Monique Ryan (Kooyong, Independent) Share this | Hansard source

I rise to commend the National Health Amendment (Passive Immunological Products) Bill 2026 to the House. Vaccines are a cornerstone of our public health system. They protect us against serious and preventable illnesses, reduce the burden on our hospital system, help manage our chronic disease load and lower our lifetime healthcare costs. The World Health Organization and the Australian Medical Association recognise immunisation as the world's single most effective medical intervention. Globally, immunisation programs prevent two to three million deaths every single year. And the AMA reports that, since the introduction of vaccines to Australia in 1932, there has been a 99 per cent decrease in the number of deaths caused by vaccine-preventable diseases—conditions like tetanus, polio and diphtheria.

That's why Australia's National Immunisation Program, or the NIP, is so important. The NIP increases Australia's national immunisation coverage by providing free essential vaccines to eligible cohorts for a whole range of diseases. Under the current legislation, the NIP extends only to modes of active immunisation. The definition of 'vaccine' is limited to substances that elicit an immune response. Products that provide only passive immunological protection in a way that does not actually elicit an immune response can't, at this stage, be listed on the NIP. This bill will amend the definition of 'vaccine' in the National Health Act 1953 to include preparations conferring disease protection via either active or passive immunity.

Under this new definition, the minister will be able to more easily and more quickly list new and emerging technologies on the National Immunisation Program. It will render it more flexible and able to respond more quickly to a rapidly evolving healthcare environment. One example of the positive impacts this bill will have is for the monoclonal antibody Beyfortus, which provides prolonged protection for children and babies from respiratory syncytial virus, or RSV, which causes serious and often life-threatening chest infections in premature and susceptible babies. It can cause persistent and sometimes lifelong respiratory problems, like asthma. Beyfortus has substantially reduced infants' risk of hospitalisation from RSV infection in recent months. But, until now, the Pharmaceutical Benefits Advisory Committee has had to defer approval for Beyfortus because it doesn't actually fit under the NIP's remit.

So I'm glad the minister is bringing this issue to parliament. I support this bill and the potential for us to increase protection against preventable infectious diseases, which it will deliver. But as a paediatrician I remain concerned about access and uptake issues contributing to the declining immunisation rates in Australia. Australia's national aspirational coverage target for vaccinations is 95 per cent. There's a reason we have that number. It's the number needed to achieve herd immunity—the slowing or even prevention of highly contagious diseases.

But across Australia we're seeing a really concerning trend. Vaccination rates are falling below the herd immunity benchmark. Once a global leader in vaccine coverage, Australia is now seeing sustained declines across childhood, adolescent and adult vaccination programs. Data from the Productivity Commission released in January shows that Australia's rate of childhood immunisation has fallen to a 10-year low. Only 89.8 per cent of children aged 24 months or less are fully immunised. This represents an almost three per cent decrease since the COVID pandemic. Full vaccination coverage for Aboriginal and Torres Strait Islander one-year-olds dropped to 89.2 per cent in 2024, while coverage for two-year-olds declined to 86.7 per cent over the same period.

While this decrease might seem modest, it takes us below the limits for herd immunity. Its effects are already clear. We're seeing a resurgence of vaccine preventable diseases in children. Measles is on the rise in Australia, as is RSV and influenza, across all age groups. That puts strain on our healthcare system. In 2023-24, nearly 10 per cent of all preventable hospitalisations were attributed to diseases that could have been prevented by vaccines. Infections with pertussis, or whooping cough, are at their highest since records started in 1991. They are at least four times higher than pre-pandemic levels. Babies are very susceptible to whooping cough as they're not yet protected by their own vaccinations. They're simply too young to have received them.

I've seen babies die in hospital from whooping cough. It's a preventable disease, but they've died because others in the community have chosen not to be immunised and those people have spread the disease to babies who were too small, too young, to have received the vaccines themselves. There is no greater tragedy than the unnecessary death of a child because of negligence towards them.

These numbers reflect more than epidemiology. They reflect a loss of public trust. They reflect vaccine hesitancy and a post-Covid fatigue with immunisation. Rebuilding trust and public buy-in on Australia's vaccination program requires consistent engagement, clear communication and strong leadership.

We have to ensure that as many vaccines as possible are accessible to Australians. Accessibility remains a major barrier for many Australians to receive their full immunisation schedule and, in many cases, that's because of cost. Under the National Immunisation Program schedule, vaccines for diseases like shingles, pneumococcus and influenza are available at no cost to specified groups—those with specific medical conditions, those who are older Australians and Aboriginal and Torres Strait Islander people. Those are appropriate and important protections. But millions of Australian adults who fall outside of those categories are left to cover the out-of-pocket costs themselves. And, like for many products in health care, those costs can be very significant. A two-dose course of Shingrix, the vaccine protecting against the painful and often debilitating varicella virus, can cost $560 for someone who's ineligible for funding under the NIP.

