Title

An Argument

Against

Childhood Immunisation

 

This is a mirror of a site uploaded on 17 November 1998 to

http://www.geocities.com/Heartland/Fields/8254/vax.html

by   [email protected]

amended 14 December 1998
HYPER
LINKS
Table of
Contents

TABLE OF CONTENTS

               I.   Introduction
               II.   The Schedule
               III.   The Policy
               IV.   The Compulsion
               V.   The Doctors
               VI.   The Money
               VII.   Conclusion
               VIII.   Reference List
                   
  
Introduction

I     INTRODUCTION

A Sydney nurse and mother warns of pitfalls in the current Australian (Commonwealth/ federal) Government 'immunisation' policy for children under two years. 		Link to:
Author's
Email Address
Point of
Contention 		The current government policy regarding 'immunisation' of children under 2 has undesirable elements; and
 it should be reviewed. 		Link to:
joint Commonwealth- State
Immunise Australia Program
[sic.] overview.
 

II    THE SCHEDULE

  
Fact The Australian National Health and Medical Research Council ["NHMRC"] 'Recommended Immunisation Schedule' requires children under 2 to have the following 21 or 22 vaccinations:
  • Age: 2 months
    1. pertussis (whooping cough)
    2. diphtheria
    3. tetanus
    4. Hib (Haemophilus influenzae type B)
    5. poliomyelitis
  • Age: 4 months
    1. pertussis
    2. diphtheria
    3. tetanus
    4. Hib
    5. poliomyelitis
  • Age: 6 months
    1. pertussis
    2. diphtheria
    3. tetanus
    4. Hib; if 'HiBTITER' vaccine is used
    5. poliomyelitis
  • Age: 12 months
    1. measles
    2. mumps
    3. rubella
    4. Hib; if 'Pedvax HIB' vaccine is used
  • Age: 18 months
    1. pertussis
    2. diphtheria
    3. tetanus
    4. Hib; if 'HiBTITER' vaccine is used
'Non-schedule' vaccines, such as 'HBV' (for Hepatitis B), are acceptable "as long as compliance with schedule vaccines is not jeopardised". The paramountcy of 'schedule vaccines' applies even if the child is in a group with a high Hepatitis B carrier rate. (NHMRC, 1997) 		Link to:
NHMRC 'Immunisation' Schedule for 0 to 6 years
including 'immunisation milestones'.
Assumption Although the vaccinations numbered 1 to 3 in the above list are usually given together, and the polio vaccine is administered orally, the NHMRC Schedule requires at least eight skin-piercing injections in the first two years of every child's life. These injections are administered by practitioners with varying degrees of skill and compliance with asceptic technique.

Assertion

III   THE POLICY

It has been reported that: 'combination vaccines', by reducing the number of injections, "makes immunisation more acceptable to parents"; and combinations of 4 or 5 vaccines "may soon be available" (Botham, 1998).

Fact Current 'immunisation' policy seems to have led to the trend of creating larger mixtures of 'schedule' vaccines with 'lesser' mixtures becoming unavailable. For example, there is a move to 'scrap' children's diphteria/tetanus vaccine so that doctors will not be able to "avoid vaccinating against pertussis" (McIntyre, 1998). Single vaccines, and 'lesser' mixtures, enable greater freedom to choose particular vaccines. They also assist the monitoring of side effects through the isolation of individual vaccines. Link to:
Australian Doctor report on
Move to scrap CDT vaccine.
Fact The Australian Government states that immunisation is "a simple, safe and effective way of protecting children against certain diseases" through a process of getting a vaccine ('vaccination') and "becoming immune to the disease as a result of the vaccine" where "the risks of these diseases are far greater than the very small risks of immunisation"(Dept of Health & Family Services, 1997, p.4). It also notes that 'vaccination' and 'immunisation' "are not exactly the same", but then uses the term 'immunisation' for both concepts "because this is the expression most commonly used in the community" (Dept of Health & Family Services, 1997, pp.4-6). However, publicity from that department, such as the items in and linked to its internet 'site', may be responsible for at least some of that 'community use'. Link to:
(Australian) Commonwealth
Department of Health
main internet 'site'.
Fact 'Immunization' has been defined as the process of rendering a subject highly resistant to a disease, usually because of the formation of fluid or semifluid antibodies and/or the development of cellular nonsusceptibility to microorganisms or the toxic effect of antigenic substances (Miller-Keane, 1992, pp.706 & 748-753).

