In the sleepy weeks after my daughter was born, I read Eula Biss' excellent On Immunity with her sleeping on my chest (little did I know then how I should have savoured that book: it would turn out to be the last book I'd read until she turned nine months). As I read, feeling the lightness of her being rise and fall with my breath, I imagined her tiny body wracked by the powerful whooping cough I had experienced some years earlier when my mother, a former primary school principal who takes immunosuppressants, brought it home from school and it did the rounds of our family.
My daughter's arrival rendered deeply personal a debate – if it can truly be called that – that had previously been theoretical to me. I was determined to protect her as best I could, but short of never leaving the house I could not prevent her from being exposed to disease. The maternal health nurse assured me we lived in an area where virtually all children were fully vaccinated – unlike my friend who lives in an inner city suburb, and had to exclude her baby son from certain activities because her suburb is a notorious hotspot for anti-vaxxers.
![Bayside suburbs have the lowest vaccination rates.](http://web.archive.org./web/20170610090039im_/https://www.fairfaxstatic.com.au/content/dam/images/g/w/m/u/4/n/image.related.articleLeadwide.620x349.gwn8j2.png/1496867359274.jpg)
Periodically – but, unfortunately, with increasing frequency – the vaccination "debate" enters the public consciousness, with airtime given to the baseless views of "skeptics" (who would in truth be better termed "non-thinkers"). While it is true that in the long-term more work needs to be done to understand why parents might refuse to vaccinate and to build trust and improve engagement between skeptics and medical practitioners, in light of evidence published in The Age this week that immunisation rates are not improving in wealthy inner-city suburbs, in the short-term our policymakers must protect the rest of us as best they can.
As the mother of an infant, in my mind that means going beyond the positive reforms already introduced in Victoria – of requiring not only evidence of vaccination status to be shown before government payments can be received, but also before enrolment at childcare or kindergarten is possible – and making enrolment at any school that receives any public funding conditional upon demonstration that a child is fully vaccinated (unless, of course, they are unable to be vaccinated for medical reasons). Linking vaccination status to enrolment rather than financial sanctions (like those introduced by the Italian legislature in May, following a record number of measles cases) would avoid favouring wealthy parents who might care little about a fine. Furthermore, as part of vaccination operating on an "opt-out" system, parents who refuse to vaccinate should be required to sign a form agreeing to bear all financial cost if their child contracts a preventable disease and requires publicly-funded treatment. Measures such as these have unfortunately been necessitated by the need to deter those who persevere with their irrational and deeply anti-social anti-vaccine nonsense.
For aside from anything else, the decision not to vaccinate is inherently anti-social. It allows unvaccinated children to piggyback on the herd immunity that vaccinated children generate. Parents who vaccinate accept all the risk in vaccinating our children (insofar as some minor risk does accompany vaccination, as does all medical procedures), but all of us get to share in the benefits. It is time that more is done to remedy the situation.
Catherine Williams is a new mother and recent PhD graduate.
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