Continuing on with the trend of reforms, this time we go to the other end of the scale and look at "No Jab, No Pay" reforms. While I'm aware that every single anti-vaccine blog out there has done the "No Jab, No Pay" thing to death, I am going to keep this simpler and deconstruct each part of it, also including what vaccines your child SHOULD receive and if you do have a genuine reason for not vaccinating (that is, medical), how to go about solving it.
To help me answer these questions correctly, I've deferred to a number of different factsheets on this subject, as well as a brilliantly written booklet on vaccination from the Australian Academy of Science. The link to the booklet will be provided at the bottom of this blog post.
WARNING: I have absolutely zero tolerance for parents who refuse to vaccinate their children for reasons other than genuine medical conditions. If you are a parent of a child who has a valid medical reason for not being vaccinated (that is your licensed GP has said so), you have the absolute patience of a saint and for this, I applaud you. For the rest of you, I will get snarky throughout this blog at anti-vaccine folks. You have been warned.
First off, what are the "No Jab, No Pay Reforms?"
These are not to be confused with the "No Jab, no PLAY" reforms which have been introduced in Victoria and to a mild extent, in NSW and Qld. The No Jab no Pay reforms are federal and are tied entirely towards benefits you receive from Centrelink for your child.
I will cover the "No Jab No Play" reforms later.
Anyway, what this translates to is twofold: From January 1, 2016, your child must either be:
a) fully immunised (according to the current federal schedule) for their age group (so your 2 year old would've received all of his vaccinations up to the 18 month mark) OR
b) on a catch-up schedule devised by your GP (and this must be adhered to) OR
c) have a medical exemption that has been verified by a GP (who should also attach documentation backing this claim up. If it's due to an allergic reaction, it must also by law have been reported to the state/territory health department.)
This will be tied in with any Centrelink payments you receive for the purposes of caring for your child. As a result, the National Immunisation Register will now be extended to cover all your vaccines your child receives up until the age of 19 (previously it was up to the age of 7). The register is available online and you will need copies of this when you enrol your child at daycare or at school.
The other main aspect of these reforms is that they will no longer accept religious reasons, cultural reasons or conscientious objection as a reason for your child's immunisation record being nonexistent/not up to date. Some states may still allow this as a valid excuse for not showing an immunisation record upon enrolment (or a partial one), but on a federal level, it is no longer acceptable.
What vaccines will this cover?
All vaccines in the federal health schedule. This is readily available here.
This will not cover any vaccine that is not on that schedule, including the flu vaccine (NB: while the flu vaccine is encouraged/compulsory for certain children at-risk, this will not necessarily interfere with payments). This also includes vaccines that are required for travel that are also not on the schedule, and will also not include any boosters for tetanus that are given outside the schedule. (your child will receive a tetanus shot as part of their diptheria/tetanus/whooping cough shot, what I'm referring to is if the child needs to receive a tetanus shot as part of a hospital visit.)
When does this come into effect?
1 January 2016. If you submit a form stating you are an anti-vaxxer before this date, you will only receive any payments you would've been eligible for before this date. After January 1st, this form will become invalid.
What payments will this affect?
It will affect the following payments.
-Family Tax Benefit A supplement (the one that you will receive at the end of the year). This will not affect your fortnightly payment (if you receive this). This will include any backdated claims for the supplement from the 2012-13 financial year onwards.
-Child Care Benefit (the one that requires an income test and depends on your income). This will also directly affect the Child Care Rebate (the one that does NOT require an income test and can be claimed to the tune of $7500 per year per child) as in order to be eligible for the rebate, you either need to be receiving, or be otherwise eligible for the benefit but earning too much.
-Grandparent Child Care Benefit. (This means that your child is being looked after by the grandparents as the primary carer-that is, they are raising your child.)
-Special Child Care Benefit (granted in rare circumstances, although you still do need to be otherwise eligible for CCB)
-The Jobs, Education and Training Child Care Fees.
The Family Tax Benefit A & B fortnightly payments will not be affected-only the end of year supplement will be affected.
