A Critical Analysis of the Australian Government's
Total Page：16
File Type：pdf, Size：1020Kb
University of Wollongong Research Online University of Wollongong Thesis Collection University of Wollongong Thesis Collections 2015 A critical analysis of the Australian government’s rationale for its vaccination policy Judy Wilyman University of Wollongong Recommended Citation Wilyman, Judy, A critical analysis of the Australian government’s rationale for its vaccination policy, Doctor of Philosophy thesis, School of Humanities and Social Inquiry, University of Wollongong, 2015. http://ro.uow.edu.au/theses/4541 Research Online is the open access institutional repository for the University of Wollongong. For further information contact the UOW Library: [email protected] Faculty of Law, Humanities and the Arts School of Humanities and Social Inquiry A CRITICAL ANALYSIS OF THE AUSTRALIAN GOVERNMENT’S RATIONALE FOR ITS VACCINATION POLICY JUDY WILYMAN MSc BSc Dip Ed This thesis is presented in fulfilment of the requirements for the award of the degree of Doctor of Philosophy from the University of Wollongong September 2015 DECLARATION OF ORIGINALITY I, Judy Wilyman do hereby declare that this thesis contains no material which has been accepted for a degree or diploma by the University of Wollongong, or any other institution, except by way of background information and duly acknowledged in the thesis, and to the best of my knowledge and belief, no material previously published or written by another person except where due acknowledgement is made in the text. Signed, Judy Wilyman MSc BSc Dip. Ed. September 2015 ii STATEMENT OF AUTHORITY OF ACCESS This thesis may be made available for loan and limited copying in accordance with the Copyright Act of Australia 1968. Signed, Judy Wilyman MSc BSc Dip. Ed September 2015 iii Abstract Vaccination policies in Australia need to be scrutinised because the use of a medical intervention in the prevention of infectious disease has serious health and social implications. Deaths and illnesses to infectious diseases were significantly reduced due to environmental and lifestyle reforms prior to the widespread use of most vaccines in the mid-20th century. Mass vaccination campaigns were adopted after this time as the central management strategy for preventing infectious diseases, with many new vaccines being recommended in the National Immunisation Program (NIP). The implementation of mass vaccination programs occurred simultaneously with the development of partnerships between academic institutions and industry. The Australian government’s NIP, like all member countries of the World Health Organisation (WHO), is recommended by the Global Alliance for Vaccines and Immunisation (GAVI). This is a partnership with the WHO and UNICEF that includes the World Bank, the International Monetary Fund, the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA), the Bill and Melinda Gates Foundation (BMGF), the Rockefeller Foundation, the United Nations Development Fund (UNDF) and other private research institutions. All members of this public-private partnership influence the development of WHO global health policies. It is important that independent research is carried out to assess whether all the vaccines being recommended today are safe, effective and necessary for the protection of the community. It is also important to have comprehensive evidence that it is safe to combine multiple vaccines in the developing bodies of infants. The framework for undone science is used to analyse the Australian government’s claim that the benefits of vaccines far outweigh the risks. Whilst the government claims serious adverse events to vaccines are rare this is not supported by adequate scientific evidence due to the shortcomings in clinical trials and long- term surveillance of health outcomes of recipients. A close examination of the ‘Swine Flu’ 2009 vaccine and the vaccine for human papillomavirus (HPV), intended to prevent cervical cancer, shows shortcomings in the evidence base and rationale for the vaccines. This investigation demonstrates that not all vaccines have been demonstrated to be safe, effective or necessary. It also concludes that the government’s claim that the benefits of vaccines far outweigh the risks cannot be sustained due to the gaps in the scientific knowledge resulting from unfunded research and the inadequate monitoring of adverse events after vaccination. iv Acknowledgements I would like to thank my family - Ken, Alexandra, Callum and Scott - for supporting me throughout this thesis and for their understanding and love during the more difficult challenges that arose due to the controversial nature of this topic. I would also like to thank Professor Brian Martin, my primary supervisor at the University of Wollongong, for