Bills Digest no. 25 2015–16
PDF version [661KB]
WARNING: This Digest was prepared for debate. It reflects the legislation as introduced and does not canvass subsequent amendments. This Digest does not have any official legal status. Other sources should be consulted to determine the subsequent official status of the Bill.
Alex Grove
Social Policy Section
1 October 2015
Contents
Purpose
of the Bills
Structure of the Bills
Background
Committee consideration
Policy position of non-government parties
Position of major interest groups
Financial implications
Statement of Compatibility with Human Rights
Key issues and provisions
Other provisions
Concluding comments
Date introduced: 10
September 2015
House: House of
Representatives
Portfolio: Health
Commencement: The Australian
Immunisation Register Act 2015 commences on 1 January 2016. The Australian
Immunisation Register (Consequential and Transitional Provisions) Act 2015 commences
on various dates set out in section 2 of the Bill but is conditional upon the
commencement of the Australian Immunisation Register Act 2015.
Links: The links to the Bills,
their Explanatory Memoranda and second reading speeches can be found on the
Bills’ home pages for the Australian Immunisation Register Bill 2015 and the Australian Immunisation Register (Consequential and Transitional
Provisions) Bill 2015, or through the Australian
Parliament website.
When Bills have been passed and have received Royal Assent, they
become Acts, which can be found at the ComLaw
website.
The purpose of the Australian Immunisation Register Bill
2015 (the AIR Bill)[1]
is to:
- create
a consolidated legislative framework to govern the operation of Australian
immunisation registers and
- expand
the age range covered by the Australian Childhood Immunisation Register (ACIR)
from children under seven years of age to ‘young individuals’ under 20 years of
age (commencing from 1 January 2016).
The purpose of the Australian Immunisation Register
(Consequential and Transitional Provisions) Bill 2015 (the Consequential Bill)[2]
is to amend the Australian Immunisation Register Act 2015 (the AIR
Act) and other legislation to incrementally:
- expand
the ACIR to become the Australian Immunisation Register (AIR) (to capture all
vaccinations given to people from birth to death commencing from late 2016) and
- expand
the National Human Papillomavirus (HPV) Vaccination
Program Register (HPV Register) to become the Australian School Vaccination
Register (ASVR) under the broad umbrella of the AIR (to capture all adolescent
vaccinations given through school programs commencing from the start of the
2017 school year).
The AIR Bill is divided into a number of parts. Part 1 is
preliminary, Part 2 establishes the ACIR, Part 4 deals with protected
information in the ACIR, and Part 5 deals with forms, delegations and rules.
There is no Part 3.[3]
The Consequential Bill has three Schedules. Schedule 1
repeals the existing legislative provisions for the ACIR, Schedule 2 expands
the ACIR to become the AIR and Schedule 3 expands the HPV Register to become
the ASVR.
Immunisation involves giving vaccines to people to protect
against infectious diseases. The use of vaccines in Australia has greatly
reduced infections and deaths from diseases such as diphtheria, whooping cough,
tetanus, polio and measles. However, vaccine-preventable diseases can re-emerge
in developed countries if vaccine coverage (the proportion of the population
who have received the vaccination) falls below the level required for ‘herd
immunity’. Depending on both the vaccine and the particular disease, between 75
per cent and 94 per cent of a population may need to be vaccinated to stop
diseases circulating and protect people such as newborns and those with
suppressed immune systems. For this reason, governments and health
professionals work hard to maintain high rates of vaccine coverage in the
population.[4]
The Australian Government provides funding to the state and
territory governments to purchase vaccines listed on the National Immunisation
Program (NIP) Schedule.[5]
The NIP Schedule currently includes 16 infectious diseases for which free
vaccinations are provided to people in the specified age or risk groups.[6]
This includes vaccines given to children at specified ages between birth and four
years of age, vaccinations given to older children through school programs, and
vaccinations for people aged 65 and over. The NIP Schedule also includes
additional vaccines for people in at-risk groups such as Aboriginal and Torres
Strait Islanders and pregnant women.[7]
Many of the vaccines received by adults are
not listed or funded on the NIP, but are recommended in particular
circumstances. Groups who may require additional vaccinations include travellers, women who are planning a pregnancy, immunocompromised people, health
and childcare workers, migrants, prisoners, men who have sex with men, people
who inject drugs and sex industry workers.[8]
Although the Explanatory Memorandum to the AIR Bill
indicates that the proposed registers (the AIR and the ASVR) are only intended
to record vaccinations given under the NIP, the Bill itself does not confine
the registers in this way.[9]
An immunisation register is a confidential system that
records information about vaccinations given to a particular population. Such