How will it affect these payments?
Each payment will be affected differently. From what I could find, here is how this will work.
FTB A Supplement: In the financial year that your child turns 1, 2 or 5, their immunisation record will be checked. If the record shows that they are not meeting the schedule and don't have an exemption due to medical reasons (or a catch-up schedule showing this), then the supplement will not be paid. (For example, Mavis turns 2 in January 2015. Her record will be checked for the 2014-15 financial year. If she does not meet the requirements, the supplement is not paid. Meanwhile Joshua turns 2 in July 2015. His records would be checked against the 2015-16 financial year.)
Child Care Benefit and Rebate: Previously, if you met all other eligibility criteria barring the immunisation requirement, your claim was approved and you had a 63 day "grace period" to get your kid up to scratch with their immunisations. This is actually being made a little bit simpler: from Jan 1 2016, if your kid's record is "not up to date" (and you cannot show an exemption or catch-up schedule) before you submit your very first claim, your child will not receive the benefits. (this also means that you cannot claim CCR as the only waived requirement for the Rebate is the income test) I will cover more about this one in a minute.
Grandparent CCB and Special CCB: The requirements are very much the same as the previous CCB. Take note that being on one of these does not grant you automatic access to Child Care Benefit or Rebate.
JET Child Care Fees: How this will directly affect these parents is unknown at this stage.
For all of the above payments as well, the age limit will also be extended. Previously it only applied to children up to the age of 7. It will now apply to all children up to the age of 19. So if you are making the claim for CCB/CCR and your child attends an OSHC program, they will still be affected. This will also mean that your child's immunisation records will be checked annually against the Family Tax Benefit requirements.
My child is under 5, I have been approved for Child Care Benefit (and therefore rebate), so what happens to all the immunisations between the claim date and the age of 5?
If you miss a scheduled vaccination (and are not on a catch-up/exempt) you will receive a letter from Centrelink informing you that you have missed a particular vaccination. You will have 63 days from the date of that letter to get that vaccination and submit proof of this to the childcare centre/Centrelink office. If you continue to get your child vaccinated at the normal schedule, this should not affect you.
For children over 5:
It's not clear how this will be addressed (since most of the major vaccinations occur before this age), but it would make sense that if you have not previously used childcare before your child starts school and you need to do so now, you will be subject to the 63 day grace period. Keep this in mind!
If I miss the FTB A supplement, is there a way I can fix this?
You will have 1 year from the last financial year in which you did not receive a payment, to fix this. Keep in mind that this does not stack up (that is, if you missed vaccines in the 2012-13 financial year, 2013-14 financial year and the 2014-15 financial year, you will still only have 1 year to fix these, not 3).
Does this bar me from enrolling my child in daycare or school?
No. What it does mean however, is that the government will not be "subsidising your lifestyle choices" (to quote Tony Abbott previously). Refusing to vaccinate (as opposed to not vaccinating because your GP-who has had years upon years of training for this and has actually seen first hand the effects of vaccine-preventable diseases-has stated that the risks do not outweigh the benefits in this case ) is a lifestyle choice.
HOWEVER: State and territory legislation will differ on the entry requirements for daycare (in particular) for each state. It would be wise to contact your child's daycare centre or OSHC program to get more information on this. Some states will be introducing ongoing checks on immunisation (that is, if you get your child immunised up until the 12 month mark and miss the 18 month mark, you will be affected) while others will be allowing daycare centres and such to set their own policies. Childcare centres and OSHC programs that run nationally will most likely set one policy across all their centres regardless of what state the centre in question is located, or they may simply place it in line with the state that has the harshest policies.
Are homeopathic vaccines an acceptable alternative to any of the above legislation (state or federal)?
Nope and nope. In addition, the Australian Council of Homeopathy (yes, they actually exist) has also stated that they do not support these and actually say that you should get your child vaccinated with the normal vaccines. They do not suggest using these to reduce side effects (in this case, mild side effects i.e. fever, rash, sore arm, are a good thing as it means the immune system is doing what it should be doing)
I have a religious objection to vaccines!
