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But this morning I had reason to leap out of bed at the ungodly hour of 05:30 to hit the computer and report on some very good news.

Our government has gone done something good and given that this doesn’t happen very often, I reckon it’s worthy of a pre-dawn blog post.

The news, which was brought to my attention by Fuzztwin on Twitter, reports on changes to the current childhood immunisation schedule to include three new vaccines and increase the incentives for parents who complete the schedule, effective 2013.

From http://www.heraldsun.com.au/news/more-news/inject-children-or-lose-money/story-fn7x8me2-1226205382138

Chickenpox or varicella which as not previously been covered by the schedule (and hence was an out-of-pocket expense for parents wanting to vaccinate against chickenpox) will now be included.

Also new is vaccinations for meningococcal C and pneumococcal.

The new schedule brings the number of infectious diseases covered by the schedule to twelve.

Importantly, reports indicate that the number of shots kids will be required to get will actually be reduced however, since there will be new combination vaccines used.

According to a report in The Herald Sun a new combination vaccine will cover measles, mumps, rubella and chickenpox in one shot and will be administered at 18 months replacing the previous MMR given at 4 years. The number of visits will increase however, owing to the new scheduled shot at 18 months.

There are also changes to the incentive scheme for parents and this is where it gets interesting (well, for nerds of legislation like me).

Under the current maternity immunisation allowance scheme introduced in 1997, parents receive two one-off payments totalling $258 if they complete the vaccination schedule. This will be scrapped under the new system and replaced with three payments of $726 each, paid at one, three and five years. If kids are not fully vaccinated, then the $2100 will be withheld. (This is part of the current family tax benefit part A end-of-year supplement so it’s not an entirely new benefit).

From http://www.smh.com.au/national/tax-threat-to-parents-who-dont-have-their-children-immunised-20111124-1nwwx.html

Health Minister Nicola Roxon said: “We know that immunisation is fundamental to a child’s lifelong health and that’s why we want to make sure that children are immunised at the right time.

“We want all Australian kids to grow up healthy, and immunisation is essential to that.”

What is not mentioned in any of the news stories is whether this effects the current options for conscientious objectors. Under the current system, you can still get the maternity immunisation allowance even if you don’t vaccinate, if you identify as a conscientious objector (CO). Excerpt from the Centrelink website which administers the payment:

a recognised immunisation provider (e.g. your doctor) signs a letter or form saying that:

• they have told you about the benefits and risks of immunising your child and you have a conscientious objection to immunising your child (your provider should complete a Health Insurance Commission Immu-12 form),

• immunising your child with a particular vaccine is medically contraindicated (your provider should use the Health Insurance Commission Immu-11 form),

• the child has a natural immunity to the disease, or

• the vaccine is not available,

• you or your partner are a member of the Church of Christ, Scientist and you have a letter from an official of the Church advising that you are a practising member of the Church.

This is certainly going to be the bit the anti-vaxers are interested in. The news stories appeared overnight (at least one was published at 12:00) so we have yet to see a reaction from Meryl and her buddies. But you can expect some major *head asplosions* on this one, guaranteed. Particularly since Meryl had previously claimed she has some sort of influence when it comes to vaccination policy. It seems she might have missed this one.

This is not the only piece of good news in this story either. Reports also detail a new pertussis awareness campaign in the form of mail-outs to warn parents about the dangers of the current epidemic and advise on ways to protect their kids.

This is a direct response to campaigning by the McCaffery family who lost their baby Dana in 2009 at 4 weeks of age in the grips of a pertussis epidemic. The family was never warned about the risks of pertussis or that they needed, as parents and carers, to get boosters, since the effectiveness of the vaccines wanes over time.

From the Age:

Ms Roxon said the aim of the whooping cough campaign was to raise awareness, particularly among parents planning pregnancies and others to be aware of the dangers to infants and the need to have vaccinations at two months, four months and six months after birth.
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But the vaccinations do not provide lifelong protection from whooping cough and children should have booster shots at age four and then during teenage years, Ms Roxon said.

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”Whooping cough is not just a childhood disease, as adolescents and adults can account for half the cases in the community.”

Overall, this is a step in the right direction by the Australian Government and I applaud Nicola Roxon for (finally) taking action. The introduction of the chickenpox vaccine is also a welcome addition to the schedule, since it costs as much to get as the current maternity immunisation allowance (~$200) making the incentive seem moot.

It’s still early in Australia, and since this story only broke overnight, I wait with interest for the response of the anti-vaxers. I’ve also searched, but to no avail, for a government media release, as I’m keen to find out if any changes have been made to the CO conditions.