registers are an import tool for improving the performance of immunisation
programs.[10]
Immunisation registers are used to:
- collect
data on vaccines given
- generate
reminder (due) and recall (overdue) notices prompting clients to have their
next vaccination
- provide
certificates of vaccination and
- monitor
vaccine coverage in the population.[11]
Vaccination information in Australia is currently collected
in a number of overlapping national and jurisdictional registers, as well as in
primary care software used by General Practitioners (GPs).[12]
Most states and territories maintain vaccine registers, but some only cover
school based adolescent programs, some cover school and local government child
and adolescent programs, while others cover all NIP vaccinations. GP practice
software systems are the major stores of data for NIP vaccines given to adults,
and non-NIP vaccines such as travel vaccinations. Both jurisdictional registers
and GP software systems provide some data to the two national registers, which
are briefly described below.[13]
The Australian Childhood Immunisation Register (ACIR) was introduced
in 1996 as one of a series of measures to reduce the incidence of
vaccine-preventable diseases in Australia.[14]
The ACIR is administered by the Department of Human Services
(DHS) on behalf of the Department of Health (DoH). It is a national register
that records the details of vaccinations given to children under seven years of
age who live in Australia. Immunisation details are sent to the ACIR by
immunisation providers, who receive a payment for providing this information.
Data from the ACIR can be used to check on the immunisation status of a child
(for health or family payment reasons), to issue Immunisation History
Statements, and to measure levels of vaccination coverage.[15]
The HPV vaccination program began in 2007. It
provides HPV vaccine free of charge to 12 and 13 year olds through schools, in
order to protect against HPV-related cancer and disease.[16] HPV vaccine is included
on the NIP Schedule for this age group.[17]
The National HPV Vaccination Program Register (the HPV
Register) collects information about doses of HPV vaccine given under the HPV
vaccination program, but does not collect data on any other adolescent
vaccinations. The HPV Register is operated by the Victorian
Cytology Service and is fully funded by the Australian Government Department of
Health.[18]
Information on the HPV Register is used to
issue completion statements and reminder notices to vaccine recipients, and to
inform vaccination providers about patients who have not completed their course
of HPV vaccination. It is also used to monitor HPV vaccine coverage and to
measure the effect of the vaccine on HPV-related diseases such as cervical
cancer.[19]
The idea of a national whole-of-life register that covers
vaccinations at all ages has previously been considered by the Australian
Government. In 2006, the then Department of Health and Ageing announced a $1.2
million ‘Australian Childhood Immunisation Register – Redevelopment scoping
study’. The study was intended to:
- explore
options for turning the ACIR into a whole-of-life register, including adult
vaccinations, ‘with the potential to improve health and reduce wastage of
expensive vaccines’
- consider
consolidating other population health registers such as the bowel screening
register into a single register and
- advise
the Government on how to improve the existing register in order to provide
complete immunisation history information and improve vaccine coverage
monitoring and targeting.[20]
It appears that the scoping study did not proceed. An
answer to a 2007–08 Budget Estimates question on notice lists the study as a
terminating measure without showing any actual expenditure.[21]
A recent recommendation of the Pharmaceutical
Benefits Advisory Committee (PBAC) has given the Australian Government another
reason to consider a national register for adult as well as childhood
vaccinations.[22]
In November 2014 the PBAC recommended that
Zostavax should be listed on the NIP Schedule for adults aged 70 years old,
with a catch up program for 71 to 79 year olds.[23] Zostavax is a vaccine
that is used in older people to prevent shingles (herpes zoster) and the
long-lasting nerve pain that sometimes follows shingles (post-herpetic neuralgia).[24]
In making this recommendation, the PBAC
endorsed the advice it had received from the Australian Technical
Advisory Group on Immunisation (ATAGI) that ‘the establishment of
an adult vaccination register is a high priority’.[25] The ATAGI advice was made
due to concerns about the lack of a national register for adult vaccines funded
under the NIP, as well as uncertainty about the effectiveness over time of the
Zostavax vaccine:
Accurate recording of vaccine administration is essential to
optimize vaccine provision for effective disease prevention, to avoid repeat
vaccination, under-vaccination, and vaccine wastage and leakage. ATAGI
considers that an immunisation register is also an essential requirement to
enable robust assessment of vaccination program impact, particularly for
Zostavax. Given the uncertainty around Zostavax vaccine effectiveness and
duration of protection against both herpes zoster and post-herpetic neuralgia,
the potential need for additional changes in policy and practice in the future (e.g.
