Western suburbs walk-in vaccination service axed

A children’s vaccination service is closing its doors despite a spike in vaccine-preventable diseases, following a funding dispute with the state government.

The Joan Kirner Women’s and Children’s Hospital’s vaccination centre in St Albans, in Melbourne’s western suburbs, will close its walk-in service late next month.

The Joan Kirner Women’s and Children’s Hospital in Sunshine. Credit: Penny Stephens

The service’s funding was tied to a program intended to cater for immunising children with complex needs while they were sedated, but the Victorian government said Western Health was instead using its allowance to vaccinate the broader population.

Under Victoria’s vaccination program, local governments, GPs, pharmacists and community health services administer vaccines to the general population, rather than public hospitals.

But public health experts insist all options, including hospital drop-in services, should be on the table given declining childhood vaccination rates.

The Royal Children’s Hospital and Monash Health continue to provide specialist vaccinations.

“As Western Health has been unable to deliver specialist immunisation services, the Royal Children’s Hospital and Monash Health have expanded their services to meet demand,” a government spokeswoman said.

“The Department of Health will work with Western Health as they explore reintroducing their specialist immunisation service.”

Western Health acting chief operating officer Christine Neumann said her health service was in discussions with the department.

“Patients and consumers can also access vaccination services at a range of other local health services, including GPs, some pharmacies and local councils,” she said.

One Western Health source, speaking on condition of anonymity because they were not authorised to speak publicly, said staff members had “deep concerns” about the changes.

“This clinic provides an essential service,” the employee said.

Melbourne mother Isabel Fernandes – who started a Change.org petition signed by more than 700 people opposed to the cut – said she learnt the clinic would be closing in late August while attending for her daughter’s routine vaccination.

“One of the nurses told me that the clinic has been running at full capacity for some time now and had even asked for additional funding to keep up with demand,” Fernandes said.

“It’s really sad. Having the flexibility of walk-in appointments made a huge difference, especially when juggling the unpredictable schedule that comes with a baby.

“I was also really anxious about her first vaccinations, and it gave me real peace of mind knowing they were being done in a hospital setting, just in case of a rare reaction.”

Child immunisation rates have dropped in the past few years. At the same time, there has been a jump in vaccine-preventable diseases.

In the Brimbank local government area, where the Joan Kirner Women’s and Children’s Hospital is located, there have been three reported cases of measles this year – up from one case last year and none in 2023.

There were eight reported cases of whooping cough in Brimbank in 2023, which jumped to 146 cases last year. There have been 71 detections this year.

For chickenpox, there were fewer than 20 reported cases in Brimbank between 2020 and 2022. There were 20 cases last year and nine have been reported so far this year.

Childhood vaccination rates have dropped across Melbourne’s north-western suburbs, with 92.02 per cent of one-year-olds now fully vaccinated compared with 94.54 per cent in the 12 months to December 2020.

National full vaccination coverage for one-year-olds fell by 0.35 per cent – to 92.14 per cent – in the 12 months to December last year, according to Australian Institute of Health and Welfare data.

University of Sydney professor of public health Julie Leask said it was “very, very bad timing” for a drop-in vaccination service to be closing.

“Walk-in services are incredibly important for families who struggle to make planned appointments,” Leask said.

“There’s this thing we call opportunistic vaccination, and it’s one of the most important things healthcare services can do. When an adult or child turns up and you ask them about their vaccinations and find out they’re not up to date, you can send them down the corridor.

“Some of the small measles outbreaks we’ve seen in the past have come from communities where the kids weren’t up to date because of access barriers.”

Burnet Institute director Brendan Crabb said the re-emergence of whooping cough and measles was a sign of “real trouble”.

“We have to think creatively,” he said. “Nothing should be off the table. The cost-effectiveness of it is extraordinary. If you don’t prevent, you’ve got to spend money treating.”

Victorian councils have separately raised the alarm that they could be forced to reduce access to free vaccinations for children.

The Age last year revealed the Victorian government had rushed through a new co-payment system for providers to use its online platform, Central Immunisation Records Victoria (CIRV), to register vaccine history, bookings, consent and stock.

The government is charging an average of $2.32 per immunisation, with annual fees for councils capped at $25,000.

The Municipal Association of Victoria and several councils state they had been repeatedly assured that access to the crucial record system would always be free.

Councils provide about 430,000 immunisations to Victorian children a year, covering 90 per cent of all vaccinations for school-aged children, and 45 per cent of those for younger children and babies.

A Department of Health briefing document last year said the co-payment model was introduced “due to the current fiscal constraints in the state”.

A parliamentary inquiry into local government funding called on the state to fully fund the platform, saying it acted as a disincentive to participate in a program vital to community health. The government rejected the recommendation last month.

Stonnington Council said the new fee strained local government budgets and threatened the delivery of free vaccination programs as well as the health of vulnerable children.

In a letter to Health Minister Mary-Anne Thomas last year, the council said just 18 per cent of the cost of immunisations was covered by state and federal governments. Stonnington contributed $317,000 to the program last year.

While councils are required under the Health Act to provide immunisation services, Stonnington said outreach services could be reduced and clinics scaled back.

“We are being asked to promote the RSV vaccine, deliver it at no cost to families, and then pay the state government a fee through CIRV for doing so,” Stonnington mayor Melina Sehr said in a statement this week. “That is an extraordinary situation.

“If councils abandon CIRV, records could be split across multiple private platforms, raising serious questions about data security, quality and accessibility.

“Our most vulnerable community members, including babies and young children, should not be caught in the middle of a funding dispute. Stonnington remains committed to working with the Victorian government to protect public health. But this charge must be scrapped and the CIRV platform fully funded to ensure councils can continue delivering these essential services.”

Moonee Valley City Council told the parliamentary inquiry that state and federal funding covered 48 per cent of the cost, leaving a shortfall of $99,000 for the local government in 2022-23.

Opposition health spokeswoman Georgie Crozier said Labor’s priorities were all wrong when it came to the funding dispute with Western Health.

“Health services should be able to have the flexibility to make decisions that meet the needs of the community.”

Greens health spokesperson Dr Sarah Mansfield said the clinic’s closure would put unnecessary pressure on other parts of the health system.

“Families in outer suburbs and regional areas already face barriers to care, and vaccination rates are slipping below herd immunity thresholds,” she said. “We need more free vaccination services, not less.”

Councils have long complained the state has been offloading costs onto them by shifting responsibilities onto local governments, particularly in maternal and child healthcare, while capping rates.

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