Australia is currently undertaking a review of its national immunisation strategy, the first since it was established in 1993.
There’s been quite a bit of comment in the media lately about parents who refuse to allow their children to be vaccinated, helped along by Adele Horin’s recent column in the SMH.
It’s a reminder that the national strategy needs to make communications with the public a key priority.
Judging by the experiences in the UK and USA, we will be in for some major challenges if a vaccine scare gets traction in Australia.
The UK has been hit hard by publicity about the unproven theory linking MMR vaccination to autism. Despite an abundance of research negating these claims, UK vaccination rates are still down and they now have a major measles epidemic with two deaths.
Meanwhile, US officials are concerned they may be reaching a tipping point with early indications of an expansion in the proportion of people who claim exemptions from vaccination.
A country can afford to have about 5% of children not up to date with vaccination. But any more, and there will be enough susceptible to give diseases like measles a foothold. In the US, one strategy has been to involve consumers in policy forums and daringly, representatives of lobby groups who are active and vocal in their criticism of vaccine programs.
Earlier this month, I attended three meetings in Washington DC which sought to hear input from stakeholders on policy matters regarding vaccine safety, autism and communication.
In the US, they do democracy well. Each meeting was open to the public, many of whom represented lobby groups with major concerns over vaccines.
There seemed a genuine willingness among government, vaccine experts and parent lobby groups to come together, look beyond the differences and focus on the common ground of child health.
Samuel Katz, the developer of the measles vaccine who is widely considered to be the “grandfather” of vaccination in the USA, and Louis Cooper, former president of the American Academy of Pediatrics, backed up parent groups calls for further funding of vaccine safety research and better public engagement.
Australian health authorities need to keep an ear to the ground on what the general public is thinking and doing with regards vaccination. To date, we’ve been unaffected by vaccine safety scares from overseas but the very expansion of our successful vaccination program brings unique challenges.
New vaccines regularly join an already crowded childhood schedule in a context of concern about the sheer number of vaccines given to children. Also, other target groups — teenagers, pregnant women, older adults — are increasingly being vaccinated.
To manage communication if a vaccine scare hits this country, we must be prepared with a coordinated, cohesive and thoughtful response which engages all relevant groups. This includes health professionals, government, vaccine manufacturers and most importantly the public.
It’s often assumed that the 2-3% of Australian parents who refuse vaccines are merely misinformed and that, with a good dose of science, will see the error of their ways. But deeper issues are at play, including distrust in government, rejection of orthodox medicine, and the back to nature idyll. An abundance of research shows vaccine refusers to be firm in their resolve and hard to change.
We shouldn’t invest our efforts in convincing them but with ensuring others do not follow suit with the next vaccine scare.
To do this, we need to back up our health professionals, the cornerstone of immunisation delivery. Parents trust health professionals when it comes to immunisation advice. Committed and confident health professionals ensure that children are offered the right vaccines at the right time.
It is my belief that the erosion of health professional confidence is the tipping point by which public concern becomes vaccine refusal and lowered rates. Supporting health professionals is a sound and efficient investment in maintaining public confidence in safe and effective vaccines.
There are challenges ahead as vaccines increasingly become a victim of their own success. The national review now underway should ensure we are prepared for when, not if, Australia encounters a vaccine safety scare that really does threaten our vaccination rates.
Julie Leask is a Conjoint Senior Lecturer with the School of Public Health and Discipline of Paediatrics and Child Health, University of Sydney. She also leads the social research program at the National Centre for Immunisation Research and Surveillance. This piece represents her own opinions.
It’s pretty damn obvious that anyone who is so patently against immunisation has never seen a baby with whooping cough struggling to breathe. Tens of thousands of people die every year in 3rd world countries from diseases that could have easily been prevented by vaccination for lack of nothing other than funding, yet here in Oz, one of the most affluent nations in the world, we have people too stupid to do the smart thing.
It has been suggested that the excessive cleanliness of modern homes,and children could be the reason for increased allergic reactions among today’s. children; it is suggested that their immune systems have failed to develop strongly because they are unchallenged.
Could vaccinations for so many ailments have a similar effect?
I am well into my 70s and never seem to have illness of any sort (although I do get Flu injections annually), yet as a child i had measles,rubella, whooping cough, scarlet fever, and of course mumps, maybe these challenges developed my immune system.
I of course know that some of these diseases can have very serious consequences.
There are already people concerned about vaccinating children in Australia. There are too many vaccines in too short a time and many of the illnesses are not that bad for kids to catch, from first hand experience measles is much worse as an adult. The Australian Vaccination Network (http://avn.org.au) contains links and information so that everyone can be informed. the increase in vaccinations must have something to do with the increase in autism. If I had children I would be hesitant to vaccinate without naturopath support and would probably not allow all the vaccines. According to the vaccination schedule you have to get boosters of most of the vaccines in your teens and as adults anyway, and your brain is more able to cope with the mercury levels then.
10 years ago I would have read Adele Horin and cheered, joined Kate and Kitty in abusing selfish parents who don’t protect their kids by vaccinating. It’s a media-driven national pastime – identify a sub-group that thinks differently and denigrate them. Julie Leask seems reasonable by comparison, but dismisses vaccine safety as a PR issue. It is easy to discredit any causal theory when it comes to autism – which is after all just a defined set of behaviours. The underlying problems may vary, a confounding variable making most experiments non-repeatable.
10 years ago we had our first child. At nine months old he was staring at objects sideways. Doctors said don’t worry – babies do wierd things as they develop. But he didn’t develop – at 2 he had no eye contact, few words and screamed at other kids. After MMR, words stopped altogether and he could no longer recognise us from other adults. At 2.5, he was formally diagnosed with autism. We were told he would never talk, never ‘know’ us and would be institutionalised for life. We were told to prepare ourselves for this – he no longer had a life.
Here are some facts. Aged 10, he is a happy kid at a normal school, with lots of friends, aced his 2008 NAPLAN – he has a life. The doctors now say it was a misdiagnosis – code for curing the incurable. We spent 5 years on those “wacky internet sites” that explained the connection between our son’s symptoms, the pertussis vaccine and thimerosal. We followed their advice, we spent our time, house and savings curing him through therapy, diet and supplements. We rid his body of mercury and other toxins. We watched our son improve – very fulfilling, I recommend it! We gained confidence to have another child – and did not vaccinate her. We did not have any issues. That this could ever happen is totally discredited by medical authorities. We are stupid, selfish, uninformed, bad parents to the Adele Horin brigade – slavering with condemnation but lacking personal experience.
Brownwyn’s comment is ill-informed and irresponsible. The rise in cases of Autism in recent years are due to a rise in detection, thanks to an increase in research and better informed doctors and parents. In previous decades, a mild to medium case of autism would quite often have gone undetected or blamed on the child’s personality – “He’s an odd child.”
The ‘Australian Vaccination Network’ are nothing but an anti-vaccication propaganda group and should not be considered a credible authority on the matter. Quite frankly, if vaccinations caused Autism, then it would stand to reason that all vaccinated children would end up Autistic. This is obviously not the case.
I urge all parents to vaccinate and protect their children from harmful, and quite often fatal, diseases. I have done so with my little girl. I couldn’t think of anything worse than exposing her to measles or whooping cough.