need for a booster dose) and the importance of monitoring vaccine safety, a
register that allows access to data at both the individual patient/provider
level and at a population level is a requirement.[26]
The 2015–16 Budget contained three immunisation measures ‘aimed at improving vaccination rates and reducing the spread of vaccine
preventable disease’.[27]
These measures are briefly outlined below. The first two measures include the
expansion of the existing national vaccine registers, and the third measure
depends on the expansion of the ACIR for part of its implementation.
The Budget included $26.4 million over four
years to improve immunisation coverage rates, particularly in children and
adolescents.[28]
Activities under the measure include:
- making
a six dollar incentive payment to doctors and other immunisation providers when
they identify a child who is overdue for vaccination and catch them up
- funding
an awareness campaign to promote the NIP and address parents’ concerns
regarding immunisation and
- expanding
the HPV Register to the ASVR to include all adolescent vaccinations delivered
in schools under the NIP.[29]
The ASVR will ‘provide the tools needed,
such as recall and reminder systems, to improve adolescent coverage rates’, and
will also allow families to access an immunisation history record of all NIP
vaccines their child has received at school.[30]
The Budget provided $161.8 million over five
years for new and amended listings to the NIP Schedule, including the addition
of Zostavax vaccine to prevent shingles for 70 year olds from 1 November 2016. [31] The same measure also
provided for the expansion of the ACIR to record all adult vaccines provided
under the NIP from 1 September 2016.[32]
The expansion of the ACIR is intended to ‘assist with the monitoring of safety,
quality and delivery of vaccinations to the adult population’,[33] as well as to support the
PBAC’s November 2014 recommendations regarding the listing of Zostavax on the
NIP.[34]
Prior to the Budget, the Government announced that from 1
January 2016 it would end the conscientious objector exemption that allows
parents to retain eligibility for the Family Tax Benefit Part A (FTB-A)
end-of-year supplement, Child Care Benefit (CCB) and Child Care Rebate (CCR)
payments even if they choose not to vaccinate their children. The reason given
was concern about the risks to other children and the community from increasing
numbers of unvaccinated children whose parents object to vaccination. [35]
This ‘No Jab No Pay’ measure is expected to
save $508.3 million over five years.[36]
In addition to removing conscientious objection as a valid exemption category,
it also extends the immunisation requirements for the FTB-A supplement, CCB and
CCR to all children up to 19 years of age. Children who are not up-to-date with
their childhood immunisations will need to follow a catch-up schedule for their
family to regain eligibility for these payments.[37]
The ‘No Jab No Pay’ measure is implemented by the Social
Services Legislation Amendment (No Jab, No Pay) Bill,[38]
but the AIR Bill and the Consequential Bill contain a number of amendments to
facilitate the implementation of the measure.
The Senate Standing Committee for the Scrutiny of Bills
expressed two concerns with the AIR Bill. The first is that subclause 22(3)
gives the Minister for Health a broad power to authorise the disclosure of
protected information from the ACIR (which will become the AIR and ASVR) for a
specified purpose that the Minister is satisfied is in the public interest. This
power is in addition to subclause 22(2) which provides for the uses and
disclosures that are authorised for the purposes of the Privacy Act 1988.
The Committee noted that the Explanatory Memorandum did not discuss why such a
broad power was necessary and considered that this may affect individual
privacy, and thus asked the Minister to justify the inclusion of such a provision.
