Australia is currently undertaking a review of its national immunisation strategy, the first since it was established in 1993.
There’s been quite a bit of comment in the media lately about parents who refuse to allow their children to be vaccinated, helped along by Adele Horin’s recent column in the SMH.
It’s a reminder that the national strategy needs to make communications with the public a key priority.
Judging by the experiences in the UK and USA, we will be in for some major challenges if a vaccine scare gets traction in Australia.
The UK has been hit hard by publicity about the unproven theory linking MMR vaccination to autism. Despite an abundance of research negating these claims, UK vaccination rates are still down and they now have a major measles epidemic with two deaths.
Meanwhile, US officials are concerned they may be reaching a tipping point with early indications of an expansion in the proportion of people who claim exemptions from vaccination.
A country can afford to have about 5% of children not up to date with vaccination. But any more, and there will be enough susceptible to give diseases like measles a foothold. In the US, one strategy has been to involve consumers in policy forums and daringly, representatives of lobby groups who are active and vocal in their criticism of vaccine programs.
Earlier this month, I attended three meetings in Washington DC which sought to hear input from stakeholders on policy matters regarding vaccine safety, autism and communication.
In the US, they do democracy well. Each meeting was open to the public, many of whom represented lobby groups with major concerns over vaccines.
There seemed a genuine willingness among government, vaccine experts and parent lobby groups to come together, look beyond the differences and focus on the common ground of child health.
Samuel Katz, the developer of the measles vaccine who is widely considered to be the “grandfather” of vaccination in the USA, and Louis Cooper, former president of the American Academy of Pediatrics, backed up parent groups calls for further funding of vaccine safety research and better public engagement.
Australian health authorities need to keep an ear to the ground on what the general public is thinking and doing with regards vaccination. To date, we’ve been unaffected by vaccine safety scares from overseas but the very expansion of our successful vaccination program brings unique challenges.
New vaccines regularly join an already crowded childhood schedule in a context of concern about the sheer number of vaccines given to children. Also, other target groups — teenagers, pregnant women, older adults — are increasingly being vaccinated.
To manage communication if a vaccine scare hits this country, we must be prepared with a coordinated, cohesive and thoughtful response which engages all relevant groups. This includes health professionals, government, vaccine manufacturers and most importantly the public.
It’s often assumed that the 2-3% of Australian parents who refuse vaccines are merely misinformed and that, with a good dose of science, will see the error of their ways. But deeper issues are at play, including distrust in government, rejection of orthodox medicine, and the back to nature idyll. An abundance of research shows vaccine refusers to be firm in their resolve and hard to change.
We shouldn’t invest our efforts in convincing them but with ensuring others do not follow suit with the next vaccine scare.
To do this, we need to back up our health professionals, the cornerstone of immunisation delivery. Parents trust health professionals when it comes to immunisation advice. Committed and confident health professionals ensure that children are offered the right vaccines at the right time.
It is my belief that the erosion of health professional confidence is the tipping point by which public concern becomes vaccine refusal and lowered rates. Supporting health professionals is a sound and efficient investment in maintaining public confidence in safe and effective vaccines.
There are challenges ahead as vaccines increasingly become a victim of their own success. The national review now underway should ensure we are prepared for when, not if, Australia encounters a vaccine safety scare that really does threaten our vaccination rates.
Julie Leask is a Conjoint Senior Lecturer with the School of Public Health and Discipline of Paediatrics and Child Health, University of Sydney. She also leads the social research program at the National Centre for Immunisation Research and Surveillance. This piece represents her own opinions.