I've also heard from constituents about Arexvy, which is recommended by ATAGI, the Australian Technical Advisory Group on Immunisation, for adults aged 75 years or more but is not supported on the NIP. This important protection against RSV can set seniors back more than $300. This is something I wrote to the Minister for Health and Ageing about more than two years ago. I've had no response as yet. The minister replied that Arexvy has received a positive PBAC recommendation, but it's still not getting coverage under the NIP.

Beyfortus, which is not on the NIP, is funded in some jurisdictions but only seasonally. That means that a newborn in one state might be entitled to state funded RSV prevention at little or no cost but an infant in another state might miss out completely because their parents cannot cover the $550 cost of this agent. While this bill should secure national access to Beyfortus on the NIP, other immunisations will remain unfunded in some jurisdictions.

Last year, I wrote to the health minister about two devastating cases of meningococcal B disease in young Victorian men. Meningococcal disease is devastating and often fatal. It causes sepsis and meningitis. A vaccine for meningococcus is funded through the NIP for all adolescents aged 14 to 16 in Australia, but the B and W strains, which are responsible for most meningococcal disease in children, adolescents and young adults, are not covered by that vaccine. Many parents are unaware of that fact. The B-strain is included in the NIP only for Aboriginal and Torres Strait Islander children under two, and individuals with specific risk factors. For other Australian children additional vaccination is necessary.

Some Australian states—Queensland, South Australia and the Northern Territory—have made that vaccine free for all children and teens, but Victoria, New South Wales, the ACT and WA are yet to do so. For many families, the cost of vaccinating their children against Meningococcus B—approximately $200 to $300 for the two doses required—is a significant barrier. Tragically, most are simply unaware that their children are not protected against a tragic but preventable disease. Case numbers of the B strain are low in Victoria, but I would argue that the loss of even one child's life from a preventable disease is unacceptable. I know that the Minister's office has engaged supportively and repeatedly with the families of the two boys from Victoria—Levi Syer and James Hall—and that they're doing their best to get this vaccine on the NIP, but our state government has not agreed to fund meningococcal B in the interim. I call on the Allan state government to do that in the name of Levi Syer, who died within six hours of the very first symptoms of meningococcal disease.

We should have a harmonised immunisation program across Australia so that access is consistently funded for all vulnerable Australians no matter their postcode. Accessibility issues are not just limited to the states and territories. It's not just inconsistent funding across jurisdictions. There's also significant variation in the practitioners who can actually administer vaccines. In different states and territories pharmacists can give different vaccines to different age groups and under varying conditions. It creates confusion and inequity, especially when a community pharmacy is people's first port of call for their vaccines. For example, community pharmacists in Victoria are not permitted to prescribe vaccines for haemophilus influenzae type b—another cause of meningitis—or for rotavirus, despite those vaccines being listed on the NIP, whereas pharmacists in other jurisdictions can.

The challenges and accessibility and costs of vaccines aren't isolated within just that sector. I fear that there is a cost-of-health crisis unfolding in Australia. The cost of private health insurance is soaring. Specialist fees and out-of-pocket fees are continuing to surge, and according to the Australian Institute of Health and Welfare, health inflation is rising faster than general inflation. The cost of accessing health care in this country should not be prohibitive. It's unacceptable that many Australians are forced to delay or forego care altogether. Our health care system is shifting from that of a universal guarantee—a guarantee which is, after all, one of the lights on the Labor hill—to a source of anxiety and uncertainty. So while we have to consider the cost barriers to accessible immunisations for Australians, they form only part of a much broader and growing set of cost pressures across the healthcare sector that we need this government to confront.

While I strongly support this bill's amendment to the definition of 'vaccine' so that passive immunisation products can be listed on the NIP, this is a small part of a much bigger problem. Australia's vaccination rates have slipped below herd immunity levels, and we're already seeing the consequences, with rising preventable diseases, cost barriers and inconsistent rules across states. Every community deserves equal protection no matter their postcode. It's time for national consistency, equity and more investment in immunisation coverage. In closing, I thank the House and I move:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House:

(1) notes that:

(a) there is inconsistent funding of potentially life-saving vaccines in different state and territories, leading to significant inequity of healthcare outcomes; and

(b) all Australians deserve equal access to life-saving vaccinations such as those for meningococcal and RSV infections; and

(2) calls upon the Government to urgently work constructively with state and territory governments to facilitate access to life-saving immunisation products for vaccine-preventable diseases".

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