It also expressed an interest in whether consideration had been given to
drafting the power more narrowly.[39]
The Committee was also concerned by clauses 24 to 27
of the AIR Bill, which provide exceptions to the offence of unauthorised use of
protected information. Each of these clauses is accompanied by a note which
reads ‘A defendant bears an evidential burden in relation to the matters in this
section (see subsection 13.3(3) of the Criminal Code).’[40]
The Committee considered that this reversal of the onus of proof may trespass
unduly on personal rights and liberties, and has sought justification for the
reversal from the Minister.[41]
At time of writing the Digest, the Minister’s response had
yet to be published.
The Committee had no comment on the Consequential Bill.[42]
The Australian Labor Party has expressed its support for the
ASVR, believing it will assist parents to ensure that their children are fully vaccinated.
It also supports exploring the expansion of the AIR to ‘enable adults to keep
their vaccinations up to date’.[43]
No statements by the Australian Greens specifically relating
to the AIR and Consequential Bills have been identified. However, Senator
Richard Di Natale, the Greens’ spokesperson on Health and Leader of the
Australian Greens, has expressed his strong support for vaccination, describing
it as ‘one of the most successful and cost-effective public health
interventions in human history’.[44]
There have been a number of calls over the last decade for a
national whole-of-life immunisation register.
In 2007, two physician academics argued in the Medical
Journal of Australia that an expanded immunisation register would make it
easier to determine a patient’s vaccination status, improve vaccine coverage,
prevent over-vaccination, and allow evaluation of programs and improved monitoring
of adverse events from vaccination.[45]
Since 2007, calls for a whole-of-life immunisation
register have continued, including from the Royal Australasian College of
Physicians, the Australian Medical Association, immunisation conferences
sponsored by the Public Health Association of Australia, and academics.[46]
Other doctors and academics, while supporting the call for
an expanded register, have observed that clearly defined policies would be
needed to protect the privacy of information on such a register.[47]
Privacy has also previously been raised as a concern by the Consumers’ Health
Forum of Australia:
The privacy of a whole-of-life immunisation register is a
concern to consumers. This includes the collection, inappropriate access and
secondary use of information by government and non government agencies and
researchers. Consumers are concerned that people with stigmatised conditions
could be further stigmatised through recording immunisations for these
conditions.[48]
The above concerns could be particularly relevant if
non-NIP vaccinations, such as those discussed earlier, are recorded on the AIR.
Funding for the measures contained in the AIR Bill and the
Consequential Bill was approved as part of the 2015–16 Budget. Expanding the
ACIR to become the AIR will cost $27.2 million over four years. Expanding the
HPV Register to become the ASVR will cost $9.2 million over four years.[49]
As required under Part 3 of the Human Rights
(Parliamentary Scrutiny) Act 2011 (Cth), the Government has assessed the
Bills’ compatibility with the human rights and freedoms recognised or declared
in the international instruments listed in section 3 of that Act. The
Government considers that the AIR Bill and the Consequential Bill are
compatible.[50]
At the time of writing this Bills Digest, the
Parliamentary Joint Committee on Human Rights had not yet considered the AIR
Bill and the Consequential Bill.[51]
The AIR Bill introduces a new legislative framework for the
ACIR. The Consequential Bill expands the ACIR to the AIR, and also moves the
ASVR under the same new framework. It is intended that other registers will
also come under this framework in the future, such as the proposed National
Australian Cancer Screening Register.[52]
The ACIR is currently established under Part IVA of the Health
Insurance Act 1973 (the HI Act).[53]
The HI Act provides for:
- the
establishment and keeping of the ACIR to record immunisations given to children
under seven years of age[54]
- the
Medicare database to be used to populate the ACIR[55]
- using
information in the ACIR to determine whether a child has been immunised and to
notify their parent or guardian when they are due for immunisation[56]
- payments
to immunisations providers and state or territory authorities for transmitting
information to the ACIR[57]
- the
disclosure of information on the ACIR to immunisation providers, departmental
officers and other persons in specified circumstances and[58]
- offences
relating to the unauthorised disclosure of personal or sensitive information
from the ACIR.[59]
Items 5 and 6 of Schedule 1 of the
Consequential Bill repeal the existing legislative framework for the ACIR
(including offence provisions for unauthorised disclosure of personal or
sensitive information).[60]
Item 7 of Schedule 1 of the Consequential
Bill will facilitate the transfer of information from the Medicare database to
the ACIR continuing under the new framework.[61]
The AIR Bill establishes a new legislative framework for
the ACIR, which is considerably more detailed than the current one. The key
clauses of the new framework are briefly described below. Further information
on expanding the age range covered by the ACIR then follows.
