Far northern NSW is a honeypot for health and wellness seekers, yet one local intensive care specialist says, “I’ve seen more vaccine-preventable diseases since working in the Northern Rivers than I saw in 10 years of working in remote Aboriginal communities.” Credit:Paul Harris

Anti-vaccination fervour has taken off around the globe, with dire consequences for public health. Ground zero for this kind of thinking in Australia is Mullumbimby, where it’s best not to discuss it.

Normal text size Larger text size Very large text size In 1995, after the end of what she calls an "unfortunate relationship", Eve Jeffery left her home in Myrtleford, north-east Victoria, with her two young children, hit the road in her yellow Kombi and drove north, to Byron Bay, on the far north coast of NSW. Back then, before the tourist boom that has subsequently swamped it, Byron was a quiet place, a counter-culture refuge with reliably great surf, a strong sense of community, and as much wholefood as you could eat. "All the people I knew who had been here said this is where I belong," Jeffery says. "When my circumstances changed, I ended up coming here, and they were right." Jeffery is an amply bosomed 55-year-old woman with greying hair and a silver nose ring, an enthusiastic nudist with what she calls "tuck-shop-lady arms" and "a bum the size of a small country". She is a vegan who likes to make fun of vegans, a one-time theatre producer, puppeteer and animal lover who helps pythons off the road and slows down for wallabies. She's also partial to writing and photography. In 2003, she was hired by the Byron Shire Echo, a progressive weekly newspaper. She has worked there ever since, toiling away beneath a cartoon of a surfing caveman named Fug and a bumper sticker that reads "Honk if you are Jesus". This article is one of the most-read Good Weekend features for 2019 The Echo's offices are not actually in Byron Bay but the small town of Mullumbimby, 15 minutes' drive away. The day I arrive, it's a steamy, windless 29°C, which may explain why almost everyone in the Echo office is barefoot. Though originally hired as a photographer, Jeffery has since become a jack of all trades, working as a reporter, website manager and Facebook moderator. She has helped cover some controversial topics, including the area's pothole epidemic, the erection of an NBN tower outside of town, and local real estate prices, which have been pushed sky-high by the influx of celebrities and cashed-up seachangers. But the most contentious topic, by far, has been vaccination. "Any time we do anything on vaccination, our Facebook page goes nuts," she says. "It gets to the stage where we have to stop people threatening to kill one another." Despite overwhelming and incontrovertible evidence that vaccines are safe and effective, an increasing number of parents in the Northern Rivers region, which includes Mullumbimby and the nearby towns of Bangalow, Nimbin and Byron Bay, are choosing not to vaccinate their children. According to the Australian Institute of Health and Welfare, only 52 per cent of five-year-olds in the Mullumbimby area were fully immunised in 2015-16, compared with 92.9 per cent nationally. This infuriates vaccinating parents, who are inclined to regard anti-vaxxers as selfish and ignorant, and their children as walking petri dishes. The anti-vaxxers, meanwhile, regard the vaxxers as naive and sheep-like, blithely submitting their kids to unnecessary and potentially dangerous medical interventions. Jeffery knows people on both sides of the divide. She is, herself, a big fan of mainstream medicine. "I had a grade-three pre-cancer removed from my cervix in 2012, so modern medicine saved my life." At the same time, she didn't vaccinate her kids. "It was a long time ago," she says. (Both her daughters are now in their 20s.) "But at the time I thought, 'I had rubella and measles as a kid and, yeah, I was sick, but I came through okay.' " She also visited her local doctor, in Myrtleford, who told her that vaccination was essentially a lottery.


"He said, 'If you vaccinate them and they have a bad reaction, you'll feel terrible, and if you don't vaccinate them and something happens, you'll also feel terrible.'" She remembers looking at her first-born baby girl, "just a little jelly roll", and deciding not to go ahead. She did the same with the second. Today, her daughters are very much alive and well; in fact, one of them is a midwife who fully intends to vaccinate her own children. "Still," says Jeffery, "sometimes I look back and wonder if I did the right thing. And I'm certainly not sure what I'd do today." Jeffery says many locals who don't vaccinate their children are equally equivocal. "Some of [the anti-vaxxers] are nutcases, but many of them are very well informed." She shrugs. "It's a complex situation." Mullumbimby-based reporter Eve Jeffery: locals “go nuts” when vaccination is covered by the weekly paper: “It gets to the stage where we have to stop people threatening to kill one another.” Credit:Paul Harris Vaccination is one of the most successful public health measures in history, one credited with saving hundreds of millions of lives worldwide. Since the introduction of the first vaccine, for smallpox, by English scientist Edward Jenner in 1796, governments have used immunisation programs to eradicate lethal diseases such as smallpox and rinderpest, a virus that once devastated livestock. And yet the past decade has seen an increase in what experts call "vaccine hesitancy". This term covers a range of behaviours, including those of parents who vaccinate despite substantial concerns, or who postpone vaccination, selectively vaccinate, or don't follow the vaccination schedule. Some parents oppose vaccinations for political reasons (they don't like the government telling them what to do), or because of misguided medical beliefs. Whatever way you look at it, vaccine hesitancy is a bad thing. The World Health Organisation (WHO) recently nominated it as one of the top 10 threats to global health in 2019. Anti-vaxxers, those who refuse to vaccinate, have been around for as long as vaccination.


