How is the government trying to improve immunisation coverage rates?

Children continue to die from vaccine preventable diseases in Australia, and with many new legislative changes commencing on 1 January, I thought it would be a good time to outline exactly what the changes are, and to ask for your thoughts on some of the measures that are about to be introduced to strengthen immunisation coverage.

Every week in the RCH Immunisation Clinic, I speak with parents who are concerned about vaccinating their children. There are many reasons why parents don’t vaccinate their children including: feeling that the risks of the vaccine seem higher than the risk of the diseases, having specific concerns about vaccines, not trusting  vaccines or the system that delivers them, or having difficulty actually accessing vaccines or a vaccination program.

The science is clear. Vaccines work and are a safe and effective way of protecting children against diseases that can cause serious illness or even death.

Have immunisation rates fallen?

Immunisation rates have remained relatively steady in recent years, with 93 per cent of five year olds in Australia currently fully vaccinated. However, the number of people who call themselves “conscientious objectors” has risen seven-fold to 1.77 per cent from 1999 to 2014, which represents about 39,000 children who are not fully vaccinated. Of course these families are the tip of the iceberg and represent those families that registered as conscientious objectors, with up to 166,000 children under seven years not fully vaccinated in 2014. These families have both access issues and concerns about vaccines and can cluster in certain communities creating pockets where the vaccination coverage rates are much lower, putting vulnerable children and adults at risk. We know that certain diseases, such as measles, need 95 per cent of the population to be immunised to stop the disease from spreading, so there is still work to do to increase our immunisation rates and avoid a measles outbreak.

What changes have been put in place to increase immunisation coverage rates?

There are two main changes, and both start from 1 January 2016:

1.  No jab, no play (Victorian Government legislation)

  • In Victoria, parents must show that their child is fully immunised and “up-to-date” with their vaccines for their age at the time of enrolment into childcare and kinder.
  • If children are not up-to-date, they must provide evidence of starting a catch-up immunisation schedule in order to be allowed to enrol.
  • Parents can get a form signed to show that their child has a medical reason for not receiving all their vaccines, i.e. a medical exemption.
  • Refusing to have your child immunised or having a  “conscientious objection” are no longer accepted as valid reasons.
  • Some children who are in more vulnerable situations, such as out-of-home care, may be given up to four months to provide their immunisation records or start a catch-up schedule.

2.  No jab, no pay (Commonwealth Government legislation)

  • Parents of children up to the age of 19 years who are not fully immunised will not be eligible for the Child Care Benefit, Child Care Rebate or Family Tax Benefit A.
  • Children who have medical reasons not to be vaccinated or are already immune to certain diseases will still be able to claim an exemption.
  • Refusing to have your child immunised or having a “conscientious objection” are no longer accepted as valid reasons.
  • Every child under 10 will be able to receive free catch-up vaccines.
  • All children aged between 10-19 years will also be able to receive free catch-up vaccines for a limited period if their parents wish to immunise them to continue to receive family assistance payments.

What else has been done to try to improve immunisation coverage rates?

Alongside these new laws, the government has also announced funding to increase immunisation rates by:

1.  Providing incentive payments to providers

From July 2016, immunisation providers (nurses and doctors) will receive incentive payments to catch up children who are more than two months overdue for their vaccines.

2.  Improving communication with parents about the importance and safety of vaccination

Strategies to improve communication with parents about their concerns will be developed for healthcare workers, especially GPs and immunisation nurses.

3.  Expanding Australia’s immunisation registers

From September 2016, the Australian Childhood Register (ACIR), which records kids’ vaccines up to the age of seven, will expand to become the Australian Immunisation Register (AIR), to capture all vaccines given to a person from birth and throughout their life.

From the 2017 school year, the HPV Register will be expanded to become the Australian School Vaccination Register (ASVR), which will capture all vaccines given to kids through school programs.

In future blogs, I will try to address parents’ concerns and share some of the resources that we are developing in our immunisation service to answer your questions. If you have any concerns about the new changes, please speak with your GP or immunisation nurse in the first instance. If you have further concerns that have not been addressed you can obtain a referral to speak with an immunisation specialist at an immunisation clinic here at RCH, at Monash Medical Centre or the equivalent in your home state if you are outside Victoria.

With January 2016 fast approaching, what are your thoughts about the new policy changes to improve immunisation rates? Do you have any burning questions or concerns about these policies or vaccinating your kids?

Resources:

  1. health.vic.gov.au/immunisation
  2. immunise.health.gov.au/internet/immunise/publishing.nsf/Content/clinical-updates-and-news

Please note: Dr Margie is no longer monitoring questions on this blog. If you are concerned about your child, please contact your GP for advice, or visit the above resources. 

4 comments for “How is the government trying to improve immunisation coverage rates?”

  1. Sharon Morgan

    1: why does there need to be more than one register ( AIR and ASVR)? Why can it not just be one register from birth. Its annoying for parents trying to get the immunisation history from 2 different sources.
    2: Media campaigns to alert the population to immunise should stop using photos of needles. This provokes fear in the wrong way. The parents focus on this fear aspect ( do not want to cause pain, even though it is very short time frame). The ‘advertising’ of immunisation should show videos and photos of those with the illness and what horrible outcomes can occur after the disease has occurred.
    Regards, Sharon. Parent and paediatric nurse

    • Dr Margie

      Hi Sharon, there are two different registers because the vaccines in the NIP and in the school system are given by different providers, through different implementation programs. I agree it would be much easier if the two registers were combined and I hope this will happen in the future. Regarding your second point, I agree children receiving needles provides a very negative image of immunisation and that images of the diseases the vaccines are aiming to prevent would be more effective. This has been raised by many immunisation providers so you are not alone! Thanks for your comments. – Dr Margie

  2. Darren

    Hi, if in the rare event there is a reaction to the vaccine does a compensation fund exist to help the affected child? Thanks

    • Dr Margie

      Hi Darren, at present there is not a no fault compensation scheme but you would be happy to hear when the bill was passed recently the issue of compensation was raised and will be considered now, given the new policies. I agree it is very important if we are moving towards mandating vaccination as unfortunately no vaccine or medicine is 100 per cent safe. – Dr Margie

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