Clause 8 of the AIR Bill establishes the ACIR.
Clause 9 specifies that the ACIR may contain
information relating to:
- the
identity of individuals
- vaccinations
received
- natural
immunity (where a vaccination is not required because the person has already
had the disease) or medical contraindication to a vaccine, as assessed by a
general practitioner and
- other
information relating to vaccinations of young individuals.
Identifying information on the register will include an
individual’s ‘name, contact details, gender, date of birth, indigenous status,
healthcare identifier and medicare [sic] number.’[62]
This information will be checked daily against the information recorded in the Medicare
database to ensure that information on the ACIR (such as a new address) is up
to date.
Clause 10 lists the purposes of the ACIR,
including:
- monitoring
and publishing statistics about vaccination coverage across Australia
- identifying
areas that are at risk during disease outbreaks due to low vaccination coverage
- monitoring
the effectiveness of vaccines and vaccination programs
- checking
a person’s vaccination status for their own or their parent’s information, for
the information of a vaccination provider, or to determine eligibility for family
assistance
- advising
individuals when vaccinations are due or overdue
- certifying
that a course of vaccination has been completed and
- payments
and research relating to vaccination.
This list of purposes is considerably more detailed than
those contained in the HI Act.[63]
The AIR Bill makes explicit uses of the ACIR that are already occurring in
practice such as vaccine coverage monitoring and checking vaccination status to
determine family assistance eligibility.[64]
Clause 11 allows an individual (or their parent or
guardian) to opt out of receiving certain correspondence from the ACIR and/or
request that their personal information on the ACIR not be disclosed. They
cannot, however, request that their information be removed from the ACIR
altogether, nor can they prevent the sharing of their information with
Centrelink for the purposes of determining eligibility for family assistance
payments.[65]
Clause 12 provides for the Commonwealth to make
payments to recognised vaccination providers who notify the ACIR of a
vaccination. In addition to the current payment made to providers, the provision
also provides for a new incentive payment to be made to providers when they
catch up a child who is overdue for vaccination. This implements the part of
the ‘Improving Immunisation Coverage Rates’ Budget measure relating to
incentive payments for doctors and other providers.
Clauses 22 to 27 protect the confidentiality of
information contained in the ACIR.
Clause 22 provides for protected information
(defined in clause 4 as personal, identifying or
commercial-in-confidence information) to be collected in the ACIR and to be
disclosed for the purposes set out in Clause 10. Protected information
is also permitted to be disclosed to a court or coronial inquiry, or when
authorised by the Minister in the public interest (such as for child protection
purposes).[66]
Clause 23 creates an offence of recording,
disclosing or using protected information in a way that is not authorised by clause
22. The offence is punishable by a maximum two years imprisonment and/or
120 penalty units ($21,600), which is considerably more than the current maximum
penalty of five penalty units (or $900).[67]
There are exceptions to the offence if the person acts in
good faith (clause 24), if the person did not know that the information
was commercial-in-confidence (clause 25), if the information is
disclosed to the person to whom it relates (clause 26), or disclosed to
the person who provided the information (clause 27).
The ACIR currently includes information on vaccinations
given to children under the age of seven years.[68]
In order to facilitate the ‘No Jab No Pay’ Budget measure, from 1
January 2016 it will be expanded to record vaccinations given to young
individuals under the age of 20 years.
Clause 4 of the AIR Bill defines a young
individual as ‘an individual under the age of 20 years’. Subclause
10(2) provides that a parent or guardian may communicate with the ACIR on behalf
of ‘a young individual who is incapable of managing his or her health affairs’
(such as a small child).
In addition to extending immunisation
requirements for certain family assistance payments to all children and young
people under 20 years of age, the ‘No Jab No Pay’ measure also removes
conscientious objection as a valid exemption category for these immunisation
requirements. [69]
Paragraph 9(c) of
the AIR Bill maintains consistency with this measure because it allows for the
recording of natural immunity or medical contraindication to a vaccine
on the ACIR, but does not mention conscientious objection.
