immunisation

Michael Leunig, Conscience, and The Choice to Vaccinate

Popular whimsical Australian cartoonist Michael Leunig has again raised controversy with a cartoon published in The Age and the Sydney Morning Herald on the 19th of August on the topic of vaccination.

The cartoon, depicting a close-up of the hands in Michaelangelo’s painting “The Creation of Adam”, with the hand of Adam holding a syringe is titled, “Fascist Epiphany”, and states, “The God of Science grants politicians the divine right to enforce mass medication upon babies and children”.

Michael Leunig's August 19 cartoon, via his website

Michael Leunig’s August 19 2015 cartoon, via Leunig’s website.

Criticism via social and online media was prompt, with several news outlets running stories that morning – one of which was Mamamia, who contacted me to discuss the cartoon.

Speaking to Mamamia, Alabaster said she believed the cartoon to be “highly problematic”.

“It sends the community a message of fear and mistrust, based on ideas that simply aren’t truthful. Science gives us the knowledge that vaccines are the safest and most effective way we can protect our children against vaccine preventable diseases.”

She argues that reframing the Government’s policy as “forced mass medication” is disingenuous at best, and at worst, could put children in danger.

“We need to be reassuring parents with the facts, not scaring them with emotive cartoons about fascism,” she said.

Leunig has made several statements in response to the public’s reaction to his cartoon, in which he’s refused to disclose his personal opinion on vaccination, nor acknowledge the science supporting them, instead diverting the conversation to his opinions on the government’s decision.

From The Age:

“I was conscripted for military service in Vietnam when I was young,” Leunig said.

“I felt the full weight of that kind of authoritarianism for a futile and sad tragedy that took place in Vietnam.

“I am weary of compliance in the name of civic responsibility.”

I feel immense compassion for those who experienced the tragedies of the Vietnam War – any war – and thoroughly support conscientious objection to military conscription. However, I take great issue with comparisons being drawn between conscientious objection to taking part in war, and so-called “conscientious objection” to vaccinations.

Vaccination is in part a matter of conscience, but not in the way the vaccine refusers would like to think. Conscience is involved in making the moral decision to vaccinate, to protect not only our own children, but the wider community… especially those who cannot be immunised due to compromised immune systems, being too young to receive vaccinations, or other legitimate medical reasons.

It is inaccurate to frame parents’ decision not to vaccinate their eligible child as a matter of conscience, in any way similar to a person’s refusal to participate in a war; it’s a matter of fear-driven misinformation – not morality – influencing a decision, which tragically robs children of protection against disease.

I have sympathy with the urge to mistrust something which is being perceived as a direction from the government (I am a skeptic after all – blind acceptance is not one of my fortes), but we’ve got to stand back and look at the evidence here. While some might find the tactics of “No Jab, No Play” and “No Jab, No Pay” policies heavy handed, their goal is to protect lives. I urge people to please not let their feelings on our current governments and these policies influence their view of the science supporting vaccination.

I’d also like to add that throwing around emotive and hyperbolic words such as “fascist” and “enforce” aren’t adding much reason to the narrative, to be frank – and they’re both inaccurate. While Leunig argues that:

… he was not saying that the government was fascist, but that every government could have a “fascist moment” or make “fascist decisions”.

The cartoonist argued that “fascist” was just another word for authoritarian.

“Why can’t we name something for what it is?,” he said.

“Fascist is just another name for totalitarian. What are we afraid of about this word?

“I am a cartoonist who uses the words that are real. I don’t want to pussyfoot around here.”

I would argue that “fascist”, while used colloquially as a denigration to suggest authoritarianism, is inescapably linked to fascist regimes, in the same way that “nazi” recants the National Socialist German Worker’s Party and Hitler. It’s an incredibly strong word to use, with specific connotations. Leunig is welcome to invoke such connotations of course, but I think it disingenuous for him to defend “fascist” as being “just another word for authoritarian”.

I also take issue with the suggestion that the “No Jab, No Play” and “No Jab, No Pay” policies are equivalent to enforced mass medication. Putting aside the pedantic point that vaccines are preventative biological agents and are not technically classified as medications, I think that “enforced” is too strong a word for these policies. Parents still have a choice to refuse to vaccinate their children, though the consequences for not doing so (risk of disease, disability and death aside) will be somewhat harder to live with. Alternative arrangements will need to be made by the families of preschoolers in Victoria whose parents refuse vaccination but require childcare. Vaccine refusing families nationwide who rely on the family benefits which are to be revoked under “No Jab, No Pay” will do it tougher financially. It could be argued that there’s some coercion involved in both of these policies, but it isn’t mandatory enforcement.

As you may have guessed by now, I’m actually with Leunig to a degree; I do think that the ethical issues surrounding “No Jab, No Play” and “No Jab, No Pay” policies need to be examined carefully. At the risk of being quoted out of context by anti-vaccination campaigners, I am somebody who is very firmly in the pro-vaccination camp and there are parts of these legislations that I am a not comfortable with. In an ideal world, parents would not require any loss of benefits in order to be prompted to vaccinate their children, they’d do so because they understood the importance of protecting both their kids and the wider community from disease.

Indeed, with the proposed policies requiring children to be vaccinated (unless medically exempt), before being permitted to attend preschool services, or their families granted government payments, we could invoke the United Nations Conventions on the Rights of the Child, which determine that children have the right to access education and social welfare. When discussing the rights of children, I think that it is important to note that the treaty also recognises the right of children to access quality healthcare, including preventative healthcare. This is an obligation that the parents who refuse to vaccinate their children are failing to meet.

