about adverse outcomes'. We need to make sure that vaccines are produced to the highest possible standard. What happened with the Fluvax vaccine—where children were injured as a result of that situation—indicated, I think, a failure in appropriate quality controls. I also think that it is not unreasonable that there be ongoing monitoring of adverse effects of vaccines. We also need to look at what Canada has done for a number of years now with their statutory compensation scheme. That way, the issue is less about emotion, in a sense, and more about dealing with the facts that we have before us, on a scientific basis, so that we can ensure that our children are as safe as they can be, and free not only of disease but also of any unnecessary adverse impacts.