The ACIR currently publishes conscientious objection
statistics which provide information on the levels of vaccine objection by
jurisdiction. It appears that these statistics will no longer be produced from
1 January 2016.[70]
The Government intends to expand the age range of the ACIR
to include vaccinations given by GPs and community clinics ‘from birth to
death’. At the same time, the ACIR will be renamed the Australian Immunisation
Register (AIR).[71]
The Government is aiming to implement this change in October 2016, in time for
the listing of the adult Zostavax vaccine on the NIP on 1 November
2016.[72]
Schedule 2 of the Consequential Bill amends the AIR
Act to:
- change
the name of the ACIR to the AIR
- expand
the scope of the AIR from young individuals to all individuals and
- allow
any legal personal representative of an individual (such as a
trustee or a person who holds an enduring power of attorney), rather than just
a parent or guardian, to interact with the AIR on the individual’s behalf if
they are not capable of managing their health affairs.
These amendments will create, for the first time, a
national register of vaccinations given to adults as well as children, which
can be consistently accessed by individuals and healthcare providers throughout
life.[73]
As previously noted, individuals will be able to opt out
of having their personal information disclosed from the AIR, but they will not
be able to ‘opt off’ the AIR altogether.
The HPV Register is currently established under the National
Health Act 1953 (the NH Act).[74]
The HPV Register records information about people who receive the Human
Papillomavirus (HPV) vaccine under the National HPV Vaccination Program. The
current purposes of the HPV Register include:
- monitoring
the effectiveness of the HPV Vaccine
- sending
out reminders for missed or booster doses and other vaccination information and
- certifying
vaccination status.[75]
Individuals on the HPV Register (or their parents if they
are children) can currently request that their personal details be removed from
the HPV Register (an ‘opt off’ provision).[76]
Personal information on the HPV Register may currently be disclosed by the
Commonwealth to prescribed bodies and vaccination providers.[77]
From 1 January 2017, the HPV Register will move to the
same legislative framework as the AIR (described previously). At the same time,
it will be expanded to capture all adolescent vaccinations given in schools and
be renamed the ASVR.[78]
Subclause 8(2) of the AIR Bill provides that parts
of the ACIR may be kept separate from each other. This allows for the ASVR ‘to
be maintained and operated on a separate register platform, whilst still being
covered by the provisions of [the AIR] Bill from 1 January 2017 onwards’.[79]
Item 1 of Schedule 3 of the Consequential
Bill amends the AIR Act to provide that parts of the AIR may have
different names (and a note gives the ASVR as an example).
Item 4 of Schedule 3 of the Consequential
Bill repeals the existing legislative framework for the HPV Register.
Bringing the ASVR under the same framework as the AIR will
result in an expanded list of purposes and strengthened privacy provisions for
the information currently held in the HPV Register. However, it will also mean
that there is no longer an ‘opt off’ provision for people who don’t want their
information stored on the register.
In addition to amendments to the HI Act and the NH
Act, the Consequential Bill also makes a number of minor consequential
amendments to the following Acts:
- Freedom
of Information Act 1982[80]
- A
New Tax System (Family Assistance) Act 1999[81]
- Healthcare
Identifiers Act 2010[82]
- Child
Support (Registration and Collection) Act 1988[83]
- Human
Services (Medicare) Act 1973[84]
and
- Human
Services (Centrelink) Act 1997.[85]
These amendments are adequately described in the Explanatory
Memorandum.[86]
Vaccination is a very effective public health measure, and
national immunisation registers are important tools for maintaining high rates
of vaccination in the population. The expansion of the current national
childhood and HPV registers to cover vaccines given at all ages has bipartisan
support and has long been called for by the medical community. Questions have
been raised by a Parliamentary Committee and some stakeholders about the
protection of private information in the proposed registers, despite the inclusion
in the AIR Bill of increased penalties for the unauthorised use of such
information.
Members, Senators and Parliamentary staff can obtain
further information from the Parliamentary Library on (02) 6277 2500.
[1]. Parliament
of Australia, ‘Australian Immunisation Register Bill 2015 homepage’, Australian Parliament website, accessed 14 September 2015.
