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HEALTH / Apr ‘2014

The Vaxxing Debate

HEALTH / APR ‘2014

The Vaxxing Debate

Have you ever considered what you would do if you came across a parent who didn’t share your views on immunisation? Beth Johnston explores the social minefield of immunisation.

Words LISA FERNANDEZ

Picture this: eight new mothers, sitting around chatting in a newly formed mothers group at a house in Perth’s northern suburbs. One mum, let’s call her Robin, takes a sip of tea and with the group now quiet, says, “So what’s everyone doing about immunisation?”

I’m shocked. What are we doing about immunisation? It’s 2011 and I’m new to this parenting game, blissfully unaware that any kind of debate around vaccination even exists. I thought it was something we all just did because it protected our children. I decide to sit back and let others speak first, to see if I’m the odd one out.

Robin continues, “I was doing some research on the internet on whether or not vaccination can cause autism, I found some pretty scary stuff so I think I’m going to go with natural immunisation instead.”

‘Natural’ immunisation is something I had never heard of before. It turns out I wasn’t alone in being concerned by these comments, as the other six mothers in the group also had a raised eyebrow. The ‘natural’ immunisation Robin was referring to was a homeopathic alternative, which is meant to stimulate the body’s natural healing response. It’s her choice and she’s entitled to that, but my instincts are to protect my own child and I wonder if I should associate with Robin and her baby.

Nationally, Australia's child immunisation rate sits at around 92 percent, with almost 77,000 children not fully immunised

On the other side of Perth, in Fremantle, Katie Attwell found herself facing an even trickier social situation – she was the odd one out in a group of mothers who had decided not to immunise their children. Katie had always been pro-vaccination and contracting adult mumps solidified that decision for her. Having a homebirth for her second child, using cloth nappies and baby wearing drew Katie into a community of parents who shared similar values. Some may call them alternative. Regardless of titles, it soon became clear to Katie that her views on vaccination were something she did not share with her new friends.

Katie attended a coffee morning run by a local community not-for-profit group shortly after the airing of the SBS documentary The Vaccine Wars. It soon became the topic of discussion and Katie began feeling very isolated. “I was really upset because pretty much everyone in the room was saying they wouldn’t vaccinate their babies and hadn’t vaccinated their older children either,” she recalls. “Then there were others who didn’t know what decision to make, but it felt like it was just the norm in that community that you don’t vaccinate your children. I felt very isolated and frightened.”

Katie was astounded that a community so passionate about living ethically shared a view which she believed simply did not fit with the rest of their values. It became an area of great interest for Katie and she ended up joining the Immunisation Alliance WA, at first as a volunteer then as a project officer. Her experiences in her community gave her the idea for the Alliance’s current campaign, “I Immunise”, which features Katie and five other like-minded parents who are also pro-vaccination. Massive billboards featuring photos of these parents sharing what Katie describes as stories of social responsibility are scattered around the Fremantle area, branded with statements such as “I homebirth, I use cloth nappies and I immunise.”

"We're trying to bust open the stereotype and say, if we're positing ourselves as these people who are living ethical lifestyles, then immunisation is an essential part of that." - Katie Attwell

The Alliance team is quick to point out that this campaign is not aimed at those who are staunch anti-vaccinators, but rather those who are undecided. Katie says there is little chance of changing someone’s mind when they are set against immunising, but she doesn’t want people who are yet to decide to think that’s the norm.

“I want to make sure that when a conversation is happening in the community, there is a robust debate and remove what I see as the dominance of the anti-vax decision,” Katie says. “We’re trying to bust open the stereotype and say, if we’re positing ourselves as these people who are living ethical lifestyles, then immunisation is an essential part of that.”

Immunisation is an incredibly emotive issue. Nationally, Australia’s child immunisation rate sits at around 92 per cent, but there are still almost 77,000 children who are not fully immunised, according to the National Health Performance Authority (2011-2012 Healthy Communities report). The current immunisation schedule sees a baby born in Australia receive approximately 14 vaccinations from birth until the age of four to potentially protect them against 12 serious illnesses (which can vary from state to state).

Julie Leask is an Associate Professor in the School of Public Health, University of Sydney and a Senior Research Fellow at the National Centre for Immunisation Research and Surveillance. Julie says immunisation is such a sensitive issue because ultimately the decision that we make for our child will influence the health of others.

Julie is quick to point out that Australia does not have declining immunisation rates, but says public confidence is an issue that needs closer monitoring. However, she says most parents with concern about vaccination will still go on to immunise their children. Through their research they have developed different positions people might take on immunisation, from unquestioning acceptance right through to total rejection of vaccines. She says the latter only accounts for 2 per cent or less of unvaccinated children, but non-vaccinators tend to cluster in certain regions.

