By CELA on 28 Nov, 2017

new study led by a researcher from The University of Western Australia has analysed the use of complementary and alternative medicine (CAM) by parents who reject some or all vaccines for their children. While the study didn’t find a causal link between the two practices, it did find a connection that might help ECE professionals discuss immunisation more effectively with families who refuse vaccinations for their children.

Why do educators need to know?

While 94.23% of all Australian children are fully immunised by age five the rate of vaccination has been in decline for many years following now-discredited ‘studies’ linking vaccination with autism or heavy metal poisoning. Many early childhood education services are connected to families who refuse all or a few vaccinations against preventable diseases for their children.

As health authorities attempt to restore the necessary level of ‘herd’ immunity in Australia, early learning access has become a tool in the campaign to force anti-vax families to accept immunisation or miss out on subsidised long day care or preschool for their children. The Federal Government’s No Jab No Pay policy removed access to childcare subsidies for unvaccinated children at the start of 2016.

From No Pay to No Play

…[educators are at] the frontline of a public health battle

In Victoria and now NSW, the state governments went a step further to introduce a No Jab No Play policy – denying enrolment to any funded services for children whose parents could not provide medical grounds (such as a compromised immune system) as a reason for failing to immunise.  These parents are often known as ‘conscientious objectors’, but ‘beliefs’ were removed as an exemption category for enrolment in both NSW and Victoria.  Other jurisdictions may follow this policy in future.

What this means is that preschool and long day care directors, family day care providers and OSHC leaders are in the frontline of a public health battle. Some ECE educators find it hard to reconcile refusing entry on immunisation status with their desire (and the government’s) for all children to access quality early learning.

Where will the children go?…if I do have to shut down the immunised children will miss out too

For our earlier story we interviewed Donna, a preschool director from a tiny town in far northern NSW. Her current enrolment consists of four immunised students and 11 non-immunised.

“This area has one of the lowest immunisation rates in the state,” Donna said.

“So yes, my first fear was that we would have to close down, but that’s closely followed by where will the children go if they can’t come here?

“There aren’t any other services nearby, so if I do have to shut down the immunised children will miss out too.

“How does that work with the principles of universal access? These children will have no early learning at all – that can’t be the best outcome.”

Meat in the sandwich

…facts aren’t enough

Nationally, few services would have a majority of unvaccinated children enrolled.  In some areas services can report that every child’s vaccinations are up to date.  All the same, conversations about the need for vaccination are far more frequent now that subsidy payments or even enrolment access depend on the health measures.

The Commonwealth Government’s Department of Health website provides resources aimed at families and health professionals which can be useful for educators, such as this section on understanding vaccine safety, and advice about the No Jab No Pay policy is available in many places including

The fact is, facts aren’t enough to appeal to families who aren’t swayed by accepted scientific research. This new study shines a candle on one common anti-vax motivation that might help educators have more meaningful discussions with families at the frontline of this policy battle.

The DIY connection

…a symbiotic relationship

Dr Katie Attwell, Senior Lecturer from UWA’s School of Social Science, said their study was the first in Australia and one of the first internationally to look at the reasoning informing parents’ vaccine rejection and CAM use.

“There are studies that do show a correlation between vaccine rejection and CAM use but none so far that have specifically examined the reasons behind it. This study is one of the first of its kind and it’s produced some very interesting findings,” Dr Attwell said.

Dr Attwell said the study showed parents had a range of attitudes, but also some distinct patterns, that led to their engagement with CAM.

“We found a symbiotic relationship,” she said.

“CAM use doesn’t cause vaccine refusal, or vice versa, but there is a definite link between the two.”

My child, my choice

…it’s a DIY ethic

For the group of families that choose to use alternative medicines and to reject vaccinations, choice and control are very important.

“If you’re a CAM user, you may feel like you don’t need to vaccinate and your CAM provider may support this view. And if you’re a vaccine refuser, you may rely upon CAM as part of your toolbox to pursue a healthy life for your family and not see vaccinations as a necessity,” Dr Atwell said

Dr Attwell said the study found the vaccine refusers were a cohort of parents who really valued autonomy, choice and action.