Plain English defines 'immunis[z]ation' as "making free from a communicable disease"; while the term 'inoculation' (or, more recently, 'vaccination') is defined as "protection against disease", a "safeguard against disease" or, simply, something administered with a purpose merely "against disease". 'Inoculation' and 'vaccination', unlike 'immunisation' (at least in the stricter senses of the word), does not necessarily make the subject 'free' (i.e. 'immune') from a disease (Oxford, 1991).

 
Assumption Even supporters of Australia's 'immunisation' policy only claim vaccine efficacies of 70% to 95% (Hall, 1998, p.9). The term 'vaccination', or 'innoculation', would be a more accurate description of procedures such as those recommended by the NHMRC Schedule. The use of the very term 'immunisation', rather than a more accurate alternative, appears to be part of the programme of persuading parents to consent to such procedures.
Exhortation

IV  THE COMPULSION

The NHMRC recommendation is becoming a mandatory requirement. From 1 January 1998, payment of some Commonwealth Government benefits have been linked to vaccinations "[t]o encourage families to have their children adequately protected against preventable diseases" (Dept of Health & Family Services, 1997, p.48). $200 of the Maternity Allowance is now withheld until the child turns 18 months and has received "age appropriate immunisation". Childcare Assistnce is now also linked to "age appropriate immunisation" (Dept of Health & Family Services, 1997, pp.48-49). To the extent that benefits are only available to low-income and low-asset families, poorer families are being subjected to mandatory vaccinations to a greater extent than wealthier families. The government should not subject poorer families to vaccination requirements which do not apply to wealthier families. 		 
Assertion It is possible that some children may benefit from 'immunisation', without riskng any adverse side-effects, if other children are vaccinated; because those other children become less likely to carry the illnesses vaccinated against. To the extent that this could happen, current government policy might lead to children of poorer families being vaccinated, and exposed to side-effects, while children of wealthier families could be at less risk of contracting those illnesses even without vaccination.  
Fact The admitted side effects of vaccination are such that the Department of Health advises that "[P]aracetamol should be given just before your child gets an immunisation, and four hours later to reduce the likelihood of fever occuring". This amounts to at least ten doses of Paracetamol during a child's first two years. "When MMR [Measles, mumps and rubella vaccination] is given a fever may occur about 5 to 12 days later, and paracetamol should be given then" up to six times per 24 hours (Dept of Health & Family Services, 1997, p.45). Mandatory vaccination is therefore often tantamount to mandatory medication with drugs such as parcetamol.  
Assertion

V   THE DOCTORS

There is provision for a "medical or conscientious objection exemption", which enables parents to receive benefits after having "discussed the risks and benefits of immunisation with their medical practitioner or immunisation nurse" and obtaining certification from same (Dept of Health & Family Services, 1997, p.49). However, the government has provided those practitioners with materials such as a guide for "responding to arguments against immunisation", which assists them in supporting 'immunisation' by presenting "an attitude which results from a critical review of the evidence" (Hall, 1998, p.19). Doctors can use that guide, with its references to 84 sources, to put a biased pro-vaccination argument forward under the guise of the result of an objective and intensive study of the issue. 		Link to:
online HTML version of
Immunisation Myths & Realities - Responding to arguments against immunisation
Side
Comment 		Some parents have reported that many medical practitioners refuse to sign the relevant certificate for conscientious objection, even after long discussions about the risks and benefits of 'immunisation' (Australian Vaccination Network, 1998). If this is correct, one might ask why so many medical practitioners are so much in favour of 'immunisation'. Link to:
Australian Vaccination Network
Assertion This may be a manifestation of the government's financial 'incentives' in relation to 'immunisation'.  
Value

VI  THE MONEY

If income from standard consultations and procedures does not increase in line with cost increases, medical practices may be under financial pressure to seek other sources of income. Particularly if the Medicare scheme (Australia's universal health insurance, funded by the federal government) is a practice's major source of income, doctors may try to qualify for other catagories of government funding to make up for any real or perceived shortfall of money from Medicare. There might even be doctors who simply want more money even if they don't need it.