One suspects they will remain in place, at least in some form, since they are necessary for kids with genuine medical reasons for not vaccinating, but given that the maternity immunisation allowance scheme is to be scrapped, it appears they will at least need to be migrated, if not re-drafted.

I await with interest.

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Update: the government statement about changes can be found here

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I get emails. And recently I was reminded of one I got back in June which somehow slipped from my consciousness. With all the negative attention Nimrod has been receiving of late the response from some authorities has been, “we can’t respond unless someone reports him.” Indeed, last month, chair of the Chiropractic Board of Australia urged people to make a formal complaint against Mr Weiner after Australian Doctor posted audio of his two-hour public lecture on the dangers of vaccination.

So I went back through my emails and found a complaint from Dr John Cunningham, forwarded to me and submitted to AHPRA (then passed onto the Chiropractic Council of NSW) on April 4th, 2011. Dr Cunningham received the following response on May 31st, 2011 (my emphasis).

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Really? So it’s okay for a registered health professional to disseminate false, misleading and dangerous information under the guises of “it’s my opinion”? But what if the evidence says the opposite, which in this case it most certainly does.

If you take a look at the references Weiner uses in the 4 pages of anti-vax rhetoric posted on his website (which was the subject of Cunningham’s complaint), and his 2-hr long lecture on “18 reasons to not vaccinate” (pdf of references here) you’ll find a grab-bag of some of the most prominent anti-vaxers. He cites all my favourite loons including the AVN and their previous publication “Informed Choice”, Not-a-doctor Andrew Wakefield, Viera “parsnip box” Scheibner, Joseph Mercola, Whale.to and Vaccine Information Service Australia or VISA (amongst others).

There’s a glass and a half of crazy right there.

Weiner also drags out the some of the old favourite canards of the antivaxers. See the following paragraph as an example of vaccines cause everything;

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“Other conditions linked to vaccination include pervasive developmental disorder (PDD), Asperger’s syndrome, eczema, encephalitis, Guillain-Barre syndrome, convulsions, seizures, anaphylaxis, thrombocytopenia, optic neuritis, ocular palsies, retinitis, deafness, otitis media, ulcerative colitis, bowel disease, Crohn’s disease, headaches, dizziness, hearing and vision problems, arthritis, arthralgia, learning disorders, chronic fatigue, diabetes, multiple sclerosis and more.”

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He doesn’t provide a reference for these claims.

And as usual, Weiner beats the dead horse of vaccines = autism

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“After years of denying a link between vaccination and autism, on November 9, 2007 the US government in Court of Federal Claims admitted that vaccines can cause autism.”

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The reference Weiner cites for this claim is David Kirby writing for the Huffington Post in 2008. Kirby is also the author of “Evidence of Harm” a book detailing the personal stories of parents of children who have autism who went onto establish the advocacy group SafeMinds. So there may be a conflict of interest in what Kirby has to say.

There also *may* have been some advances on our understanding of the evidence against a link between vaccines and autism – which have occurred since 2008, both in the courts and in the lab.

But despite the fact that Weiner claims to base his information on the latest science, he uses outdated references, claims Wakefield’s work is “sound” and uses scary language that has no basis in science.

There’s more…

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Robert Mendelsohn, MD writes: “My suspicion, which is shared by others in my profession, is that the nearly 10,000 SIDS deaths that occur in the U.S. each year are related to one or more of the vaccines that are routinely given to children.”

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My suspicion? So you don’t have any evidence for that then? The reference for this statement is simply Mendelsohn. Ibid:250 which makes no sense to me. In any case, Mendelsohn is well known for his “unusual ideas”.

For example, he has opposed water fluoridation, immunization, coronary bypass surgery, licensing of nutritionists, and screening examinations to detect breast cancer. He has a listing on Quackwatch and whale.to.

The spurious claims about vax go on for 4 pages and at last check they were still there. (I’m actually surprised it is still up given the criticism Weiner has been under of late. Perhaps his cognitive dissonance is so strong that he thinks he is right. Sadly, I suspect this is the case).

But whether Weiner thinks he is right and that vaccines are bad “in his opinion” is irrelevant when it comes to his role a health care professional, especially when dealing with kids. Remember he’s a pediatric chiropractor dealing with kids as young as one-day-old.

And science is not formed via opinion, it’s based on evidence and there is no evidence for just about everything he claims (even chiropractic subluxations actually).

The fact that the CCNSW thinks it’s okay says a lot about their responsible approach to chiros under their jurisdiction and patients.

This story was covered in Australian Doctor today and rest assured, we have not seen the last of the Weiner files. More to come very soon.

