Things went a bit topsy-turvy on Sunday. First we saw Tony Abbott explaining a public policy decision in terms of scientific evidence. If that wasn’t enough, we then heard Scott Morrison expressing concern for the welfare of children.
Never fear – there has been no change of heart on climate change or refugees. The policy announced yesterday was aimed at parents who do not vaccinate their children. They will be denied the childcare benefit, childcare rebate and end-of-year supplement to Family Tax Benefit A that other Australian parents receive.
This is just a fraction of the largesse that mums and dads get, but it can add up. The small number of people who now express a “conscientious objection” to immunisation will now have to either give those objections up, or give up the money.
The get-out clause has been narrowed to those who have legitimate “religious objections”. Whatever the concerns some may have about the distant association between some vaccines and abortion, no major religious tradition prohibits vaccination. Exemptions will be few.
This isn’t necessarily a damascene conversion to evidence-based policy, the benefits of public health or the primacy of the rights of children. The fact is that Australia’s overall vaccination rates are very high, conscientious objection rates very low, and where they exist they are concentrated in specific areas.
Immunisation rates are steady, at around 92%, and the number of conscientious objectors decreased slightly in the most recent Australian Childhood Immunisation Register survey, from 1.79% to 1.77%. Morrison himself admitted that 97% of children would currently meet the standard for continuing payments.
According to the Department of Health’s most recent reporting, the areas with significant numbers of conscientious objectors are mostly notorious alternative lifestyle enclaves: places like Kuranda, the Gold Coast hinterland, Byron Shire, the Adelaide Hills and Daylesford.
There was something of a crisis in the 1990s, when immunisation rates sagged and disease outbreaks went up. A national immunisation strategy was devised as a response. In 1993, only 53% of children were immunised against all preventable diseases, which was mostly turned around by the early 2000s, and has by some measures continued to improve. Since the mid-1990s immunisation has been linked to certain welfare payments. The current moves extend that.
In the meantime, the organised anti-vaccination movement has fallen into political and organisational disarray, not least because the “science” behind their theories has been shown time and again to be completely discredited. In the USA – especially in states like California and Oregon – parents’ opting out of vaccination is contributing to a nascent public health emergency. Australia doesn’t have one of these at this stage, though it may have contracted a nasty dose of moral panic.
The reason that Abbott and Morrison are moving on this now is that politically there is nothing to lose and a lot to gain. Only a tiny group of parents will now be forced to make the choice between losing money and allowing their children to be immunised in violation of their own beliefs. Most of those would never consider voting Liberal, and perhaps not even Labor. Indeed it may be a way of forcing elements in the Greens to justify themselves publicly.
The speed with which Labor agreed to Abbott’s proposal suggests they share his judgment, that only a small, politically insignificant rump of voters will be upset by this move. They also get to reassure worried middle-Australian parents that their kids won’t pick up something nasty at preschool.
It also fits neatly into the development of Morrison’s own image as the minister who will make the tough but necessary decisions (softened a bit, now he’s in the social services portfolio). He’s doing it for the kids. But it’s low-hanging fruit compared to the most intractable public health problems regarding children, which are largely in Indigenous communities.
All this considered, it was worrying to see many ostensible progressives congratulating the government on what amounts to a pretty authoritarian piece of political theatre. We can agree that anti-vaxxers are wrong about the science, and still be disturbed at the state trying to compel people to do things to their children they would rather not. Anti-vaxxers are not, after all, guilty of a crime of neglect or cruelty: their actions are born of divergent (if scientifically unsound) beliefs about what constitutes child welfare.
Recent attempts to make vaccination mandatory in some US states have foundered in the face of concerns about personal autonomy and parental choice. These concerns, in Australia, seem utterly marginal. What is it about Australian political culture that sees people across the spectrum praising the state for a move which can only result in the effective punishment of some children for the commitments of their parents?
The long history in Australia of the state interfering in the child-rearing of minority cultures is not a happy one. Nor is the more recent trend of using the welfare system to compel behaviour. These facts should give us pause and lead us to ask why Australians so often reach for and defer to state authority.
Regardless of your personal opinion of anti-vaxxers, the best evidence we have says they are marginal both politically and numerically. Do we really want to applaud the withdrawal of state assistance from all parents who don’t vaccinate (including people who forget to get their kids jabbed, or can’t for whatever reason) on account of this group? What else are we prepared to try to compel people to do to their children? Is this the only way we can resolve deep value conflicts?
These questions are all the more pressing because there’s not a lot of evidence that it will work to get more kids vaccinated, at least according to social scientists who are experts in this area. In fact, academic Julie Leask wrote on Saturday: “It amounts to a form of mandatory vaccination for lower-income families, but without a no-fault vaccine injury compensation system implemented alongside.”
She suggests that it would be more effective to implement a national vaccine reminder system, home visiting programs, and to build respect for vaccination centres. This, of course, would cost money. On the other hand, punishing parents with reduced incomes inevitably means punishing kids. Abbott christened it a “no jab, no pay” policy: with a name like that, can it really be anything more than a form of displaced social revenge?
In the end, the equation feels pretty brutal. Of the small number of people who currently object to vaccination, those with the deepest convictions will be unlikely to be swayed by this move, and those who really need the money will submit their kids to something they believe to be harmful. You don’t need to be an anti-vaxxer to feel extremely queasy about this.