House debates

Thursday, 3 December 2020

Bills

Australian Immunisation Register Amendment (Reporting) Bill 2020; Second Reading

9:55 am

Photo of Greg HuntGreg Hunt (Flinders, Liberal Party, Minister for Health) Share this | | Hansard source

I move:

That this bill be now read a second time.

In particular, the Australian government is a strong supporter of immunisation in that it is a safe and effective way to prevent the spread of many diseases in the community that can cause hospitalisation, serious ongoing health issues or, tragically, as we well know at this time above all others, the loss of life.

This Australian Immunisation Register Amendment (Reporting) Bill 2020 supports and builds upon the longstanding action of successive governments to ensure that Australians have access to safe and effective vaccines and that we maintain world-leading immunisation rates.

Currently not all vaccination providers make a record in the Australian Immunisation Register (the AIR) when a vaccine is administered which means that the individual or a health professional may not have access to vaccination history which could be vital information in an emergency, when undertaking medical treatment and in managing health and wellbeing.

The effect of the amendments in this bill is to make it mandatory for all vaccination providers to report vaccines given, including any COVID-19 vaccine, to the AIR whilst maintaining the fundamental Australian position of voluntary vaccination of and in itself.

These changes will ensure that every Australian can access their vaccine history through this safe and secure register.

While the government strongly supports immunisation, it is not mandatory, vaccination will remain voluntary and individuals will retain the fundamental choice not to vaccinate.

The amendments in the bill will support Australians' health and wellbeing by improving reporting to the AIR to better inform vaccine projections, purchasing, delivery and program performance, and analyses of vaccine effectiveness and safety, which will be particularly important for the COVID-19 vaccines.

The world is facing an immense, once-in-a-generation challenge from the COVID-19 pandemic, as this House well knows. Over 64 million cases of the virus have been formally notified and, sadly, over 1.4 million deaths so far globally have been recorded. Inevitably, the real numbers are significantly higher.

In Australia, while there has been loss and tragedy we have been mercifully spared much of the anguish faced by the rest of the world. We have had minimal cases in recent weeks and many days of zero cases. Agonisingly by comparison the rest of the world saw over 575,000 cases in the last 24 hours and almost 12,000 lives lost.

These results came about because of a deep national partnership based on our COVID-19 pandemic plan, which we began in January and released in February and which we have lived and helped deliver in partnership with the Australian states and territories and people ever since. But precisely because of these global figures Australia will not be fully safe until the world is safe.

That's why our next step is to ensure the provision of free COVID-19 vaccines, on a voluntary basis, available to the entire Australian population.

Against that background, the Australian Immunisation Register Act 2015 governs the AIR as a whole-of-life, national immunisation register which records vaccines given to all people in Australia. This includes vaccines given under the National Immunisation Program (the NIP), through school based programs and privately, such as for seasonal influenza or travel.

AIR data is used:

              The Australian government is committed to providing all Australians with access to free, safe and effective COVID-19 vaccines as soon as available. A safe and effective vaccine, available globally, will dramatically improve health outcomes and societal wellbeing and facilitate economic recovery. As a nation, we welcome the news from the United Kingdom of the first emergency approval of the Pfizer vaccine. The lessons learned in the UK will be of deep value not just to Australia but to the world as a whole. And, as I say, Australia, will not be fully safe until the world is safe.

              The Australian government has therefore acted decisively to secure production and supply agreements to ensure early access to over 134 million doses of a COVID-19 vaccine to Australians in 2021-21 and 2021-22 through an investment of $3.3 billion. That is also strengthened by the additional 25½ million units which will be available under the COVAX international facility.

              Should these vaccines prove to be successful—and the latest advice from the regulator is positive—and safe and meet the Therapeutic Goods Administration's (TGA) stringent assessment requirements and approval processes, Australians will have access to:

                      It is important, therefore, to note that all four vaccine candidates are likely to require two doses per person on the best available advice from the medical experts.