To download a high resolution pdf version, click here . We encourage you to distribute this widely; perhaps drop off a copy at your local child care centre or pin one of the community notice board. We need as many parents as possible to see this information to warn them about the dangers and consequences of listening to misinformation spread by scaremongering groups such as the AVN.

First there was Rebecca Letourneau’s accurate report on the dangers of not vaccinating on Channel 7s Sunday night programme. You can hear my interviews with her on The Skeptic Zone episode 28 and 29.

Further, an update on my most recent post about the ABC Immunisation Fact Files. This was brought to my attention by my blogging colleague, Fuzztwin, who wrote to the ABC to ask them why, on a page purporting to offer sensible advice about vaccination, they had hyper-linked to the Australian Vaccination Network. Testament to the power of Twitter, and the tenacity of those who think the anti-vaxers are doing harm, the following paragraph was modified today. The original appearing below;

“The internet has become a popular source for those seeking further information on vaccination. But be warned, studies have shown that when you type immunisation into a search engine, you will get a disproportionate number of sites that carry an anti-immunisation message.”

has now been modified to say the following;

“The internet has become a popular source for those seeking further information on vaccination. But be warned studies have shown that when you type immunisation into a search engine you will get a disproportionate number of sites that carry an anti-immunisation message. The Australian Vaccination Network is one such anti-vaccination site.”

Thank you to the ABC for listening, considering what we said and making changes for the benefit of the community. Also, thank you to Fuzztwin for alerting me to this and to all who commented, especially David McCaffery.

“..Well done sceptics! Keep working hard to save and protect our babies and community”.

Following on from an equally damning article by Adele Horin from the Sydney Morning Herald in January 2009, the Sydney tabloid newspaper, the Daily telegraph published an article written by Joe Hildebrand about the irresponsible anti-vax movement today.

It has not been a good day for the anti-vax movement in this country. To add insult to injury, the Stop the AVN Facebook page reached over 500 members today, and this has occurred shortly after the AVN Facebook Fan page (can’t show you the link, because I quite simply can’t find it!) has seemingly disappeared off the face of the earth.

Fear not readers, we have many other irons in the fire, which I hope to reveal to you very soon. In the meantime, keep up the fight by signing the Stop the AVN petition and leaving a message of support at Dana McCaffery’s Facebook page.

Also, don’t forget my report from Dr Rachie that started my campaign against this group of scaremongers. Or listen to the audio from Episode 19 of The Skeptic Zone.

The world really has gone topsy-turvy and I couldn’t be any happier!

The Australian Government has produced a guide on vaccine myths and misconceptions. The one I have posted here is for providers, but much of the information is easy to read and understand.

You can view the pdf here. I’ll be back as soon as I have blogged today’s debate.

It was established in 1997 by Dr Michael Wooldridge, the then Federal Minister for Health and Family Services, in response to low levels of immunisation in Australia.

The new initiatives were designed to reach the 97 per cent of parents who are in favour of immunisation, but who did not finish the full vaccination regime.

During the launch, Dr Wooldridge said; “With such a high rate of acceptance of immunisation, it is appalling that only 53 per cent of Australian children are fully immunised for their age. This leaves all children at risk of contracting vaccine preventable diseases such as measles, whooping cough and German measles.”

“Present childhood immunisation rates in Australia are among the worst in western countries and lower than many Third World countries.”

Dr Wooldridge said the Federal Government was so concerned about the low rates of childhood immunisation that it had put its full weight behind an ambitious national strategy to significantly improve immunisation compliance.

This included the introduction of the Maternity Immunisation Allowance, a non-means tested bonus to encourage parents to fully immunise their children and the offer of financial incentives to medical practitioners as part of the Better Practice Program.

The Maternity Immunisation Allowance aims to encourage parents or guardians to fully immunise children in their care. Maternity Immunisation Allowance is a payment for children aged 18 to 24 months who are fully immunised or have an approved exemption from immunisation.

However, you can still get the money even if you don’t get your kids vaccinated. Following is an excerpt from the exemption clause.

a recognised immunisation provider (e.g. your doctor) signs a letter or form saying that:

• they have told you about the benefits and risks of immunising your child and you have a conscientious objection to immunising your child (your provider should complete a Health Insurance Commission Immu-12 form),

• immunising your child with a particular vaccine is medically contraindicated (your provider should use the Health Insurance Commission Immu-11 form),

• the child has a natural immunity to the disease, or

• the vaccine is not available,

• you or your partner are a member of the Church of Christ, Scientist and you have a letter from an official of the Church advising that you are a practising member of the Church.

