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Legislative Assembly for the ACT: 2004 Week 04 Hansard (Wednesday, 31 March 2004) . . Page.. 1406 ..

I support that the pneumococcal vaccination program should be extended. But we need more evidence about whether it should be given to every child without looking at the implications. We should not be giving people vaccinations when they do not need them, as there are associated risks of vaccinations. A lot of research is still being done about the impact of vaccinations on young people and on whether the protection they get from the vaccination is harming their health in other ways.

There needs to be more research. The United States is now working on some programs, including the vaccine safety datalink study, which is a partnership program that looks at the medical records of millions of children and adults and allows that research to be consolidated to see the impact, through independent studies, of vaccinations of millions of patients over a 10-year period. Without that work being done I do not think we can make the blanket statement that there is a health and financial benefit of providing a vaccine free to all Australia. More work needs to be done. As I said, the vaccination should be provided free to all those people who have identified need for the protection offered by the pneumococcal vaccination. But we cannot make that sweeping statement for the whole of Australia until further research has been done.

MS TUCKER (11.55): According to Jill Forest and others of the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases the pneumococcal bacteria is responsible for more deaths worldwide than any other single pathogen. It causes meningitis, bacteriaemia, pneumonia and otitis media, particularly affecting infants and children under five years of age, adults over 60 years of age and those with chronic underlying medical conditions or immunosuppression. However, there are quite different rates of infection and different levels of invasiveness of the disease in indigenous versus non-indigenous population and different age groups. Invasive pneumococcal infection is the most likely to cause death, but ear diseases—otitis media—in remote areas, and particularly in indigenous children, is likely to be associated with perforated tympanic membranes and discharge.

This review noted that in the non-indigenous population the invasive infection primarily manifests as pneumonia and mainly affects adults over 60 years of age, particularly with various predisposing conditions. In non-indigenous children the invasive infection is mostly associated with bacteriaemia, blood infection and meningitis and is highest in the first two years of life. Significant risk factors in these young children include attendance at childcare centres, parental smoking and otitis media—ear disease. In this group pneumococcal meningitis causes significant illness. The case fatality rate is 10 per cent and there are long-term health consequences.

However, in the indigenous population, in all age groups, indigenous rates of invasive pneumococcal infection are up to 75 times higher than in non-indigenous groups and are caused by a broader range of types of bacteria. The paper notes that in all age groups indigenous rates of invasive pneumococcal infection are up to 75 times higher than in non-indigenous groups and are caused by a broader range of serotypes.

In Queensland meningitis occurs earlier than in non-indigenous children—at six versus 12 months. Across Northern Australia a striking difference is the high incidence of infection in younger indigenous adults aged 15 to 50 years, as well as the extremes of

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