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New Bill allows specialists to certify medical exemptions to vaccines

Starting with the 2015–16 Budget, the Australian Government has made significant changes to immunisation policy in recent years. These include removing conscientious objection as a valid exemption to immunisation requirements for certain family payments (the ‘No Jab, No Pay’ policy), and recording immunisation information nationally for people of all ages, rather than just young children.

On 23 March 2017, the Government introduced the Australian Immunisation Register and Other Legislation Amendment Bill 2017 (the Bill) in the House of Representatives. This Bill expands the list of medical professionals who can certify a medical exemption to immunisation, and clarifies that only vaccination providers can advise the national register that a vaccine has been given. These minor changes to the immunisation legislation do not represent a significant change in policy.

What is the Australian Immunisation Register?

The Australian Immunisation Register (AIR) is a secure Australian Government database that records information about vaccinations given to people of all ages. The AIR includes information on all government-funded National Immunisation Program (NIP) vaccines, as well as most privately purchased vaccines. Information in the AIR is used to:

  • monitor immunisation coverage levels
  • check immunisation status and provide Immunisation History Statements
  • identify people who are due or overdue for immunisation
  • make information and incentive payments to immunisation providers and
  • check whether immunisation requirements for Family Tax Benefit (FTB) Part A supplement and Child Care Benefit (CCB) payments have been met.

The AIR replaced the Australian Childhood Immunisation Register (ACIR) on 30 September 2016. The ACIR originally recorded vaccinations given to Australian children up to seven years of age, although this was extended to adolescents up to the age of 20 on 1 January 2016. Please refer to the 2015 Bills Digest on these changes for further information.

What changes does this Bill make?

The Bill amends the Australian Immunisation Register Act 2015 (the AIR Act) and the A New Tax System (Family Assistance) Act 1999 (the Family Assistance Act) to expand the list of medical professionals who can certify a medical exemption to a vaccine.

It also amends the AIR Act to clarify that only a recognised vaccination provider can inform the AIR that a vaccination has been given. Further detail on these amendments is given below.

Some specialists will be able to certify medical exemptions to vaccines

In order to meet the immunisation requirements for FTB Part A supplement and CCB payments, a child must be immunised in accordance with the National Immunisation Program early childhood vaccination schedule, be on an approved catch-up schedule, or have a valid exemption. Valid medical exemptions to one or more vaccines can currently only be assessed and certified by a general practitioner (GP). The GP fills out a form to notify the AIR that the child has either natural immunity (immunity due to catching a disease) or a medical contraindication to the vaccine (such as a life-threatening allergic reaction or an impaired immune system).

The Bill amends section 9 of the AIR Act and section 6 of the Family Assistance Act to provide that paediatricians, public health physicians, infectious diseases physicians and clinical immunologists can also certify a medical exemption to a vaccine (in addition to GPs).

Minister Hunt stated in his second reading speech that these changes have been requested by immunisation clinicians. According to the Minister, the specialists included in the Bill provide care for children with complex health requirements, and are often best placed to assess children for immunisation. The proposed changes would remove the need for these specialists to send patients back to GPs to obtain medical exemptions.

No stakeholder comments on these changes have been identified.

Only vaccination providers can notify vaccinations to the AIR

The AIR records information about vaccinations that have been administered to individuals. The previous legislation under which the ACIR operated specified that this information would be notified by recognised immunisation providers or prescribed bodies (Health Insurance Act 1973, December 2015 version, section 46B). The current AIR Act does not specify who will notify the information, which could raise the possibility of members of the public seeking to notify the AIR that they or their children have received vaccinations.

The Bill amends subsection 9(b) of the AIR Act to provide that the AIR may record information provided by recognised vaccination providers about vaccinations that have been administered.

According to the Explanatory Memorandum for the Bill, the amendment ‘does not change the requirement for who is able to provide information to the AIR, however it removes the ambiguity in the legislation in relation to this requirement.’ The Government’s position continues to be that members of the public cannot notify vaccinations to the AIR.

The amendments commence the day after the Bill receives Royal Assent. According to the Explanatory Memorandum, the amendments are minor in nature, and the Bill has no financial implications. It does not appear likely to be controversial.