“We didn’t just look at parents visiting CAM practitioners, but also their use of remedies at home, and their network of friends that may also support their home remedies. Doing things for themselves is important – it’s a DIY ethic and it seems to empower them in both their use of CAM and their decision to reject the medical consensus on vaccinating.”

Nuances in the data

…only a handful were concerned that CAM also operates for profit

Dr Attwell said a subset of the parents in the study, mostly those who accepted some vaccines, were sceptical of the use of some or all CAM.

“Others think their family is so healthy that they don’t need CAM or vaccines. And while many of our parents were sceptical of pharmaceutical companies, only a handful were concerned that CAM also operates for profit. So there were some really interesting nuances within our data, as well as an overall explanation for why vaccine refusal and CAM use travel together.”

Dr Attwell said the study could inform how vaccination policymakers and health professionals discuss vaccination with parents who value natural products and their own input into child health.

Relate it to empowered parenting

Families are supported in their parenting role and their values and beliefs about childrearing are respected.

“Emphasising the immune-boosting capacities of vaccines through the natural responses they elicit in the body is one option,” Dr Attwell said.

“However, it’s even more important to consider that CAM means something to vaccine-refusing parents, who feel like it works for them.

“Discussing how vaccinating supports their existing parenting practices is important if you want to engage with them.”

Sound familiar?

Educators who are committed to quality relationships with the families of children at their services will already appreciate the need to respect parents’ views on childrearing. However, federal and state legislation carries penalties for those who help parents breach regulations to claim subsidies (or enrol in NSW or Victoria), so that respect cannot go so far as breaking the law by accepting or creating false records.

Anti-vaxers are made, not born

The study was built around interviews with families in Fremantle, WA, and Adelaide, SA. Among the cases published in the report are stories showing how a previously pro-vaccination parent might lose faith in immunisation and develop different beliefs. For instance:

A more common example was that of Kavita whose son was unwell after his two-month vaccinations.

The doctor said ‘Oh, it’s a virus,’ and at that point I thought, “What does that mean? What is a virus? Oh, it means that they’ve got no idea what it is, so they’re just going to call it a virus …”

Kavita took her son to a naturopath “who said, ‘He is just reacting to all of the preservatives in the vaccinations.’”

Kavita had “always seen naturopaths” due to “tummy issues,” … This experience informed Kavita’s ultimate rejection of further vaccines.

[The study has been published in the Social Science and Medicine journal here]

“Do-it-yourself”: Vaccine rejection and complementary and alternative medicine (CAM)

  • Katie Attwell, School of Social Science, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia, & Immunisation Alliance of Western Australia, Cockburn Integrated Health and Community Facility, Suite 14, 11 Wentworth Parade Success, WA 6164, Australia

  • Paul R. Ward, Department of Public Health, Flinders University, Adelaide, SA 5001, Australia

  • Samantha B. Meyerd, University of Waterloo, 200 University Ave West, Waterloo, Ontario N2L3G1, Canada

  • Philippa J. Rokkase, Adelaide University, North Terrace, Adelaide, SA 5005, Australia

  • Julie Leask, School of Public Health, Faculty of Medicine, Faculty of Nursing, University of Sydney, NSW 2006, Australia

​Meet the author


Bec Lloyd is the founder and managing director of Bec & Call Communication, providing professional writing, editing and strategy services to the school and early childhood education sector since 2014. In 2018 she launched UnYucky mindset and menus for happier family mealtimes. Formerly the communications lead at ACECQA and BOS (now NESA), Bec is a journo and mother of three who produces Amplify for us at Community Early Learning Australia.

About CELA

Community Early Learning Australia is a not for profit organisation with a focus on amplifying the value of early learning for every child across Australia - representing our members and uniting our sector as a force for quality education and care.

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