Explanatory Statement

Family Assistance (Vaccination Schedules)

Determination 2003

Summary

The Family Assistance (Vaccination Schedules) Determination 2003 (this Determination) sets out new standard and catch up vaccination schedules for the purposes of the definition of “immunised” in subsection 3(1) of the A New Tax System (Family Assistance) Act 1999 (the FA Act). 

A new standard vaccination schedule, setting out the childhood diseases or antigens against which a child must be vaccinated at a particular age, is included in this Determination in Schedule 1. 

The catch up vaccination schedule continues to be the catch up vaccination schedule published by the National Health and Medical Research Council (NHMRC) in the Australian Immunisation Handbook (the Handbook).

This Determination is made under section 4 of the FA Act.

Background

The eligibility rules for maternity immunisation allowance (MIA) and child care benefit (CCB) include a requirement that the relevant child meets the immunisation requirements. 

The basic requirement in section 6 of the FA Act is that the child has been immunised. “Immunised” is defined in subsection 3(1) of the FA Act as meaning immunised in accordance with a standard or catch up vaccination schedule determined under section 4.  Under section 4, the Minister must, by disallowable instrument, determine one or more of each of those schedules.

This Determination replaces the Family Assistance (Vaccination Schedules) Determination 2000 (the 2000 Vaccination Schedules Determination), which defined “immunised” by reference to the standard and catch up vaccination schedules published by the NHMRC in the Handbook.

On 18 September 2003, the NHMRC met and approved a revised Australian Standard Vaccination Schedule (the revised Schedule).   The revised Schedule includes some childhood vaccines that are currently not funded under the National Immunisation Program (NIP), such as the universal conjugate pneumococcal vaccine. 

It is considered inappropriate to require parents to have their children immunised in accordance with the revised Schedule (which now includes some vaccines that are not Government funded) in order to be eligible for MIA and/or CCB.

Accordingly, this Determination provides a new standard vaccination schedule that sets out the relevant childhood diseases and antigens for which vaccines that are funded under the NIP are available.   The Acting Chief Medical Officer in the Department of Health and Ageing has approved this schedule.

The catch up vaccination schedule in the Handbook, as it relates to vaccines for the diseases and antigens set out in the standard vaccination schedule in Schedule 1 to this Determination, remains relevant. 

Explanation of the changes

Part 1 – Preliminary

Clause 1 states the name of this Determination.

Clause 2 states that this Determination is taken to have commenced on 19 September 2003.  This is the day after the NHMRC approved the revised Schedule. 

Linking the commencement of this Determination back to the NHMRC decision will ensure that children are only required to receive vaccines that are fully funded under the NIP in order to be “immunised” as defined in the FA Act.  The vaccines required to immunise children against these diseases or antigens set out in Schedule 1 to this Determination are fully funded.  By contrast, some vaccinations recommended in the revised Handbook are not fully funded.

Clause 3

This clause sets out the relevant definitions for terms used in this Determination.  These definitions will be referred to below in the context in which they appear.

Clause 4

This clause revokes its predecessor, the 2000 Vaccination Schedules Determination.

Part 2 – Vaccination schedules

Clause 5

Subclause 5(1) provides that the standard vaccination schedule is set out in Schedule 1 to this Determination.  It also provides a series of rules that are to be read in conjunction with the new standard vaccination schedule.

The standard vaccination schedule in Schedule 1 lists the diseases/antigens against which a child born at a particular time must be vaccinated at a particular age to meet the definition of “immunised” in the FA Act. 

As a general rule, a child will be overdue for a vaccination one month after the vaccination is due.  However, if the vaccination is due at 4 years, then the vaccination is overdue at 5 years.  These rules are set out in subclause 5(2).

If a child is overdue for a vaccination, the child is not “immunised” in accordance with the standard vaccination schedule.  However, if the child subsequently receives the relevant vaccine or the child can no longer be vaccinated against the specific disease/antigen, then the immunisation requirement would be satisfied.  An example of the latter would be the Hib antigen – the relevant vaccination is not required after age 5 because the vaccine is not registered for use in children over the age of 5 years.     

According to subclause 5(3), a vaccine used to vaccinate a child must be registered as a vaccine on the Australian Register of Therapeutic Goods that is maintained under section 9A of the Therapeutic Goods Act 1989.

Subclauses 5(4) and 5(5) clarify two aspects of the new standard vaccination schedule.  First, a child may be vaccinated in accordance with either Path A or Path B for Hib.  Second, a child born on or after 1 May 2000 may receive a third vaccination against Hepatitis B at either age 6 or 12 months.

Clause 6

Catch up vaccination schedules potentially apply where a child has missed the required vaccinations.  Subclause 6(1) provides that the catch up vaccination schedule is the catch up vaccination schedule published by the NHMRC in the Handbook. 

The overdue rules are set out in subclause 6(2).  As a general rule, a child would be overdue a vaccination under the catch up vaccination schedule one month after the vaccination is due.  However, where the vaccination is due on or after the child turns 4, the vaccination would be overdue either when the child turns 5 or one month after the vaccination is due, whichever is the later.

To illustrate, a child would generally be overdue a vaccination in respect of a particular antigen one month after the vaccination is due.  However, the final dose in a catch up schedule might not be due at 4 years because the child might already be, say, 4 years and 2 months when they received the previous dose.  Therefore, if the recommended interval between doses is 6 months, the next dose would be due at 4 years and 8 months.  Under the “overdue” rule, this would mean that the dose would be overdue at 5 years rather than 4 years and 9 months.  

If the child subsequently receives the relevant vaccine or the child can no longer be vaccinated against the specific disease/antigen, then the immunisation requirement would be satisfied.