his unwavering support and encouragement. His weekly phone calls kept me focused and there were many robust discussions that helped me to overcome the significant opposition to this project. I thank him for his patience and dedication to my research. I would also like to thank my co-supervisor, Dr. Andrew Whelan, a senior lecturer at the University of Wollongong, for supporting my research and providing helpful comments on my thesis. There are other academics that have been fundamental to the completion of this thesis who prefer to remain anonymous and I am grateful for their expertise, direction and support. Thanks also to my friend and mentor Catherine Frompovich. Catherine is a health advocate in the US and author of several books. She has been untiring in her efforts to advocate on health issues and her support for my work has been invaluable I would like to acknowledge Dr. Lucija Tomljenovic and Dr. Chris Shaw from the University of British Columbia. Their support has been much appreciated in the publication of issues surrounding the implementation of HPV vaccines in national vaccination programs. I have also received helpful comments and support from Eva Vanamee, Mount Sinai School of Medicine, and Toni Bark, Boston University. Finally I would like to acknowledge the support I have received from my family, neighbours, and friends who have endured my endless discussions and demonstrated their support for the work I am doing. I thank my family and my friends Karen, Jacinta, Gabrielle, Nika, Cathy, Kerrie, Melanie, Georgina, Jacqui and many others for coming on this journey with me. Your support made a difference to my ability to complete this research. I would like to dedicate this thesis to my mother June Doyle for her inspiration and to the many parents/professionals who have shown courage and integrity in advocating for our rights in vaccination decisions for decades. v CONTENTS Declaration ii Authority of Access iii Abstract iv Acknowledgements v Table of Contents vi Publications in Support of this Thesis xiii Glossary xiv Abbreviations xviii Chapter 1 Introduction 1.1 Vaccination in Australia 1 1.2 Research 7 1.3 Thesis Structure 8 PART 1: SCIENCE AND POLICY Chapter 2 Controlling Infectious Diseases in Australia 2.1 Introduction 11 2.2 Defining Public Health and Environmental Health 12 2.3 The Control of Infectious Diseases 15 2.4 Developments in Public Health Policy in Australia 17 2.5 Immunological Theories 23 2.6 Australian Public Health Policy since 1950 30 2.7 The New Public Health Movement (1985-1995) 36 2.8 Measuring the Health of Communities 39 2.9 Conclusion 42 vi Chapter 3 Global Health Policy and Australia’s National Immunisation Program (NIP) Part 1 Global Public Health Policy 3.1 Introduction 45 3.2 Global Health Policy 46 3.3 The Influence of GAVI in Global Health Policy 53 3.4 National Immunisation and Technical Advisory Groups (NITAG) 56 3.5 The International Health Regulations (IHR) 59 3.6 Global Preparations for a Pandemic 62 3.7 Global Vaccination Policies and Human Rights 63 3.8 Contraindications to Vaccines 64 3.9 Vaccine Ingredients 65 Part 2 Development of Australia’s National Immunisation Program (NIP) 3.10 The Australian National Immunisation Strategy (NIS) 1993 68 3.11 Australia’s National Immunisation Program (NIP) 1997-2012 71 3.12 Strategies adopted in the Seven-Point Plan 72 3.13 The Reason for Increased Incentives in 2012 75 3.14 The National Immunisation Program (NIP) Since 2012 76 3.15 Vaccination in the Australian Workplace 77 3.16 The Evidence for Workplace Vaccination Policies 79 3.17 The Impact of Coercive Strategies in Vaccination Policies 81 3.18 Conclusion 83 Chapter 4 Implementation of the Australian Government’s Vaccination Policies 4.1 Introduction 87 4.2 The Governance of Vaccination Policies in Australia 89 4.3 The National Environmental Health Strategy 91 4.4 Measuring the Risk of Disease in the Community 94 4.5 The Australian Government’s Environmental Health Risk Assessment (EHRA) 95 Framework vii 4.6 Clinical Disease and Sub-Clinical Disease: The Ice-berg Concept 101 4.7 Herd Immunity 103 4.8 Surveillance of Communicable Diseases 105 4.9 Case Study: A new strain of ‘swine’ influenza or a change in Surveillance 107 4.10 Communicating Risk to the Public 111 4.11 Conclusion 115 Chapter 5 Public Health Policy and Health Promotion Ethics 5.1 Introduction 118 5.2 A Definition of Health for Public Health Policy 119 5.3 The Scientific Medical Model of Health 121 5.4 Culture and Medicine 123 5.5 Ethical Guidelines for Health Promotion 125 5.6 Conduct for Australian Medical Professionals 129 5.7 Public Health Policy and Human Rights 131 5.8 Conclusion 134 PART 2: CORPORATE INFLUENCE AND UNDONE SCIENCE IN PUBLIC POLICY Chapter 6 Industry Influence in Research and Policy 6.1 Introduction 137