Mike Freelander (Macarthur, Australian Labor Party) Share this | Hansard source

The Australian Immunisation Register and Other Legislation Amendment Bill 2017, which makes largely incontestable changes to the operation of the Australian Immunisation Register, is an important bill. On a recent parliamentary delegation to Myanmar—a very interesting trip, seeing the healthcare resources in a country that spends less than $20 per capita per year on health—I was struck by comments from a village leader—not a doctor—in one of the outlying villages some hours from Yangon. This village leader was very proud that there had not been a case of measles in his village for over four years and that the last case of tetanus in the village had been over two years ago. He said that he and the whole village were very proud of their record and they wanted to make sure that all the children in the village were protected against the common childhood diseases. He did mention also that he had lost one of his brothers to tetanus some years previously, and he was well aware of the dangers of such diseases, particularly to the children in the village.

In Australia, our overall childhood immunisation rates have crept up to over 92 per cent, but, unfortunately, as a public health policy, immunisation has been a victim of its own success. We now have a generation, including some of my children's generation, who have never seen measles or chicken pox or bacterial meningitis or epiglottitis. We actually now have several generations of doctors who have never seen tetanus or diphtheria or polio or smallpox or congenital rubella. It is very easy, therefore, for people to develop an anti-immunisation stance, as we have forgotten the terrible consequences of these previously common childhood diseases. Unless we are vigilant, however, it is quite possible for these illnesses to appear again. As a paediatrician, it absolutely infuriates me to see some people encouraging antivaccination organisations. These groups are highly irresponsible, antiscientific and vindictive. They demean our scientists, and, in many areas, significantly reduce our immunisation rates, and they endanger lives. For example, on the North Coast of Sydney recently, there was a case of childhood tetanus in an unimmunised child.

Let me tell you a little of what I have seen, because this is real life to me. As a medical student in 1974, I saw children in the Indian subcontinent with polio, tetanus and diphtheria with all its complications. Thankfully, these diseases have almost completely been eradicated in the subcontinent due to immunisation programs, often sponsored by non-government organisations, as we have heard, such as Rotary, which has done a fantastic job in the almost eradication of polio. As a paediatrician, I worked at the Sydney Children's Hospital in 1978 when we had the last great measles epidemic in Australia. Measles immunisation was included in the general immunisation schedule for children 12 months and older in 1975, so, in the late seventies, there was still a large cohort of children who were not immunised against measles.

We were completely inundated with children who had every complication of measles, from pneumonia to seizures, encephalitis and, unfortunately, death. I sat by the intensive care bed of a child with haemophilus influenzae meningitis—Hib meningitis. She was unwell at lunchtime, presented to hospital at dinner time and was dead by midnight. I sat by her bed and watched her die in spite of everything we did. I saw a child with epiglottitis have respiratory arrest—a complete respiratory obstruction—in front of me and require an urgent tracheostomy. These are real things for me.

The Hib vaccination was introduced to the child immunisation schedule in 1993 in Australia, and it was like the turning off of a tap. We no longer saw haemophilus meningitis; we no longer saw epiglottitis. In Campbelltown, in the paediatric ward where I worked, we were used to having, maybe, 15 or 20 cases of severe Hib infections, meningitis, epiglottitis and septicaemia per year. But, with the advent of immunisation, the tap was turned off, and these illnesses virtually disappeared. During the election campaign, on polling day I met, at one of the local polling booths, the mum of a girl who I looked after, who actually survived haemophilus meningitis but was left with a severe intellectual disability and a severe seizure disorder. Thankfully, we no longer see children like that. These illnesses disappeared thanks to immunisation.

I've seen children lose limbs and some die with meningococcal septicaemia. I've sat with a paediatric neurologist as he told the parents of one of my patients that their child had a condition called subacute sclerosing panencephalitis, or SSPE, which is a slow-virus encephalitis that occurs following a measles infection some years previously that leads to gradual cerebral deterioration and death. It is completely untreatable. People have forgotten about these illnesses, but, unless we improve our immunisation rates, they will still occur. I've witnessed the anguish of a mum on day 6 of treatment of her 11-month-old boy for pneumococcal meningitis. She realised on day 6 of treatment that he was completely deaf due to the meningitis.

I remember these children. They are etched in my mind. I've seen children with whooping cough cough themselves to death. I've seen a child recovering from leukaemia die from chickenpox pneumonia. Can you imagine what it's like having your child respond to treatment, start to get better and then die from chickenpox pneumonia? There are many more patients I'd like to talk about. Indeed, they all deserve my acknowledgement. They show that these illnesses are real and, to me, they've been part of my working life. We've come, indeed, a long way in our fight against these terrible diseases, but we must continue to improve our immunisation rate. In doing so, we will save lives and prevent the long-term sequelae in many people.