This, as of next year, will no longer be a valid reason for being exempt from vaccinating your child at federal level and in the states that have introduced stricter legislation. Yes, this is perfectly legal-there are many examples of exemptions in the various discrimination acts for each state/territory.
But isn't this violating my human right to decide on what medical treatment is best for my child (or some variant of this)
Since I know this one will be going around in circles, let me put this simply to you: it is NOT FORCING VACCINES. It means that you will no longer be rewarded for not vaccinating.
There are also times when legally a doctor is allowed to intervene and override the parent's wishes for the child (a common case of this is the Jehovah's Witness blood transfusions). If you're going to use that claim, at least be consistent about it.
Also guess what-even the United Nations (who set those "human rights") are big proponents of vaccines.
OK, so I'll get my kid vaccinated, but I might have trouble doing so for some reason, how do I go about doing this?
Get your kid to a GP pronto, who will then develop a catch-up schedule that takes into account what is missing, what can be given and when, the child's health and what paperwork will need to be submitted. That catch-up schedule will then need to be submitted to your child's daycare/school care service, as well as a copy of your immunisation record. Your GP should submit this to the national immunisation register, who will also inform Centrelink.
If your child has only just recently hit one of the milestones and has missed a dose, nearly every single local council, shire or similar has an immunisation service that is conducted by a registered nurse who can give your kid the missed shots. If your kid has missed multiple doses, get your kid to the GP.
For children under 10, any catch-up programs from next year will be free to allow for you to deal with this. Programs for children between the ages of 10-19 will also be free until the end of 2017. Regardless of this, vaccines that are given as part of the standard schedule (and are given on time) are always bulk-billed (both the visit and the cost of the medication).
What about high school children?
While it is on the schedule what vaccines your child needs, you can relax. Schools every year will have registered nurses coming from the local council or local hospital to conduct a vaccination program for children in a particular year. Take note that they will go by Year level, so if your child is 12 and is in year 9, he would be offered the year 9 vaccinations. This is why at this point the vaccine schedule I linked to above allows for some flexibility on the ages for the vaccines that are given.
The vaccines that are given during this time are a top-up of Hep B (if your kid did not receive them previously, 2 shots), a booster for diptheria/tetanus/whooping cough (also called pertussis, 1 shot*), a vaccine for HPV** (3 shots?) and if needed, a meningococcal C vaccine*** (1 shot) or chickenpox vaccine (1 shot). There may also be other top-ups given occasionally, but you will receive adequate notice.
*-The reason why it'll say "DTPA" on the form you are handed rather than "DTP" just means that the vaccine is an acellular one. What that means is that the vaccine contains cell material, but no actual complete cells. (think of it like an orange juice-it contains the pulp of an orange, but no actual complete oranges in there)
**-This is given to both boys and girls. You may also know of this as the "Cervical Cancer" vaccine or "Gardrasil." Australia uses the version that stops the four most common strains of HPV from occurring, which were found to cause genital warts (which is why it's given to boys, as it also stops it from being passed onto girls) and cervical cancer. It is meant to be given BEFORE they're sexually active, hence why it is usually given around the Year 9-12 mark. Your daughter will still need pap smears however. (There is also a version that has been approved in the US that stops 9 strains!)
***-There is a vaccine for Meningococcal B out there (which is the more common one in Australia). This however, is not publicly funded. The Meningococcal C is the second most common, but has dropped meningococcal cases period from about 180 or so in 2013, to about 15 in 2014.
Help, I'm missing my vaccine record!
This can happen. Best thing to do is to contact the database, who can provide you with a copy of your child's record. You will need your child's Centrelink number. Take note that Blue Books/Red Books are not always the most reliable option for vaccine records, especially if your GP subscribes to the school of chicken scratch handwriting.
Who should I talk to if I'm unsure or need to know more?
Your GP of course! If your child has a chronic health condition, speaking to the specialist that manages your child''s condition will also be of a benefit.
If you are still unsure, there are a few excellent references via immunise.gov.au on the subject.
Also, this booklet.
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