I think that we also need to consider the right of children who attend preschool services to do so in a safe environment, particularly those children who are unable to be vaccinated due to medical reasons. I cannot fathom the experiences of parents of children with cancer, who on top of dealing with their children’s illness, have the added worry that they will be exposed to a vaccine preventable disease when participating in community life. I imagine that knowing that the children their kids interact with on a daily basis were offering them as much protection as possible would alleviate some of the stress in their lives, and it would certainly reduce the risk of potentially fatal illness.

One of my concerns is that strong government policies such as these run the risk of further polarising fringe groups who oppose vaccination, removing them from discussion and reinforcing their fear and mistrust. Conversely, these policies may shift some people from closer to the middle ground, those who are merely a little hesitant, over the fence – and I very much hope that these people have compassionate GPs, or contact with people such as the Northern Rivers Vaccination Supporters, who can listen to their concerns and reassure them about the decision they’re making.

A previous Leunig cartoon which may be interpreted as being anti-vaccination, via Leunig's website.

A Leunig cartoon from April 2015 which may be interpreted as being anti-vaccination, via Leunig’s website.

So while there is certainly discussion to be had on the ethics of immunisation legislation, I think that it needs to happen very carefully, with full acknowledgement that vaccination is the safest and most effective way to protect our children from vaccine preventable diseases. Without stressing the importance and efficacy of vaccination, we risk giving people an incomplete message on the issue, and providing anti-vaccination campaigners with cartoons and quotes which they can frame with misinformation and use to try and further their cause.

It would be a terrible thing to use your freedom of expression on a nationwide platform to espouse the virtues of freedom of choice, then express yourself in such a way that some people may become focused on the ethics of policy without being mindful of the science supporting vaccination.

To be clear, I support Michael Leunig’s freedom of expression, just as I support parents’ freedom to choose whether or not to immunise their children. But with those freedoms come consequences; and I want both Michael Leunig and parents who refuse to vaccinate to be aware of the facts about immunisation, the potential outcomes of their actions, and for them to make conscientious decisions.

Queensland to Provide Whooping Cough Vaccines for Pregnant Women – Campaign for all Australian States To Follow

On July the 9th, Queensland Premier Campbell Newman and Health Minister Lawrence Springborg made a long hoped for announcement – Queensland will be providing free Whooping Cough (Pertussis) vaccinations for women in their third trimester of pregnancy, following dedicated campaigning by doctors, parent groups and concerned citizens.

Read more: Free whooping cough vaccine for all pregnant women in Queensland Courier Mail, 10th July 2014.

Premier Campbell Newman and Health Minister Lawrence Springborg announce free whooping cough vaccinations for pregnant women in Queensland.

Premier Campbell Newman and Health Minister Lawrence Springborg announce free whooping cough vaccinations for pregnant women in Queensland.

 

This is wonderful news for newborns and their families in Queensland. Maternal immunisation during the third trimester of pregnancy and the resulting passive antibody transfer to the infant has been shown to provide substantial protection to newborns during the first two months of life, before they are able to begin receiving whooping cough vaccinations (a three dose schedule, which is completed at six months). Maternal immunisation can also prevent the mother from contracting whooping cough herself, risking passing it on to her vulnerable infant.

Hopefully Queensland’s new policy will pave the way for other Australian states and territories to institute similar schemes, allowing families better access to a measure which can protect newborns from illness, disability and death.

If you are so inclined, please consider writing to and/or tweeting your state or territory leaders, health ministers and shadow health ministers to let them know that there is high community support for the provision of free whooping cough vaccines for pregnant women. I have listed contact details and Twitter accounts for them at the end of this post, and have been tweeting myself, using the hashtag #freewhoopingcoughvax.

 

 

I would like to share with you this letter written to the Premier of New South Wales, Mike Baird, and the New South Wales Minister for Health, Jillian Skinner. It was composed by Heidi Robertson and Alison Gaylard on behalf of the Northern Rivers Vaccination Supporters, a community group of concerned citizens who support vaccination and live in an area of New South Wales with alarmingly low vaccination rates.

 

Wednesday, 9th July, 2014

Dear Premier Baird and Ms. Skinner,

We write with regards the initiative announced by Queensland Premier Campbell Newman this morning (9th July 2014). Premier Newman revealed that Queensland Health will be funding a free Pertussis (whooping cough) vaccine for women in their 3rd trimester of pregnancy.

We sincerely hope that NSW will follow suit with this initiative. It is of course based on the latest research and evidence which states that the Pertussis vaccine given in the third trimester is very effective at protecting the newborn baby during those crucial first two months before they can receive their first Pertussis vaccine. Mothers-to-be are also protected from Pertussis with this initiative which of course reduces the chances of transmission to the baby. Mothers, often being the primary caregiver of the baby, are in close physical proximity on a 24- hour basis and are often inadvertently responsible for passing this potentially deadly infection on to their babies.

Losing a baby to Pertussis, a Vaccine Preventable Disease, is of course devastating; the economic cost to government will also be greatly reduced if less infants need to be hospitalised in Paediatric Intensive Care Units (over 9 out of 10 babies under three months of age need to be hospitalised as a result of contracting pertussis).

Please consider following Queensland in this important endeavour.

Regards,

Heidi Robertson and Alison Gaylard – acting on behalf of Northern Rivers Vaccination Supporters.

 

Again, if this issue is important to you, please consider writing or tweeting to your state or territory health MPs. Thank you.

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