There is an increasingly strident anti-immunisation group who will use any means whatsoever to deliver their unscientific views. The recent comments by Senator Hanson will be used and, indeed, are being used by the antivaccination lobby as some sort of justification for their ideas. That's why I delivered to Senator Hanson's office copies of the Australian Academy of Science's literature on immunisation in an effort to explain the scientific basis of and success of our immunisation programs. On several occasions I've offered to meet her but, as yet, have had no response. I want to discuss with her her views on immunisation and the importance of maintaining trust in our scientists and repudiating the completely irresponsible statements that she has made regarding immunisation.

Recently in my electorate the anti-immunisation group arranged a screening of the unscientific, malicious and misleading film Vaxxed. I wrote to the cinema chain involved. Whenever they present this completely malicious film, I want to present the true immunisation science and explain why it has been so important to our public health in Australia. I have as yet had no response.

This bill also introduces some important improvements to our immunisation monitoring, such as the increased list of practitioners who can grant medical exemptions from vaccination requirements, to include people like paediatricians, like myself, infectious diseases physicians and immunologists. It increases the coverage of the register. However there is still much more that can be done. The change to the whole-of-life register is to be applauded but we must couple this with improved access to newer vaccinations, such as meningococcal type C vaccine, and improving availability of and knowledge of newer vaccines for things like herpes zoster, or shingles, in older Australians.

The overwhelming need for a new community-based education program about immunisation is fundamentally clear to me, and I wish the government had taken steps to make sure this happens. The government should strongly consider this on an ongoing basis, as we need to continue to improve everyone's knowledge about and understanding of the basis of immunisation and how important it is. The increasingly virulent, if I can describe it that way, attitude of the antivaccination groups, which ignore our scientists, portray themselves as experts and infiltrate social media with fanciful, unscientific information, is to be deplored. We need to make sure that, at every stage the antivaccination groups present their terribly false information, we counter it publicly and make sure people understand why immunisation is important to our children and also now to our older Australians. There's lots of evidence now that immunisation for influenza can be very important in our older Australians. Immunisation against bacterial infections such as pneumococcal disease in older Australians can be very important, particularly in those who have cardiovascular disease or peripheral vascular disease. We really need to encourage everyone to be up to date with their immunisations, and this includes adults as well as children.

We also need to increase funding for immunisation research. Australia has led the world. We have a very, very proud record in Australia in our immunological research and in our research into immunisation. People may not be aware, but congenital rubella syndrome, which still occasionally occurs, was discovered by an Australian ophthalmologist, Sir Norman Gregg, and he is famous around the world for his discovering of the congenital rubella syndrome. People like Sir Macfarlane Burnet, Professor Peter Doherty and, more recently, Professor Ian Frazer have been instrumental in improving access to and understanding the importance of immunisation. We have a very proud record and it is important that this continue and that we continue funding for institutions such as the Kirby Institute, the Walter and Eliza Hall Institute and the Children's Medical Research Institute at Westmead. It is very important that we fund these organisations properly. Australia can also help our overseas neighbours with funding to improve their immunisation rates and surveillance of infection diseases. We live in a global world. Many of the recent outbreaks of measles that have occurred in Australia have started with arrivals from infected people from overseas. If we can improve immunisation rates in our near and not-so-near neighbours that will improve our response to infectious diseases.

The future for immunisation is really a fascinating one. New immunisations are becoming available. I saw my aged father go through a terrible time with shingles towards the end of his life. It made the last 12 months of his life very, very uncomfortable. But we now have an immunisation available for herpes zoster, or shingles. In older Australians, it's very effective. Many people, however, are unaware of its availability. Again, we need to improve our knowledge and education about immunisation.

There are some recent surveys that show that older people who are vaccinated against pneumococcal disease—a bacteria which causes chest infections, and sometimes bronchitis and even septicaemia—have less cardiovascular disease. So it seems that that has a beneficial effect on cardiovascular health as well.

There's increasing investment around the world, by people like the Gates Foundation, in immunisation against diseases such as tuberculosis and malaria, and now there is a lot of research into immunisation against HIV. I went to a presentation yesterday by the peak HIV organisation in Australia, where they talked about the research into immunisation against HIV and the prospect that we will eventually be able to eradicate HIV. So this is very exciting and very important research.

The anti-immunisation groups are persistent, however, in their attacks. We must commit to better education about and explanation of immunisation and its benefits. I want all of us to be as proud of our immunisation rates and prevention of disease as the Burmese headman I met so recently.

I commend the bill to the House. I am extremely proud of the bipartisan nature of our response to improving immunisation rates. I think there is more to be done. I thank the House.

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