THE GREAT VACCINATION DEBATE
The issue of vaccination can make for tense conversation at children's parties on the Northern Beaches, where in some peninsula suburbs one in five children starting school are not fully immunised.
So controversial is the subject that the moderators of local Facebook group Northern Beaches Mums recently banned comments on the subject, with administrators explaining "the number of complaints made to us about these posts clearly indicates that they are causing more harm than good".
The federal government has set out a recommended schedule for children to receive vaccinations between the ages of zero and four. This is to protect them against several diseases including polio and measles.
While a proportion of children can't have the vaccinations due to medical reasons, another small group doesn't receive them because their parents/ guardians declare themselves 'conscientious objectors' - their decision driven most commonly by a belief vaccines are harmful to health.
The percentage of children under seven being unimmunised because of a conscientious objection rose from 0.23 per cent in 1999 to 1.77 per cent in 2014.
In 2015, the federal government declared those who do not have their child vaccinated could no longer access child care and other child-related subsidies.
In March this year, Prime Minister Malcolm Turnbull signalled plans for national 'no jab, no play' laws - banning unvaccinated children attending child care centres unless they have a medically valid reason.
In April, NSW Labor announced it would introduce a bill into the state parliament to ban unvaccinated children from child care centres, unless they had a medical exemption.
The proposed law would remove the conscientious objector clause.
Announcing the proposed bill, NSW Labor leader Luke Foley said, "We have to find ways to increase vaccination rates and, if it requires plugging loopholes like moves to set up anti-vaccination centres, then we have a responsibility to do so."
In NSW, parents who want to send an unvaccinated child to child care must lodge an 'interim objection form', signed by a general practitioner.
The proposed no jab, no play laws have been met with resistance by some on the peninsula, perhaps not surprisingly given the area's immunisation rates.
In the former Manly LGA, 80.9 per cent of five year olds are fully vaccinated, 11 per cent below the national average.
Pittwater's rate was 87.9 per cent, while Warringah's was 90.1 per cent, according to 2014-15 data from the Australian Institute of Health and Welfare.
After news of the possible introduction of nationally consistent laws broke, one Mona Vale mum called for expressions of interest for a vaccine-free child care centre on the Northern Beaches through a private Facebook page.
In the post to the over 5000 members of Vaccine Free Australia, Heidi Street said she wanted to offer unregistered care - similar to babysitting - to up to four children in her home.
"I am merely a mum hoping to help out her local community and support this lovely minority of families who do not believe in the benefits of vaccines," she wrote.
The post drew strong support from members: a few indicated they would use such a service, with one mother responding, "This will happen more and more if Malcolm [Turnbull] gets his agenda passed. There is always a way...".
A Freshwater woman, who has two unvaccinated children aged under five, agrees.
The natural therapist, who spoke to Peninsula Living on condition of anonymity, says last year she paid $130 a day for her eldest daughter to attend child care. Her child did not receive vaccines as she believes these could be harmful.
The mother plans to do the same with her youngest, however "if the no jab, no play law comes in, then my daughter will not go to kinder, or we will be forming smaller group to babysit each other’s children," she says.
"I am sure there will be other mums in the same situation as me. I have girlfriends who don't vaccinate - we won't set up a centre, but if I work one day and they work another day, that's three days covered," the mother adds.
The idea of putting groups of unvaccinated children together raises real public health concerns, says Tony Bartone, vice president of the Australian Medical Association.
Dr Bartone says between 93 and 95 per cent of people must be immunised for a high level of protection against diseases in any community.
"Once you start getting below 90 per cent, you start to really run the gauntlet and certainly low 80s is just absolutely absurd in such an educated and informed community." Wakehurst MP and NSW Health Minister Brad Hazzard echoes these concerns.
"Recently, we had a girl on the north coast who had not been immunised flown to the Gold Coast in a critical condition. We also had an outbreak of measles in western Sydney," he tells Peninsula Living.
"I'm disappointed that somebody on the Northern Beaches could potentially put her own children at risk, and others, and I would certainly encourage her to have a little think about what she's saying she would do."