Living in a suburb with lots of white, middle-class, educated mothers may be putting your child's health at risk. In such salubrious surroundings can be found dangerous concentrations of vaccine-resisters. These are women who spend too many hours on wacky internet health sites and become convinced immunisation is a giant conspiracy.
At least 90 per cent of the community needs to be vaccinated to protect the most vulnerable from disease.
The educated mother who thinks she knows better than the overwhelming majority of the world's scientists and doctors partly explains why some of Sydney's richest suburbs have the state's lowest child immunisation rates.
It is hardly surprising that North Coast NSW, home to alternative life-stylers and the "natural" wellness set, should rate lowly on coverage. But it was astounding - at first - to see that Sydney's eastern, south-eastern and northern suburbs rate near, or at, the bottom of a list compiled by the Division of General Practice, based on Medicare figures for child immunisation rates.
In the November 2008 quarter, Sydney's eastern suburbs - including the city, Vaucluse, Double Bay, Rose Bay and Kings Cross - were ranked last among the state's 34 divisions of general practice and last among 118 divisions nationally. Just above that lot was the Northern Rivers, then north Sydney, south-east Sydney and the Blue Mountains.
A similar story emerged from data published in 2005 by the National Centre for Immunisation Research when Mosman had about the same child immunisation rate as Bellingen.
It is possible doctors in these establishment suburbs are too old to be computer-literate or too lazy to record immunisation data as they are meant to do, with consequent under-estimates of the coverage in their areas. Also, parts of the eastern suburbs, such as Kings Cross, have their share of poor and transient families. But as Ray Seidler, medical director of the Eastern Sydney Division of General Practice, told me, these areas are home to "an older demographic of mothers who are conscientious objectors".
Around the world, resistance to vaccination is strongest among the affluent and educated, leading Arthur Allen, author of the book Vaccine, a history of immunisation, to observe that "living in a place with a high percentage of PhDs is a risk factor for whooping cough".
Vaccine-resisters have a range of motivations. Some believe immunisation is unnatural. Others resent the nanny state telling them how to raise their children. Some distrust the medical establishment. But the movement got a big boost in the late 1990s from a bogus health scare that linked autism with a preservative, thimerosal, in the measles/mumps/rubella jab. At least 16 epidemiological studies have disproved the link. And the British doctor responsible for the scare, Andrew Wakefield, stands accused of having doctored the results of his study, according to an investigation by The Times published earlier this month. Wakefield's theory was based on 12 cases, and now even that evidence is questionable.
But for the vaccine-resisters, facts can't be allowed to get in the way of feeling. The sceptics have a lot going for them. For the last two decades medical consumers have rightly learned to question authority; the doctor is no longer god; and consumer choice has extended to patient treatment. Aided by the internet, anyone can bone up on their diseases and ask intelligent questions. And so they should - just as independent scientists should be properly funded to monitor a vaccination's side effects.
But these dummy mummies don't differentiate between fact and hocus-pocus; between a bona fide scientific study and pseudo science. Just as some people still think fluoride is dangerous, others cling to their anti-vaccine stand as a matter of faith, regardless of the evidence.
They don't distinguish between the expert view of, say, the paediatrician Paul Offit, author of Autism's False Prophets, and co-inventor of a vaccine against rotavirus, a diarrheal disease that kills tens of thousands in poor countries; and the view of former Playmate of the Year and anti-vaccine campaigner Jenny McCarthy, who has an autistic son, and brings her partner, the actor Jim Carrey, on her rallies. Offit has had death threats; McCarthy has been on Oprah.
What is indisputable is that vaccines have saved countless lives. Smallpox has been eradicated, polio almost defeated, and diphtheria confined to pockets of poor countries. Children are mostly spared debilitating illnesses such as measles and mumps.
But 8000 children in NSW got whooping cough last year, starting with an outbreak on the North Coast, a big increase on previous years. Many were babies exposed to the virus in the months before they could be vaccinated. Babies cough and cough, go blue or red, some stop breathing and need oxygen. Tetanus is just a rusty nail away, and cases of measles are still recorded in Australia.
Ultimately it's selfish not to vaccinate your child. It's relying on everyone else to do so in order to maintain "herd" immunity, which means at least 90 per cent of the community needs to be vaccinated to protect the most vulnerable from disease. It's bad enough that ill-educated, chaotic, itinerant families fail to get their children immunised because they forget, don't know, or don't get round to it. But when smart parents deliberately desist, it's wicked. So intent on not being duped by the "medical establishment", they allow themselves to be duped instead by the likes of Jim Carrey, Jennifer McCarthy, and garbage science.
Discuss the "immunisation conspiracy" with other Essential Baby members.