Childcare And Vaccination

doctor-vaccinating-toddlerDr Melina Georgousakis reports on legislation passed in NSW that will require vaccination documentation for children enrolling in childcare centres.

The NSW Parliament last week passed legislation that will allow childcare centres to deny the enrolment of children who don't have vaccination documentation.

What Does The Law Mean?
Introduced by Health and Medical Research Minister Jillian Skinner, the legislation is an amendment to the NSW Public Health Act 2010, and will come into effect on 1 January 2014. Parents or carers enrolling children in childcare centres will be required to provide evidence their child is either fully vaccinated for their age, is on a recognised catch-up plan, or has an exemption approved by a GP. This doesn't mean vaccination will be compulsory for enrolment in childcare centres, but providing documentation of a child's vaccination status before enrolment will be. The legislation will allow exemptions for medical reasons or parents' personal reasons (such as religious beliefs). However, parents will need to complete the necessary documentation in the presence of a GP or another approved immunisation provider before being granted an exemption.

What Is The Law Trying To Achieve?
The legislation aims to increase the number of children who have received all recommended vaccines on time. In 2012, about 92 per cent of Australian children were fully vaccinated by the age of two. This is a great achievement, however there are still pockets of Australia where coverage is much lower. The main reasons for not vaccinating are logistical issues such as parents forgetting or not finding the time. Other children can't receive vaccines because of medical reasons such as cancer treatment. Only a small proportion of children (less than two per cent) are unvaccinated because of their parents' objections. The legislation will act as a reminder for parents to have their children vaccinated, as well as providing an opportunity for parents who object to vaccines to be counselled by a GP on the risks and implications of not having their children vaccinated, when completing the exemption documentation. The legislation will also mean childcare centres have a record of all enrolled children's vaccination status in the event of public-health measures such as the need to exclude unvaccinated children from care during disease outbreaks.

Why Is Having High Numbers Of Children Vaccinated Important?
High vaccine coverage is essential to preventing the spread of vaccine-preventable diseases in the community. This concept is called 'herd-immunity', and allows the protection of those who can't be vaccinated, such as babies or children with medical conditions. It is also important for preventing disease outbreaks. For highly contagious infections such as measles, 95 per cent or more of the community needs to be vaccinated to prevent it spreading. Having high numbers of children in childcare centres and schools vaccinated is especially important because of the children's close contact and interactions with each other and their families, providing opportunity for disease spread. When the number of vaccinated individuals drops, the level of immunity in the community also drops, and this is when diseases can be reintroduced, such as the measles outbreaks in Australia in 2011 and 2012. Both times a large proportion of those affected were schoolchildren.

Where To Go For More Information
The legislation has been passed in NSW only. Further information is available at NSW Health. Parents in other States and Territories can contact their local health departments to find out about vaccination requirements for childcare.


Dr Melina Georgousakis is senior research officer at the National Centre for Immunisation Research and Surveillance, Sydney.

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