"On either side it taps into very strong feelings that people have around their children and I think if you could reduce it down to a common denominator, it's about people passionately and sincerely wanting to protect their children."

“The people who oppose immunisation, their feelings are tied up in disquiet about conventional medicine and medicine’s occasion but spectacular failures such as thalidomide and resulting mistrust that can engender in some people,” Julie explains. “Unfortunately that can spill over into vaccination. Then there are heightened levels of frustration about the public discussion around non-vaccinating parents where they are made to feel like they are being actively negligent or irresponsible and there have been punitive measures proposed such as removing their family tax benefits.

“On either side it taps into very strong feelings that people have around their children and I think if you could reduce it down to a common denominator, it’s about people passionately and sincerely wanting to protect their children.”

Catherine Ranford is a midwife and mother of two who chose not to fully immunise her second child, now eight years old. When her daughter Bethany was born, Catherine recalls as a new mother she simply went along with the status quo and “did as she was told”, fully vaccinating. When she had her second child, Peter, she decided to do some research into vaccination and wasn’t comfortable with what she found.

“I decided still to vaccinate Peter, but to delay until he was six months old and then just do them one at a time,” Catherine says. “My husband agreed and we found a very supportive GP. We just wanted to give his immune system time to mature and introduce them gradually so it wouldn’t potentially knock his system around.

"...it's a really personal decision that should be made between a child's parents and their GP." - Catherine Ranford

“But then Peter had a severe reaction to his second vaccination, with vomiting and extremely high temperatures and after that we decided not to go ahead with any other vaccinations.”

Peter has been a healthy child and Catherine says she has never had any issues at school or day care, something she believes breastfeeding played a large part in. If she had her time again, Catherine says she would most likely have practiced delayed vaccination with Bethany too, but she does not preach on the topic. “If someone knows Peter isn’t vaccinated and asks me about it, I will talk about it but it’s certainly not something I go around debating,” she says. “I won’t give advice because it’s a really personal decision that should be made between a child’s parents and their GP.”

One of the main advocates for families who choose not to vaccinate is the Australian Vaccination Network (currently in the midst of a name change due to ruling by the Administrative Decisions Tribunal). AVN public officer, Meryl Dorey, says they believe vaccination should always be a matter of personal, informed choice. She says their members vary in their opinions on vaccination, with some still choosing to vaccinate, some vaccinating selectively and some not vaccinating at all.

According to Meryl, those families choosing not to vaccinate do so for a few reasons; it could be as the result of having a child or knowing of someone who had a reaction to a previous dose of vaccine, prompting them to research the topic further.

“Another reason is that they don’t necessary believe the vaccines are going to be protective,” Meryl says. “They are questioning the effectiveness and the safety, from the perspective of the ingredients of vaccinations and contaminations as well as the long term and autoimmune problems that have been associated with vaccinations.

“They are not simply saying, ‘I don’t care about vaccinations, I’m not giving them to my child,’ they are doing lots of research, reading medical journals, consulting with health practitioners on both sides of the fence and after that, making the decision that for their child, they feel that the risks of vaccination outweigh the benefits.”

Meryl speaks of families being vilified for their decision. While there is no doubt that the issue can cause immense friction, Julie Leask says that there is actually no massive debate surrounding immunisation.

“It can be terribly awkward in those situations where everybody is immunising and someone says they’re not,” she says. “Then the other mums will worry that represents a risk to their children and it can create a lot of tension and can be quite a divisive topic.

“But it isn’t a massive debate. It’s made to look like that because the opponents of immunisation are a small group but they are incredible vocal, very committed and active.

“There is such a strong reaction to them that it looks like there is a hot debate where there is 50-50, but those national figures show it’s only around 2 per cent not wanting to vaccinate. The other issue is when poverty or social exclusion creates a set of circumstances so that children are inadvertently late for their vaccines.

“In medicine, there is overwhelming commitment to vaccines because they are largely safe and effective. Of course, like any medicine, vaccines bring some risk and some vaccines are not as effective as others. I think in medicine we’ve got a real role to communicate honestly and frankly with parents about the importance of vaccination and also some of their minor limitations, so parents go in with realistic expectations.”

LISA FERNANDEZ

A Perth girl who co-hosts 92.9's Lisa, Paul & Baz breakfast show with Basil Zempilas and Paul Hogan. As a mother, Lisa wants to "nurture, encourage, teach, inspire and give my love unconditionally... because the reward is so incredibly great." Keep up-todate with Lisa daily on Twitter at @Lisa_Fernandez.