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No Jab, No Play

I move:

That this Assembly

  1. Notes:

  2. That immunisation is the most significant public health intervention in the last 200 years, providing a safe and efficient way to prevent the spread of many diseases that cause hospitalisation, serious ongoing health concerns and death;

  3. That since the introduction of vaccination for children in Australia in 1932, deaths from vaccine-preventable diseases have fallen by 99 per cent;

  4. That immunisation is critical for the health not only of individual children but of the wider community through the mechanism of ‘herd immunity’;

  5. That recent surges in cases of infectious diseases such as measles and whooping cough, both in Australia and overseas, have been linked to insufficient rates of vaccination;

  6. And that the majority of Australian parents expect childcare centres to be safe places for their children and for the community at large.

2. Calls on the:

  1. ACT Government to embrace uniform ‘No Jab, No Play’ principles, preventing unvaccinated children (without medical exemptions) from enrolling in the territory’s childcare centres;

  2. Minister for Health to clearly express the ACT Government’s unqualified support for childhood vaccination as an essential public health measure and publicly endorse uniform ‘No Jab, No Play’ principles.

Madam Speaker, the role of vaccinations and immunisation programs in significantly reducing the occurrence of many infectious diseases has been a singular triumph. As the Commonwealth Department of Health notes, ‘immunisation is the most significant public health intervention in the last 200 years, providing a safe and efficient way to prevent the spread of many diseases that cause hospitalisation, serious ongoing health conditions and sometimes death’. Likewise, the Australian Medical Association identifies immunisation as the second-most important public health measure we have today, closely behind access to clean water.

Vaccination for children was introduced into Australia in 1932, and since that time, deaths from vaccine-preventable diseases have fallen by 99 per cent despite a tripling of the Australian population over the same period. As a consequence, a great many Australians – and especially those who have been born here – have never had a childhood friend who died from measles, or one who survived the infection but lost her eyesight in the process. Many Australians have never personally met a man crippled by polio. Most of us will never live next to a woman whose baby was born deaf, blind or with heart defects or intellectual disability because she was exposed to the rubella-causing rubivirus in the early weeks of her pregnancy.

And this, Madam Speaker, is a good thing. It is a modern miracle, if you think about it. But even though many of us have no memory of what life was like only a few decades ago when diseases such as smallpox, tetanus, whooping cough, and diphtheria decimated Australia’s children and left many survivors with lingering and often serious health conditions, we can never afford to forget the story of where we have come from and how we got here. This triumph deserves to be celebrated.

Here in the ACT, we should also take satisfaction in having some of the highest immunisation rates in the nation. According to the latest annualised report from the Commonwealth Department of Health, we have the highest proportion of children fully immunised at age 12 months, the second-highest proportion at age 24 months, and the third highest proportion at age 60 months, behind only Victoria and Tasmania.

And yet we cannot afford to become complacent. The success of any immunisation program relies upon what medical experts call ‘herd immunity’. In all communities, a certain number of individuals cannot be vaccinated, either for medical reasons or because they are too young. In addition, vaccines are never 100 per cent effective, and a certain number of those who have been vaccinated will not develop immunity. To keep all of these vulnerable individuals safe, and to successfully interrupt disease transmission more broadly, it is necessary for the vaccination rate to be very high, with the goal set at 95 per cent in most instances – a rate that we have come close to in the ACT but have not yet reached.

All of this becomes tremendously important when we realise, Madam Speaker, that after years of remarkable success in tackling the occurrence of vaccine-preventable diseases, many of these diseases have started making comebacks, both in Australia and internationally. Only three years ago, the World Health Organisation announced that measles elimination had been achieved by Australia. Later that same year, a surge in the number of measles cases in our nation hit a 16-year high. Measles outbreaks occurred in both Perth and Sydney this past December, and currently a seven-year-old girl is in a Brisbane hospital in a medically induced coma, having been diagnosed with tetanus. In every case, these outbreaks have been linked to insufficient rates of immunisation.

We can certainly be grateful that such outbreaks have not occurred in the ACT, Madam Speaker, but we need to be vigilant. As Dr Michael Gannon, president of the Australian Medical Association, recently noted, about 10 per cent of Australian parents are, quote, ‘so-called vaccine hesitant. They worry about vaccination and they can be swayed very easily by any message which might be seen to question the validity of the science’. It is for this reason that governments must be very clear in their messaging: any ambiguity, even if unintentional, can easily be misinterpreted.

And consequently the recent proposal for the states and territories to adopt uniform ‘No Jab, No Play’ laws has received bipartisan support at the federal level and universal support from the medical community, including the Australian Medical Association. Dr Gannon has gone on record praising the effectiveness of the Commonwealth’s ‘No Jab, No Pay’ policy, which increased immunisation rates by 3 per cent in its first six months of operation, and Dr Tony Bartone, vice president of the association, has described ‘No Jab, No Play’ as, quote, ‘a bonus or a plus in this argument’.

Much of the effectiveness of such policies comes not with the 1 to 2 per cent of the population that Dr Bartone has identified as ‘hard-core’ opponents of vaccination, who are unlikely to change their minds, but with the remaining 8 to 9 per cent. These, according to the AMA’s Dr Gannon, are the parents who fail to get their children vaccinated on time in large part because they lead busy lives. Incentives in the form of the proposed policy are designed specifically to help remind and encourage these parents.

We can see the need for these kinds of reminders and this kind of encouragement in the Australian Childhood Immunisation Register statistics for the ACT from 2014–15. In that year, more than 90 per cent of one year olds had been fully immunised, except those in South Canberra, where the proportion was between 85 and 90 per cent. Statistics were even better for those who had already been asked to provide immunisation records to their schools upon enrolment, with more than 90 per cent of all five-year-old children across the entire territory being fully immunised. But for the cohort in the middle, children aged 24 months, vaccination rates were under 85 per cent in South Canberra and under 90 per cent in both North Canberra and the Woden Valley.

These are precisely the children who are most likely to be enrolled in the territory’s childcare centres. As indicated in the Royal Children’s Hospital Melbourne’s recent Australian Child Health Poll, this issue is a concern for many parents, 70 per cent of whom reported that ‘knowing the percentage of under-vaccinated children in a school or [childcare] centre would influence their decision to send their child to that facility’.

Madam Speaker, I am personally grateful that the Minister for Health in yesterday’s question time stated that the ACT Government, and I quote, ‘does support the no jab, no play approach’. I also understand that the details of such uniform laws will need to be hammered out by the relevant health ministers from all states and territories and then taken back to their individual parliaments. In the meantime, let us make our position clear by supporting this motion and sending a firm, unmistakable message publicly expressing the Government’s unqualified support for childhood vaccination as an essential public health measure.

Thank you.

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