Post-vaccination Status Epilepticus insufficient for exemption under No Jab No Pay/Play laws

03 October, 2018 By AVN admin

Photo: Courtesy of Light for Riley Fact Checker

We reported last week that medically-complex children were being subjected to general anaesthesia for the purpose of vaccinating them, rather than being granted medical exemptions, but the insanity doesn’t end there.

In a comment to the No Jab No Pay/Play panel at the 2018 National Immunisation Conference held in Adelaide during June, Sydney paediatrician, Dr. Nick Wood. revealed that doctors were unable to grant a medical exemption to a child who had been admitted to Intensive Care with post-vaccination status epilepticus due to the restrictiveness of current No Jab No Pay administrative arrangements.

Listen to his comments in the video below.

 
Watch the full No Jab No Pay/Play panel discussion

What is Status Epilepticus?

Most seizures last less than 2 minutes. But sometimes they don’t stop there – or they come one after the other, giving the person suffering from them no chance to recover. “Status epilepticus” literally means a continuous state of seizure.

Status epilepticus (SE) is a medical emergency that starts when a seizure hits the 5-minute mark (or if there’s more than one seizure within 5 minutes). After this point, it becomes less and less likely that doctors will be able to stop the seizure with medication. The risk of death also goes up the longer a seizure continues.  See What Is Status Epilepticus? for further information about the condition.

Post-vaccination seizures and Status Epilepticus

Seizures have been reported following all schedule vaccines.  A 2011 study found that seizures or epilepsy were present in 247 (75.3%) of 328 patients with an average interval between the vaccination and the epileptic event of 24 hours (inactivated vaccines eg. DTP) and 7.5 days (live attenuated vaccines eg. MMR).  Status epilepticus was described in 21 (8.5%) of 247 patients.

Medical Exemptions pre and post No Jab No Pay

Prior to 2016, doctors would have been able to grant exemptions to children with post-vaccination status epilepticus without question because there was nothing in the wording of the legislation which prevents doctors from exercising their clinical judgement when determining if vaccination is contraindicated for a particular child.

What most doctors probably don’t know is that the scope of medical contraindications was not narrowed with the passing of No Jab No Pay in late 2015.  The only change to the former section 6 (5) of the Family Assistance Act, which became the current section 6 (3) (a), was that from 01 January 2016, only certain classes of general practitioners were authorised to certify medical exemptions.  Prior to this, all recognised immunisation providers, which included immunisation nurses, were authorised to certify medical exemptions.

What has changed is the way the Family Assistance legislation is being administered.  The current government has artificially, and unlawfully restricted permitted contraindications to only two for the purpose of permanent exemptions, and three for the purpose of temporary exemptions.

See an extract of the wording of the old and new forms below.

Although those contraindications are the only ones provided in the Australian Immunisation Handbook, the Handbook is not a legal instrument containing specifications – it is a clinical guideline subject to a clinician’s judgement in each individual case.

The government is effectively misleading doctors by creating a medical exemption form which is inconsistent with the legislation.

We all know what happens to doctors who stick their neck out though.