WA Health & Education Ministers Roger Cook & Sue Ellery announcing ‘No Jab No Play’
Last Friday, we saw a flurry of media articles and stories announcing government plans to introduce a ‘No Jab No Play’ law in Western Australia (WA), despite Health Minister Roger Cook’s previous reassurance that he would await COAG guidance “to ensure there is a nationally consistent approach to immunisation requirements for attendance at childcare and preschool.” Read the media release.
2018 letter from WA Health Minister Roger Cook
Both COAG and the COAG Education Council met last week, however there was no mention of the national ‘No Jab No Play’ policy in the published communiques. Waiting for COAG guidelines would help ensure that ethical concerns with preventing access to early childhood education services are addressed.
In an article published in Bioethical Inquiry in March this year, Australian medical ethics experts expressed concern that No Jab No Pay/Play laws over-ride valid consent, concluding that “the evidence does not support a move to an increasingly mandatory approach that could only be delivered through paternalistic, coercive clinical practices”.
Also see Victorian paediatrician condemns No Jab No Play.
There are significant consequences for children not being able to access early childhood education services, as is recognised by the National Partnership Agreement on Universal Access to Early Childhood Education. The rationale for this federal government program is to ensure all children have access to a quality pre-school education program for 15 hours per week or 600 hours per year, delivered by an early childhood teacher in the year prior to full-time school.
The Australian Labor Party (ALP) has committed to extending this program to three year olds in the event it forms government after the federal election next year.
(1) Effective from 01 January 2019, childcare services, kindergartens and schools in Western Australia will be required to collect and, on request by the Chief Health Officer, report on the vaccination status of all students, in accordance with new regulations made under the Public Health Act 2016. This is a documentation requirement only, and does not require children to be up-to-date with scheduled vaccination. For further information see the WA Department of Health publication called Strengthening immunisation reporting requirements – Frequently asked questions or Part 2A of the Public Health Regulations 2017, commencing on page 18.
(2) A Bill to amend the Public Health Act 2016 (WA) and the School Education Act 1999 (WA) will be introduced to the parliament, to allow the Chief Health Officer to exclude children who are not fully vaccinated from enrolling in childcare services and kindergarten (non-compulsory early education and care). According to the media release, it is anticipated ‘No Jab No Play’ will commence in July 2019 for children entering childcare services, and in 2020 for children commencing kindergarten.
The Health Minister’s office has advised that there will be a public consultation process once the Bill has been drafted, which is happening currently. We will provide updates as information comes to hand.
The government is purporting to justify the proposed law based on low vaccination coverage rates, stating in the media release:
In 2017, the State’s immunisation coverage was lower than the national average for one, two and five-year-olds, with two-year-olds in WA recording the lowest immunisation coverage of 89.1 per cent.
However, use of the vaccination coverage rate for the two-year old cohort represents an example of cherry-picking, designed to mislead the general public into believing that the rate in that cohort is dangerously low. Vaccination coverage data published on the federal Department of Health website includes a disclaimer for the two year old cohort, to the effect that changes to the definition of “fully immunised” has artificially reduced coverage rates, which will resolve over time.
**From quarter ending 31 March 2017, DTP dose 4 (given at 18 months) was included in the definition for fully immunised for 24 to less than 27 months.
***From quarter ending 31 December 2014, meningococcal C (given at 12 months), and dose 2 measles, mumps, rubella (MMR) and dose 1 varicella (given as MMRV at 18 months) were included in the definition of fully immunised for the 24 to 27 month cohort.
The inclusion of these immunisations to the coverage calculation in December 2014 and March 2017 caused a drop in the 24 to 27 month coverage rates. The more antigens included in the assessment, the higher the likelihood of reduced coverage rates. This usually resolves over time as the changes become more routine.
Therefore, the government should only be relying on vaccination coverage rates for the one year old and five year old cohorts, which indicate that the true vaccination coverage rate for WA is already extremely high at over 93%, as shown in the tables below.
Vaccination coverage for one year old cohort as at 30/09/2018
Vaccination coverage for five year old cohort as at 30/09/2018
With the documentation requirement coming into effect from 01 January 2019, vaccination rates will likely reach the magical figure of 95% without the need to implement ‘No Jab No Play’.
The WA government has also conveniently ignored the fact that the states/territories with the highest vaccination coverage rate for one year olds and five year olds, the Australian Capital Territory (A.C.T.) and Tasmania respectively, have not implemented ‘No Jab No Play’ laws. A.C.T. and Tasmania have documentation requirements in place which require parents to provide vaccination status when enrolling their children, but do not require the children to be up-to-date with scheduled vaccinations.
Let’s think about that for a minute. The WA government has intentionally used misleading data to make the public believe that vaccination rates are a pressing issue that warrants introducing coercive and discriminatory legislation, which the media dutifully repeated without doing basic fact-checking.
If you find the conduct of the media in this regard as despicable as we do, we are currently compiling a list of articles and electronic news stories which published the incorrect 89.1% coverage rate for two year olds, as well as a guide to making complaints to the Australian Press Council, Independent Media Council and FreeTV Australia. We will publish this list and guide in the next day or two.
