AMA Transcript - AMA President, A/Prof Brian Owler, 'no jab no pay' plan

PHILIP CLARK: Yes, at the weekend the Federal Government said well, look, if you don't get your child vaccinated then the - your eligibility for childcare welfare benefits will be stopped. It's been dubbed a ‘no jab, no pay’ plan. It potentially could affect thousands of families. Social Services Minister Scott Morrison said it's not fair for taxpayers to subsidise parents who choose not to immunise their children. It's got the support of the Australian Medical Association. The head, National President, is Associate Professor Brian Owler, and he joins me now. Professor Owler, good morning.

BRIAN OWLER: Good morning.

PHILIP CLARK: Do many- well the degree of non-take up of immunisation, is there- do we have any empirical evidence of what it's all about? Is it people just being lazy, or is it people having a sincerely-held belief that vaccinations are bad, or what is it?

BRIAN OWLER: Yeah, look, it's a combination of all of those factors. I mean, most people actually do the right thing - they get their children vaccinated, and thankfully that's the great majority. But there are those people for whom life, I guess, gets very busy, and they sometimes it falls off the radar, and they need, I guess, a push or a reminder. There are two others. Those that really have genuine concerns because they've heard of risks associated with vaccinations - it's important that we talk to those people and give them credible sources of information. And then, of course, there are those people that it wouldn't matter what you presented them with or said to them, they would just never get their children vaccinated.

PHILIP CLARK:  I mean, you and I have spoken about this in the past. The importance of vaccination is that unless you can achieve a reasonable coverage of it, it's not worth doing is it?

BRIAN OWLER: Well, that's right. So it does work on this concept of herd immunity, and we do have people in the community whose immune system will be very low or compromised, and so to protect them it's important that the rest of the community is vaccinated. So it's not only really important for the individual child, for instance, to be vaccinated, but the decision to vaccinate that child also has benefits for the rest of the community. And that high percentage that we need, really up in the 90s, to get that herd immunity is very important.

PHILIP CLARK: I was surprised to read this, I didn't think the figures were this high, that the number of parents opting for a so-called conscientious objection to vaccination exemption in relation to welfare payments has more than doubled in the last ten years.

BRIAN OWLER: Yeah.

PHILIP CLARK: Maybe you're not surprised by that because you're very close to it.

BRIAN OWLER: Well, there has been more of a push. And certainly, our approach to date has been to try and have a mechanism to encourage parents to go and have a conversation with a credible source of information, being their family doctor or GP. But the concerning thing recently is that the number of conscientious objectors has been rising, and so there are obviously people that are not participating in that process appropriately, and so that's why I think it's not unreasonable for the Government to come up with, I guess, another measure. And I think it should be seen in that light, that it is really another mechanism, another lever to pull, to try and get the vaccination rates up. It's not going to solve all of the problems, but I think it's probably a step in the right direction.

PHILIP CLARK: Yeah. Although, you do wonder if people - if people are - have got their head in the sand about it, whether this kind of thing only makes it worse?

BRIAN OWLER: Well, I mean, we are worried about the implications for individual children.

PHILIP CLARK: Yeah.

BRIAN OWLER: And the decisions that their parents shouldn't be, I guess, disadvantaging the child. And particularly when it comes to access to things like pre-school, I think that's something that's really got to be considered. But it's also the decision not to vaccinate also is going to be harmful to the child as well. So, there are all sorts of, I guess, ethical arguments about the rights and responsibilities for individuals versus the community, children over their parents, et cetera. So it is, I guess, a much more complex problem than it would appear on the face of it.

PHILIP CLARK: Just to repeat though, is there any credible scientific or medical research which suggests that vaccination can be harmful?

BRIAN OWLER: Well, there are some risks associated with vaccination, I mean, we have seen some adverse outcomes. But they are by far a minority compared to the overall benefits of vaccination. I mean, vaccination is probably the most effective public health measure that we have. The other problem is that we still have misinformation being put out there by the anti-vaccination lobby, particularly those things like linking it to autism, which is completely false, and has [indistinct]-

PHILIP CLARK: [Interrupts] Yes, that story's been comprehensively discredited, hasn't it?

BRIAN OWLER: Absolutely. But you still hear it being brought up by the anti-vaccination lobby time and again.

PHILIP CLARK: But that's because unfortunately, Brian, that's because of Google. That's the trouble, once these things are out there on the internet they sort of sit there. And when you start searching, this stuff turns up even though it's wrong and it's been proven to be wrong.

BRIAN OWLER: That's right. And this is one of the problems that we have, is that, I guess, the internet has elevated some of these anti-vaccination lobbies to a status that they are not really entitled to. And when you compare the sort of rubbish that gets put out there to the overwhelming weight of evidence and the scientific and medical literature, there just is no comparison.

PHILIP CLARK: Okay. Alright. It's a, as I say, a stick rather than a carrot, but both policy options I guess are important.

BRIAN OWLER: Exactly. And that's one of the things we've got to keep going with – the education - encouraging parents, giving them the right messages, and getting them to go to the credible source of information, which should be their family doctor or GP.

PHILIP CLARK: Thank you for that. Professor Brian Owler, the National President of the Australian Medical Association joining us there.

13 April 2015

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