The $26 million pro-immunisation package announced by Health Minister Sussan Ley this week has provided a rare moment of bipartisan consensus. Rather than make political hay of the issue, Labor leader Bill Shorten affirmed his support for the Abbott government’s push to boost vaccination rates, saying “the public health and safety of our children has to come first.” However, there are a few aspects of this new package that are more objectionable than this bipartisan agreement would suggest.
The first concern is value for money. Ley says that around 166,000 children are more than two months late in their vaccination schedules. A $26 million package would therefore shake out to more than $150 per child. But the per-person cost could be even higher than that, since the majority of those stragglers are almost certainly behind on their deadlines due to parental carelessness or forgetfulness, and would catch up soon on their own. If the campaign is intended to target the hard-core evaders, then the value for money drops still further.
The second objection has to do with a broader trend in public health: a blurring of the line between genuine public health measures and other pro-health campaigns that do not quite qualify for the traditional definition of “public health”. Activist campaigns like the anti-tobacco, anti-sugar, and anti-fat lobbies have long attempted to draw parallels between themselves and more traditional public health issues like sanitation and vaccination — even though there are fundamental differences that make such parallels inapt. For example, a true public health issue is one that requires collective action to be effective, often due to contagion; but obesity and smoking are not contagious in the way that, say, cholera is.[pullquote] “Making vaccinations mandatory is practical for government to do, if it feels the science is conclusive enough … ” [/pullquote]
This new pro-vaccination package shows we are also seeing a blurring of categories in the other direction, with genuine public health issues coming to resemble activist campaigns. According to the Department of Health, a portion of the $26 million will be devoted to “a range of communication activities, tools and resources to increase awareness and understanding of the National Immunisation Program and to address parents’ concerns regarding immunisation, including dispelling common myths” — in short, a public awareness campaign. But for an issue like vaccination, such a campaign is not appropriate.
For one thing, it confuses public trust to put vital immunisations in the same category as, say, getting people to eat a healthy breakfast. The science behind vaccination is far more conclusive than that behind the “peel, pour, pop” nutrition pointers, and more importantly, the stakes are far higher. Immunisation supporters should not adopt the tactics of their public-health poor relations.
It is true that some real public health issues are best addressed with an awareness campaign. The famous “Grim Reaper” advertisements are a good example. These ads are credited with sparing Australia from a far worse AIDS epidemic — the national HIV/AIDS rate stands at only 1.3 per 100,000, compared with the US rate of 14 per 100,000.
But the Grim Reaper campaign was necessary because government can’t make safe sex mandatory. Regardless of the science behind condom use, it just isn’t the kind of behaviour that a law could ever enforce, by its very nature. The same can be said of other well-supported health precautions like wearing sunscreen, which lends itself to a catchy ad campaign because a legal mandate would not be practical.
Immunisation isn’t like that. Making vaccinations mandatory is practical for government to do, if it feels the science is conclusive enough — as I believe it is in this case. A public awareness campaign for vaccinations is therefore redundant and distracting. It’s not good value for money, and it’s taking a page out of the wrong guide: nanny state activism’s playbook.