                      In addition to the significant investment in COVID-19 vaccines, the Australian government invests over $400 million each year though the NIP to protect Australians against 17 vaccine preventable diseases.

                      The NIP provides free vaccines to eligible people, including children, adolescents, the elderly, pregnant women and Aboriginal and Torres Strait Islander people against conditions such as pneumococcal, meningococcal, measles, mumps, rubella, pertussis, shingles, human papillomavirus (HPV) and influenza amongst others.

                      These changes, therefore, will ensure that every Australian can access their vaccine history through the Australian Immunisation Register.

                      The need for the Australian Immunisation Register Amendment (Reporting) Bill 2020 arose from the need to provide Australians with information about their immunisation history, to support the rollout of a COVID-19 vaccine and the ongoing administration of the NIP.

                      The effect of the amendments in the bill is to make it mandatory for all vaccination providers to report vaccines given, including any COVID-19 vaccine, to the AIR. The details of the reporting obligations, including who is obliged to report and what information is to be reported in what time frames, will be prescribed in the Australian Immunisation Register rules to be made under this bill.

                      Combined with the reporting of influenza and NIP vaccines, this will inform the public health response to COVID-19 and other potential vaccine preventable diseases outbreaks.

                      Currently, vaccination providers are encouraged to report all vaccines administered to the AIR; however, as reporting is voluntary, not all vaccines administered are reported.

                      Australia continues to have a high level of vaccination reporting and AIR data that is entered is sufficiently reliable for the administration of childhood immunisations due to a number of policy and program settings which do encourage reporting.

                      For example Australia's immunisation coverage rates for children continue to be at a record high, compared to the rest of the world. As at September 2020, 94.90 per cent of all Australian children aged five years and 97.03 per cent of Aboriginal and Torres Strait Islander children aged five years were fully vaccinated. These are record numbers which have increased during the course of the pandemic, a tribute to the Australian public and our public health professionals and systems around the country.

                      However, reporting of adolescent and other adult vaccines is lower and less reliable. For example, the reporting of vaccinations against herpes zoster and pneumococcal for older Australians is around 40 per cent and reporting for seasonal influenza is around 50 per cent.

                      There is currently no statutory mechanism by which the government can require vaccination providers to report all vaccines administered. Without such a mechanism on which to rely, the government will be unable to enforce the mandatory reporting of COVID-19 vaccines administered, once a vaccine becomes available for clinical use.

                      Mandatory reporting to the AIR will therefore enable the monitoring of immunisation coverage and administration, which is key to ensuring vaccination course completion—a critical element—as well as assisting with any adverse event reporting.

                      While the government strongly supports immunisation—fundamentally believes in immunisation—and will run a strong campaign to encourage COVID-19 vaccination and general vaccinations, it is not mandatory and individuals may choose not to vaccinate.

                      I do want to thank the member for McMahon and the opposition for their strong, clear, unequivocal bipartisan support. This is an article of faith both in terms of the National Immunisation Program and shared approaches to vaccination which are abiding through different governments of different persuasions and their support has been critical and faultless. That's a personal thanks from me to my shadow minister counterpart.

                      The AIR provides Australians with an immunisation history statement (IHS) which displays all immunisations that an individual has had that are recorded on the AIR. The IHS, or immunisation history statement, can be viewed and printed via Medicare Online, myGov or the Express Plus Medicare mobile app. Vaccination providers can print an IHS on behalf of their patient. Immunisation information on My Health Record is updated via a daily feed from AIR data.

                      The IHS can be used by individuals to prove their immunisation status for child care, school, employment or travel purposes, particularly as there are cases around the world where different types of vaccinations are required for different countries.

                      The AIR provides an ICT platform incorporating themes of accessibility and usability capable of integrating with the My Health Record system and the Department of Health's Enterprise Data Warehouse, with the ability to be expanded to support further vaccination initiatives in the future. The AIR operates with clinical information systems to enable healthcare providers to provide data to the register easily and receive information back easily to better inform clinical decision-making.