[2]. Parliament
of Australia, ‘Australian Immunisation Register (Consequential and Transitional
Provisions) Bill 2015 homepage’, Australian
Parliament website, accessed 14 September 2015.
[3]. Part
3 is reserved for the future insertion of provisions relating to a proposed
National Australian Cancer Screening Register. See the Explanatory
Memorandum, Australian Immunisation Register Bill 2015, p. 14, accessed 15
September 2015.
[4]. S
Prasad, Vaccines
on the frontline against infectious diseases, Occasional paper series,
10, June 2015, Office of the Chief Scientist, Canberra, 2015, accessed 21
September 2015.
[5]. Department
of Health (DoH), ‘About
the program’, Immunise Australia Program website, 20 April 2015, accessed
21 September 2015.
[6]. DoH,
‘Individuals
and families’, Immunise Australia Program website, 29 September 2015,
accessed 29 September 2015.
[7]. National Health
(Immunisation Program — Designated Vaccines) Determination 2014 (No. 1),
ComLaw website, accessed 21 September 2015. A simpler version of the National
Immunisation Program Schedule is available at DoH, ‘National
Immunisation Program Schedule’, Immunise Australia Program website, 17 June
2015, accessed 21 September 2015.
[8]. DoH,
‘Vaccination
for special risk groups’, Australian immunisation handbook, 10th
edn, part 3, 16 July 2015, DOH website, accessed 21 September 2015.
[9]. Explanatory
Memorandum, Australian Immunisation Register Bill 2015, op. cit., p. 3.
[10]. L Chin, N Crawford, G Rowles and J Buttery, ‘Australian immunisation registers: established foundations and
opportunities for improvement’, Euro Surveillance, 17(16),
19 April 2012, p. 24, accessed 21 September 2015.
[11]. K
Johansen, P Lopalco and J Giesecke, ‘Editorial:
immunisation registers – important for vaccinated individuals, vaccinators and
public health’, Euro Surveillance, 17(16), 19 April 2012, p. 2, accessed 21 September 2015.
[12]. L Chin et al, ‘Australian immunisation registers’, op. cit.,
pp. 24, 29.
[13]. Ibid.,
p. 29.
[14]. Ibid.,
p. 25.
[15]. Department
of Human Services (DHS), ‘Australian
Childhood Immunisation Register for health professionals’, DHS website, 26
June 2015, accessed 17 September 2015.
[16]. National HPV Vaccination Program Register, ‘Health professionals’, National HPV Vaccination Program Register website, accessed 21 September
2015.
[17]. National Health
(Immunisation Program — Designated Vaccines) Determination 2014 (No. 1),
op. cit.
[18]. The National Human Papillomavirus
(HPV) Vaccination Program Register website, accessed
21 September 2015.
[19]. National HPV Vaccination Program Register, ‘Why notify HPV doses’, National HPV Vaccination
Program Register website, accessed 21 September 2015.
[20]. Department
of Health and Ageing (DoHA), ‘Australian
Childhood Immunisation Register – Redevelopment scoping study’, DoH
website, 9 May 2006, accessed 21 September 2015.
[21]. Senate
Community Affairs Committee, Answers to Questions on Notice, Health and Ageing
Portfolio, Budget Estimates 2007–08, 19 March 2008, Question
E07-130, p. 24, accessed 21 September 2015.
[22]. The
Pharmaceutical Benefits Advisory Committee (PBAC) recommends medicines for
funding under the Pharmaceutical Benefits Scheme (PBS) and vaccines for funding
under the National Immunisation Program (NIP). See DoH, ‘Role of the
Pharmaceutical Benefits Advisory Committee’, PBAC Guidelines website,
accessed 22 September 2015.
[23]. PBAC,
‘Zoster
virus vaccine live; 0.65 mL injection, prefilled syringe; Zostavax®’,
Public summary document, November 2014 PBAC meeting, PBS website, 6 March 2015,
accessed 22 September 2015.
[24]. CSL
Limited, ‘ZOSTAVAX
consumer medicine information’, fact sheet, CSL website, accessed 22 September
2015.
[25]. PBAC,
‘Zoster
virus vaccine live; 0.65 mL injection, prefilled syringe; Zostavax®’, op.
cit., p. 20.
[26]. Ibid.,
p. 3.
[27]. M
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