Alannah Mactiernan (Perth, Australian Labor Party) Share this | Hansard source

The medical practitioners and medical scientists that I talk to about this bill and about vaccines are very clear that the two things that have really done the most to improve health in our community over the last couple of hundred years have been the availability of clean water and vaccination. So there is absolutely no doubt that there are very solid public health arguments behind the Social Services Legislation Amendment (No Jab, No Pay) Bill 2015.

Like many members, I have personal experience here. I remember the enthusiasm with which my mother dragged me down to get I think the Sabin polio vaccination when I was around three or four. It is one of my first and clearest memories. With her recollection, and having lived through the risk of my older brother and sisters contracting polio, it was such a frightening thing for my mother. As I think I mentioned when we were debating an allied piece of legislation last week, a great book, The Golden Age, by Joan London was released this year. It really captured the social impacts as well as the health impacts of the polio epidemic. Also in last week's debate, I related my very personal experience with my daughter who, at the age of three weeks, contracted whooping cough from an unvaccinated child. So I completely and utterly support the principle of vaccination.

But now I am going to make what I judge to be a career-limiting move, because I am going to step outside, a little, that box of orthodoxy that I followed right up until last week, when I was contacted by some people who, having seen my speech, suggested that I might want to look at some of the other science. I have done so. I do not want to depart from the standard script, because I do support vaccination and I do support us requiring an element of incentive to be placed into the system to ensure that we have proper coverage. I am not contesting in any way that what we have done with polio, with diphtheria, with whooping cough—even though it is becoming a little more complex—and with measles is anything other than judged to be a good thing.

I have sat in this place and listened to speeches about this being a black-and-white issue—that you have to be totally and utterly one way, otherwise you are an anti-vaxxer—and saying that the science is unequivocal. I have some quotes—and these are all from people who support vaccination. I just want us to start being a little less condemning of those people who have their concerns; let us in fact be little bit more scientific. Let us not always, when contradictory evidence comes in, presume that we have to amend the hypothesis and have an auxiliary hypothesis that will help us patch up and bolster the principal hypothesis. From time to time, we have to be prepared to think that this data may have to be seriously considered and cause us to look at the paradigm.

I am going to quote people who are not crazy, unscientific trolls and anti-vaxxers. I do want to endorse comments by some of the previous speakers who have reprimanded in the severest terms those who have been trolling people like the Hughes family, who, quite rightly, have a very real concern about vaccination. Everyone should have the ability to do this without being vilified. I want to quote Natasha Crowcroft, the Chief of Infectious Diseases at Public Health Ontario, and her two colleagues from the University of Toronto in an article that appeared in The BMJ, formerly the British Medical Journal, earlier this year. I am going to quote this at length because I think it really sums up some of the issues that we need to face:

We are on a steep trajectory away from an era of inexpensive vaccines for diseases that are widespread in the absence of immunisation. Vaccines are increasingly being produced for diseases that are devastating at an individual level but have less impact on population health. Moreover, the costs of developing and getting a vaccine to market are rising because of increasingly complex technologies and the public intolerance of adverse events. For these reasons new vaccines are likely to be less cost effective than older vaccines and are unlikely to be cost saving.

Technologies such as searching genetic codes for possible antigens and the development of new adjuvants to stimulate immune responses also bring considerable uncertainty about safety and effectiveness. It may take many years for adverse events caused by vaccines to be identified and confirmed, as was the case for the link between a pandemic H1N1 influenza vaccine (plus adjuvant) and narcolepsy.

These challenges come at a time when some sections of society are less likely to vaccinate themselves or their children. Those who hesitate to vaccinate are often highly educated, well resourced, and demand respect for their perspectives. How best to reassure the public is unclear. But all the components of decision making about vaccination programmes must be high quality and transparent and should stand up to external scrutiny to sustain the confidence of both the public and healthcare providers.

I think there is a very clear message here. To lump anyone who has an objection or a concern about a particular vaccine or a particular adjuvant into the anti-vaxxer box is, I think, a very deleterious thing for the confidence that we need to have within our system.

Professor Collignon, professor of microbiology at the Australian National University and director of infectious diseases at Canberra Hospital, is a great supporter of the principle of vaccination and one of those who is very clear that vaccination has absolutely turned around public health outcomes in our community. In talking about flu vaccines for children, he made a couple of statements. He said:

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

When Professor Collignon made these reflections after seeing healthy children post-vaccine coming into his hospital, he was very surprised at the amount of negativity that he received from other health professionals. But his fundamental point is that we need a better system than voluntary notification to the TGA, because whenever you do that you really underestimate how much of a problem there is. If the notification process is purely voluntary you get an under-notification. He said:

When I interviewed families who claimed to have experienced an adverse reaction there was a common thread—medical professionals were unwilling to countenance the possibility, even when the symptoms were extreme and immediate, and their cases were never referred to the TGA.

I think that one of the things we could take out of the anti-vaxxer argument is that we do need a better system of notification. My friend and colleague at the table, the member for Brand, would no doubt be aware of Professor Bryant Stokes, a very eminent medical bureaucrat and medical specialist in Perth. He was chief medical officer and head of the health department, but I understand that he has recently stood down. He was commissioned by the state government to report on what happened during that ill-fated fluvax in 2009 when there were so many adverse reactions in Perth and across Australia in children who had the fluvax that year. His report that was tabled in the state parliament focused on just how poor and chaotic the reporting processes were. There was a lack of any real systemised process of collecting that data.

If we want the public to have confidence in this system, we have to be prepared to set in place a rigorous reporting system. We cannot continue to say to people, 'You've made it all up' or 'You're wrong and it's something else.' We do want people to have confidence in the vaccination system. It is a great benefit for our public health system. But we have an obligation to make sure that we are being scientific and that we are not falling into the same trap that we are accusing the anti-vaxxers of. We need to ensure that we are not engaging in faith-based medicine rather than evidence-based medicine.

Allan Cunningham, a retired paediatrician from the USA, said in an article in the British Medical Journal:

Vaccines are among the greatest medical advances of modern times, but public health officials have become intoxicated by success and have lost their sense of perspective. A case can be made for mandating vaccination against measles, which used to infect 3-4 million US children a year, but it is over-reach to mandate vaccination against hepatitis B, which was reported to infect only 300 children aged 1-9 years annually in the US.

One of the concerns that has been raised is what is happening with the adjuvants—those things that are added to the vaccine to enhance the immune response. I asked our library to find me the latest research on the impact of these adjuvants. I do not want to reflect negatively on the person, but the piece of research they found had been conducted by a researcher from Flinders University in Adelaide, who also just happened to be a director of a biotech firm producing adjuvants and vaccines. That certainly does not mean that he should be precluded from contributing to the academic and scientific debate but I think this is an endemic problem that we have in the pharmaceutical industry—there is not enough independence in the system; there are not enough people researching and providing this information who are free from the taint of preferment and funding by the pharmaceutical industry.

As I say, we need to get the science right here. Those who are advocating for vaccinations, like me, believe in science—but believing in science does not mean that you do not allow any contrary evidence to come within your field of operation and that you demean and belittle those people who are raising those concerns. I really do urge members to research some of these people who are raising an alarm about exactly what we are doing and whether or not employing all of these I think now 16 vaccinations—including for hepatitis B, rotavirus and the human papilloma virus—is really in the best interests of everyone and can be justified in terms of a mandated public health outcome.

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