                      Public consultation seeking stakeholder, and the broader public's, views on the proposed legislative amendment has occurred through an extensive process of engagement. It is pleasing—and I'm delighted to inform the House this—to note that key stakeholders, including health peak bodies, such as the AMA and the RACGP, are supportive of the proposed changes. The majority of individuals who responded that they did not agree with the proposed legislation amendment provided views regarding mandatory vaccination as opposed to mandatory reporting of vaccinations.

                      Therefore it is fundamentally important to reiterate again that, while the government strongly, deeply profoundly supports immunisation—indeed this is the view overwhelmingly of this parliament on all sides—it is not mandatory, vaccination will remain voluntary and individuals will retain the fundamental ability to choose not to vaccinate.

                      State and territory jurisdictions also support these legislative changes as this supports strategies they have, or are intending to introduce, to achieve increased reporting to the AIR.

                      The government is serious about ensuring the AIR maintains a complete and reliable national dataset. Compliance activities will occur for those vaccination providers who do not comply with the new arrangements.

                      It is conceivable that the vaccination providers who have failed to report a single vaccination event and are otherwise compliant with legislation are likely to have experienced isolated issues—or could've experienced. In such circumstances education and support will be provided in the first instance.

                      For those vaccination providers not reporting any vaccines to the AIR and who do not undertake behavioural change even after education and support is provided, more serious compliance action, such as a civil penalty, could be considered.

                      The Department of Health is working closely with Services Australia and the Australian Digital Health Agency on a range of system enhancements to ensure vaccination providers are able to easily meet their obligations under the new arrangements.

                      The feedback from the consultation process has informed the development of the bill, particularly in regards to compliance measures and the plans for additional provider information and support.

                      The government is keenly aware that the AIR holds sensitive information. Existing provisions in the AIR Act state how the AIR can collect, store, use and disclose personal information, and the persons who are able to access the AIR to achieve the purposes of the register. Privacy is fundamental. The types of information to be collected under the reporting obligation are the same as those currently collected on a voluntary basis under the AIR Act. The amendments will expressly authorise or require the collection, use and disclosure of information that will also meet obligations under the Australian Privacy Principles in schedule 1 to the Privacy Act 1988.

                      There are existing provisions under the AIR Act that provide individuals with control over how their personal information is used. These provisions allow individuals to opt out from receiving correspondence from the AIR and/or having their information shared with third parties. The existing limitations for purposes for which the information can be disclosed are a reasonable and proportionate use of individuals' personal information. Individual privacy is maintained and championed, and not diminished in any way by this bill.

                      The new reporting requirements commence on the day after royal assent. The intention is that the amendments will be in place for mandatory reporting to commence for influenza vaccinations and any COVID-19 vaccine (should one or more safe and effective vaccines meet all necessary regulatory requirements for supply in the Australian market) from 1 March 2021.

                      I would emphasise to the House that the latest advice I have from the Therapeutic Goods Administration is that we are on track for a decision in relation to the first of the COVID-19 vaccines before the end of January, and we are on track for delivery, subject to those approvals being positive, commencing in March 2021. This is an important milestone for saving lives and protecting lives in Australia.

                      From 1 July 2021 vaccination providers will be required to report all National Immunisation Program vaccinations to the AIR.

                      The bill will serve to benefit the health of Australians through more complete reporting of vaccinations. Over time, it will help increase vaccination coverage rates and the effectiveness of vaccination programs, and support the health system by informing policy for the NIP and service delivery at the local level.

                      I particularly want to thank for their work, from my office, Kylie Wright, Sam Develin, Stacey Edmanson and Joanne Tester, and, from the department, Secretary Professor Brendan Murphy, Chief Medical Officer Professor Paul Kelly, and the head of the Therapeutic Goods Administration, Professor John Skerritt. I want to thank all of those health professionals who have contributed. I have mentioned, and again reiterate, my thanks to the opposition.

                      Ultimately, vaccinations save lives and protect lives. This bill is about saving lives and protecting lives, and I commend it to the House in the strongest possible way.

                      Debate adjourned.