In furtherance of the goals of its 'immunisation' policy, the Australian government has begun to pay doctors a 'bounty' for vaccinating children.

 
Fact

The government pays General Practitioners as follows for vaccinating children in accordance with the NHMRC Schedule:

  1. Medicare rebate for standard consultation (Australian Doctor, 1998):
    • $21.30 per service
  2. Australian Childhood Immunisation Register "payment on the completion of each schedule as per the NHMRC standards for childhood immunisation" (Public Health Division, 1998):
  3. A "service incentives payment" (Public Health Division, 1998):
    • $18.50 for each 'immunisation episode'
  4. A "bonus for immunising 70%, 80% or 90% of target groups" (Kosterich, 1998):
    • $3.50 "per immunised patient" for 70%, with higher rates if 80% or 90% is 'achieved'; up to $7,890 per practice (Australian Doctor, 1998).
 Link to:
Commonwealth Department of Health announcement on the
General Practice Immunisation Incentives Scheme
commencing 1 July 1998
Conclusion

VII CONCLUSION

Prior to my conducting research for this assignment, I was not aware of these payments although I had been subjected to doctors' efforts to persuade me to 'immunise' my child strictly in accordance with the NHMRC Schedule; and to have my child vaccinated 'now' by that practitioner. I asked several mothers of other local children under two years, who were patients of unrelated doctors, and discovered that they were also often subjected to similar persuasion; and had never been informed of any payments to doctors in addition to that for the consultaion. My sample is too small for a statistically significant conclusion about the Central Sydney Area Health Service region, let alone all of Australia. However, one could ask whether, at least in some circumstances, these payments could constitute a secret commission or otherwise foster a conflict of interest in the absence of disclosure to the patient. It may be difficult for some doctors to put their obligations to their patients sufficiently ahead of their financial interests.

There have been claims that the incentives have led to insufficiently vaccinated children being 'dumped' by doctors who were anxious to meet targets for bonus payments (AVN, 1997).

Whether intended or not, consequences such as interfering with the doctor/patient relationship by linking payment with the provision of certain vaccinations (rather than a lesser increase in payment for whatever service the doctor chooses to provide on purely medical, not financial, grounds) are undesirable and constitute grounds for an urgent review of the Australian government policy on childhood immunisation.

 
References

VIII REFERENCE LIST

Australian Vaccination Network (1998). Internet 'site': http://www.avn.org.au/.

AVN, 2(1), 3 (1997). Newsletter of the Australian Vaccination Network.

Botham, J. (1998). Immunisation. The Lamp, 55 (9), 28-29.

Department of Health & Family Services, (1997). Understanding Childhood Immunisation. Canberra: Australian Government Publishing Service.

Hall, R. (1998). Immunisation (2nd edn). Canberra: Australian Government Publishing Service.

McIntyre, P. (1998). Move to scrap CDT vaccine, Australian Doctor Online, 12 June 1998. Internet site: http://ozdoctor.com.au/arch/98arch/06_12/news1.html.

Miller-Keane Encyclopedia & Dictionary of Medicine, Nursing, & Allied Health ( 5th edn), (1992). Philadelphia: W.B. Saunders.

National Health and Medical Research Council [NHMRC] (1997). The Australian Immunisation Handbook (6th edn). Canberra: Australian Government Publishing Service.

Oxford University Press. (1991). The Australian Reference Dictionary. Melbourne: Author.

Public Health Division (1998), General Practice Immunisation Incentives Scheme. Canberra: Australian Government Publishing Service.

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