I find it very interesting that this is never mentioned by the anti-vacc crowd. They are very quick to accuse GPs of being involved in some “big pharma” conspiracy since they also receive financial incentives to vaccinate and talk to parents about immunisation.

Did they forget to mention they also get paid for leeching off the rest of us who do comply thereby benefiting from they herd immunity we provide?

And as my mum who alerted me to this story said, if they are so opposed to vaccination shouldn’t they decline to take the money out of principle?

Basically all medications and drugs and vaccines are supposed to go through a double blind placebo study where one group is given the treatment and another group is given a placebo or like a sugar pill and in over 200 years of vaccine history, this has never been done for any vaccine. So anything we know or think we know about vaccinations is purely guess work.
Meryl Dorey, The Australian Vaccination Network, 2006.

With recent talk about how the anti-vaccine crowd have effected rates of vaccination in the UK and the States, I thought it might be interesting to look closer to home to see how Australia stacks up.

This week Medicare, Australia’s government run health body released figures from the Australian Childhood Immunisation Register detailing the rates of immunisation in this country.

The latest figures are from December 2008. On the face of it, it seems we are doing pretty well. For kids aged up to 15 months, the national average for immunisation is 91% with the lowest levels being 89.9% for Western Australia. The national average falls to 88.4 % in the up to 5 years of age group with the lowest compliance of 85.5% in South Australia. When you consider that approximately 90% vaccination is needed to obtain herd immunity, but this depends on the vaccine and the disease, these figures are encouraging.

Rob Menzies, from the National Centre for Immunisation Research and Surveillance, said low vaccination rates were often more prevalent where well-educated parents did their own research and believed the myths that vaccines did more harm than good. This was reflected in figures for Sydney’s exclusive Eastern Suburbs, including the harbour view, well-to-do suburbs of Double Bay and Vaucluse, which were ranked the worst, with only 80 per cent of children immunised. This was followed closely by the areas of Lismore, Alstonville and Byron Bay, areas known for “alternative lifestyles” so these figures are not overly surprising.

There has been much discussion and speculation about why the wealthy suburbs are less likely to get their kids vaccinated. One journalist described the parents as, “Selfish dummy mummies need consciences pricked”. Adele Horin, reporting in the Sydney Morning Herald explained; “These are women who spend too many hours on wacky internet health sites and become convinced immunisation is a giant conspiracy”. She further described them as “The educated mother who thinks she knows better than the overwhelming majority of the world’s scientists and doctors…” These statements are supported by Arthur Allen, author of the book Vaccine, A History of Immunisation. He observed that “living in a place with a high percentage of PhDs is a risk factor for whooping cough”.

Scathing stuff indeed. But in a case of backward logic the anti-vaccers have actually claimed this for themselves loudly proclaiming, “parents continue to be accused of being ignorant, uncaring and stupid for refusing vaccines which the medical community claim will keep their children healthy when the truth is older, highly educated parents form the basis of the [sic] anti-immunisation lobby’.

Not something to be proud of I would have thought. However, one wonders if these are the parents glued to morning television when the likes of Meryl Dorey from the Australian Vaccination Network (AVN) can regularly be seen, spouting her misinformed anti-vacc. nonsense. She is like a watered down version of Jenny McCarthy, without all the cash and the hilarious boyfriend.

The innocuously titled AVN, fronted by the screeching Meryl Dory, go by the catch phrase, “love them, protect them, never inject them”. Meryl is regularly given a platform on morning television shows in Australia, such as Mornings with Kerri-Anne. In defence of Kerri-Anne, they usually have a representative from the sensible side, in this case Dr Penny Adams. However just like the overseas breeds, Meryl is not shy about exposing her ingnorance to a national audience.

As a demonstration of how little the AVN understand about science and medicine, I will use an article written by them called “10 reasons why parents choose not to vaccinate”.

Reason 1: Vaccines have never been tested.
A true indication of how little AVN know about how the drug development process works. I won’t bore you with the details of this process today, but I will tell you it takes millions of dollars, around 10 years and at least 4 phases of testing, which continues even after the drug is released.
Evidence that this process works can be found in the case of a vaccine for the rotavirus called Rotashield which was released in the US in August 1988. In pre-licensure trials, the vaccine appeared to be safe, but in post-licensure surveillance it was associated with an increased risk of intussusception (a rare form of bowel obstruction occurring in infants). As soon as this problem was discovered, the vaccine was withdrawn from the market. Rotashield® was never released in Australia, and each new rotavirus vaccine has undergone testing in around 70,000 young children to rule out a risk of bowel obstruction.

