By Lara Pullin
CANBERRA — ACT chief medical officer Dr Cathy Mead told a gathering of concerned parents and health care practitioners at a forum held here on October 23 that modern immunisation practices were in effect a giant human experiment, the results of which were unlikely to be known for another 20-30 years.
Mead was responding to a range of queries regarding contemporary understanding of the human immune response, particularly in the light of the expanding list of vaccines being promoted for use in infants.
The Canberra Vaccination Information Group, comprising parents and health professionals, convened the forum at the Lakeside Hotel in response to the large number of inquiries it receives on all aspects of vaccinations and infectious diseases.
Speakers included Dr Mead, presenting the pro-vaccination case, Dr David Ritchie, who describes himself as a "converted vaccinator", and a panel of speakers taking up legal and consumer issues.
In presenting the case for immunisation as a public health strategy, Mead relied on such notions as "herd immunity" and cost effectiveness. Given that there are no data collected on the extent of outbreaks in wholly or partially immunised populations, there are perhaps more gaps in our knowledge than is ethical.
Ritchie, after presenting the case against mass immunisation programs based on orthodox research, took up issues relating to the changing epidemiology of infectious diseases, and the benefits and risks to the individual child of the various vaccines and the illnesses they aim to prevent.
While the National Health and Medical Research Council supports the right to informed choice, the AMA is continuing to push for compulsory vaccination laws. An issue raised at the forum is that legislation requiring parents to declare the immune status of their children upon school enrolment is being promoted as a law for compulsory vaccination. In fact, the laws requiring parents to give their child's status are part of the new efforts to monitor the extent of immunisation coverage and the incidence of childhood infectious diseases in variously protected populations. There is no legal compulsion for parents to vaccinate prior to school entry.
Accurate statistics on the incidence and severity of side effects are not available, though some figures are available through the Adverse Drug Reactions Advisory Committee and from the national register of side effects held by the Immunisation Investigation Group in NSW. The Public Health Association of Australia's immunisation policy states that "Coverage surveillance should include specific monitoring of adverse events following immunisation".
At this point we don't have a lot of data on the effectiveness of immunisation. Much of the pro-vaccination case is based on dogma — the limited data doesn't fit the theory, so the data is thrown out.
Fortunately, scientists either come across this data or replicate it themselves, and such researchers and clinicians are now posing new theories regarding the disease process and immunity. Developing fields such as psychoneuroimmunology are able to traverse the old and the new. The application of chaos theory to epidemiology is revolutionary in its approach.
Modern medicine's usefulness in trauma management or emergencies is undisputed. Its capabilities in organ transplants and reproductive technologies are awesome. Yet in everyday life it is increasingly challenged by a consumer health movement, an educated and informed population who are making choices about their health.
This climate sets the context, not only for the discussion of immunisation, but for a discussion about who controls the information we need to have such a discussion. Who funds the research? (Vaccine manufacturers and the state/medical bureaucracy who promote the use of mass vaccination programs.) Who disseminates the findings? Who makes the decisions?
It's a discussion which is not confined to immunisation. The provision of health services causes much hardship to the poor. Last year 64 people died on the waiting list for cardiac bypass surgery. Kerry Packer, with his immediate helicopter access to the best in cardiology, has a life saving advantage.
Such inequalities are unacceptable, and even more unacceptable are the inequalities within health spending. Programs such as IVF involve considerable finance at a huge human cost, yet less than 10% of women who enter IVF programs will ever carry a baby.
For public health to be genuinely for the public good, the majority have to debate the issues and make decisions. As long as the power remains concentrated in the hands of a few decision makers, our health system funding will continue to have its parameters set by the needs of profit, not people.