Reason 2: Vaccines contain toxic additives and heavy metals
Here they are of course scaremongering with thimerosol, a mercury-based preservative that has been used in very small amounts in some vaccines since the 1930s to prevent bacterial and fungal contamination. There is no evidence that thiomersal in vaccines has caused any health problems, except perhaps minor reactions, such as redness at the injection site. THimerosol was removed from childhood vaccines as a precaution in 2000. Some vaccines, such as pneumococcal vaccines, MMR and other live attenuated viral vaccines, never contained thiomersal. Whilst there are certain vaccines for adults that stil contain thimerosol, the levels are extrememly low. Much lower than the level of exposure we get to mercury in our daily lives.

I don’t have time to discuss all their claims, except to day that they are full of accusations and conspiracies we have come to expect from such ignorant people, such as pharmaceutical companies have paid for all the vaccine studies to date, and this outrageous statement;

“Some childhood illnesses have beneficial aspects and therefore prevention may not necessarily be in the interests of the child”

You really think so Meryl Dorey? Why don’t we use one example of a childhood illness, whooping cough, (which can be vaccinated against) and look at whether it’s in the interest of the child to contract it. I chose whooping cough since Australia is currently experiencing an epidemic.

According to some reports, more than 13,000 cases were diagnosed across Australia – a 15 year high. In October 2008, there were more than 40 confirmed cases in the Bega Valley region, most were in school aged children, from the same school and the health service said that most of the cases were in children who have not been immunised.

Whooping cough is caused by the bacterium Bordetella pertussis. Babies are vaccinated against pertussis at 2 months, then 4 months, 6 months and 4 years. Whooping cough is particularly serious in young children, where one in every 200 babies who contract the infection will die. Some can even crack ribs through violent coughing attacks. A recent report about the current epidemic cited the story of a 14 week old girl, who has had whooping cough since she was two weeks old. Her terrified mother explained how she had turned blue several times, whilst gasping for air following long coughing fits.

The ‘whoop’ (which is not always obvious) is due to a deep breath at the end of a bout of coughing. Vomiting after coughing is common. Severe complications which occur almost exclusively in unvaccinated people include seizures and pneumonia. In babies under 6 months of age the symptoms can be severe or life threatening and include;

• Haemorrhage (bleeding)
• Apnoea (stopping breathing for long periods of time)
• Pneumonia
• Inflammation of the brain
• Convulsions and coma
• Permanent brain damage
• Death.

Whooping cough is not a disease you want to mess with. According to health officials, the recent Australian epidemic of whooping cough is likely a result of a reduction in vaccination. North Coast Area Health Service director of public health, Paul Corben said, “Communities with low vaccination rates have had more than eight times the rate of disease seen in those areas with the highest vaccination rates”.

Although the AVN are a relatively small organisation they are well organised and active, therefore they can do significant damage.

Australian listeners may remember the case of parents who fled hospital and the authorities with their new born in August 2008, to avoid having to have him vaccinated for hepatitis B. The sad thing is the mother has hepatitis B herself. Although it is not compulsory to be vaccinated in Australia, it is health department policy that children born of hepatitis B positive mothers are offered immunoglobulin for the child within 12 hours of birth and four doses of the vaccine over six months. In a tragic tale of ignorance, the mother told reporters that the couple believed aluminium in the vaccine could cause him more damage than the child contracting hepatitis B. And of course the father is a member of the Australian Vaccination Network, by which the couple are now touted as heroes.

Australia also has the usual suspects, the chiropractors who don’t proclaim it from the rooftops but upon questioning will tell you not to vaccinate. They will also follow the MMR-autism line. I had one tell me this at a recent Mothers, Babies, and pregnancy expo. And of course we can’t forget the despicable homeopaths who will also tell you on the sly that you can use homeopathy to vaccinate your kids. (BTW, there is no such thing as a homeopathic vaccine or a process known as homeopathic vaccination. It is called homeopathic immunisation, sometimes known as homeoprophylaxis, according to the irresponsible website homeopathyplus.com.au).

For more information about the myths and realities of vaccinations, see the Australian government’s publication “Vaccination; myths and realities, responding to arguments against immunisation” (see below). This is a thoroughly researched and easy to read resource which addresses fact and fiction about vaccination. Also useful even if you are not in Australia and particularly good for passing on to anyone you know who might have some dodgy ideas about the merits of vaccination.

References and further reading:
Immunisation, myths and realites. Responding to arguments against immunisation. A guide for practitioners. Australian Government Department of Health Ageing. 4th edition.

Current immunisation schedule

The MMR Decison Aid from the National Centre for Immunisation Research and Surveillance, Australia.

Fact sheet – A guide to homeopathic vaccination.

Only listen to these homeopathy podcasts if you are sitting down. The stupid, it burns.