Among the first anti-vaxxers were bishops and priests, some of whom accused Jenner and his ilk of thwarting the will of God. (Some countries still allow vaccine exemptions for religious reasons, sometimes referred to as conscientious objection.) But the anti-vaxxers' principal concern, then as now, was the safety of the vaccines. In the 1800s, opponents believed, incorrectly, that vaccination caused deformities; these days, some anti-vaxxers believe, also incorrectly, that vaccines cause everything from anaphylaxis to autism. Indeed, some anti-vaxxers believe that vaccines can cause autism in their pets. The consequences of not vaccinating are being seen worldwide, most recently with measles, which can lead to blindness, encephalitis and death. There were 372 cases of measles in the US last year. This year, so far, there have been 940 confirmed cases, with outbreaks in Washington, California, New Jersey and Michigan. In Rockland County, New York, there have been 254 cases since last September, which authorities traced to the ultra-Orthodox Jewish community. (In March, the New York Times reported that some Rockland residents now wipe public bus seats and cross the street when they see ultra-Orthodox Jews.) In Europe, where the anti-vax movement has gained political traction in recent years, there were 83,000 measles cases in 2018, and 25,500 in 2017. In Australia there are anti-vaxxers in some of our wealthiest suburbs, such as South Yarra in Melbourne and the eastern suburbs of Sydney. But by far the highest numbers are in the Northern Rivers, on the far north coast of NSW. "I've seen more vaccine-preventable diseases since working in the Northern Rivers than I saw in 10 years of working in remote Aboriginal communities," says Dr Rachel Heap, an intensive care specialist at Lismore Base Hospital, an hour's drive south-west of Byron Bay. In the past few years, the hospital has seen cases of rare and easily preventable diseases such as tetanus, diphtheria, mumps and epiglottitis. The whooping cough outbreak that spread through Australia in 2009 was reported to have started in the Northern Rivers. (The epidemic led to 19,000 cases and the death of three babies, including a four-week-old girl, Dana McCaffery, in Lennox Head, just south of Byron Bay.) "It's become the norm here to shun vaccines," says Heap, who lives in Mullumbimby. "There's a cultural narrative that says anything to do with the government or mainstream medicine is not to be trusted. And that has left people vulnerable to misinformation being peddled by the professional anti-vaxxers." In order to counter this, in 2013 Heap helped found the Northern Rivers Vaccination Supporters (NRVS), an advocacy group that provides credible information about vaccines and vaccine-preventable diseases. But it's been an uphill battle. The NRVS has just 250 members and struggles to be heard. "The clusters of unvaccinated kids act as reservoirs of disease," she says. "All you need is one school with a very low vaccination rate and disease can spread like wildfire." There is an easy splendour to the Northern Rivers, a singular combination of coast and hinterland, of velvety green hills and Federation-era towns that prompts visitors to dream of a second life, of cashing in their city chips, buying a weatherboard cottage and growing pumpkins in the backyard. This seems to apply especially to filmmakers, artists or rich young trustafarians, thousands of whom have poured into the area over the past 20 years. "There are very few born-and-bred locals left here any more," Jeffery says. "Most have moved away – they got so much for their land it was worth it."


Despite its reputation for sustainability, the Northern Rivers had its beginnings in extractive industries, its wealth born from whatever the first Europeans could chop down, dig up or kill. Following the arrival of cedar loggers in the 1850s, the sugar cane, cattle and dairy farmers moved in. In the 1930s, a meatworks opened in Byron Bay, and sand miners began stripping the beaches in search of zircon and rutile. In 1954, the Byron Bay Whaling Company landed its first whale, butchering it, according to local lore, right there on Main Beach. By the time the whaling stopped, in 1962, the first wave of surfers was showing up. Only 52 per cent of five-year-olds in the Mullumbimby area were fully immunised in 2015-2016, compared with 92.9 per cent nationally. The turning point, however – the region's rebirth, as it were – came in 1973, with the Aquarius Festival. Held over 10 days in May, the event drew some 5000 free-thinking individuals and alternative lifestylers to the fields around Nimbin, west of Mullumbimby, where they camped out, listened to music, got high and took their clothes off. Some liked it so much they stayed, setting up co-ops and communes and sowing the seeds for what would soon become Australia's counterculture capital. The first Aquarians were inherently sceptical. "They wanted to break away," Jeffery says. "They were looking for alternatives." Their sources of disaffection were many, from the government and consumer culture to mainstream medicine, the last of which came into particularly sharp focus with the roll-out, in the late 1970s, of a new vaccine for whooping cough. "It was a bad vaccine, the worst one we've had," says local paediatrician Dr Chris Ingall, who has worked in the Northern Rivers for 32 years. "It wasn't very effective, and it had marked side effects, like high-pitched crying and fever. The parents would take their children back to the doctor, and say, 'My child has had a bad reaction,' and the doctor would disregard them. They told them it must be a virus, and that it couldn't possibly be the vaccine. It alienated a lot of people." Though the whooping cough vaccine was used Australia-wide, the blowback was most keenly felt in the Northern Rivers. "It was a tinderbox effect," says Ingall. "People here were already suspicious of government, and vaccines were seen as a government intrusion." Researchers developed a far better vaccine in the 1990s. "But by then, we had created a whole group of parents up here who were disenfranchised by the medical system." Anti-vaxxer groups sprung up around the country, spreading doubt about the science behind vaccines and, in some cases, harassing medical staff at clinics that offered shots. With the advent of the internet and social media, anti-vax myths have been disseminated with terrifying ease, like spores in a tornado. (Under pressure from health authorities, social media giants such as Twitter and Facebook have recently committed to stopping the spread of misinformation around vaccines, and to prioritise credible sources when it comes to online searches.) Mullumbimby’s focus on alternative lifestyles and wellness draws tourists as well as tree-changing city-dwellers. Credit:Paul Harris


In the Northern Rivers, however, even some doctors have become susceptible to anti-vaxxer sentiment. One morning in Mullumbimby I get talking to a cafe owner, a middle-aged woman who moved here from Sydney nine years ago with her parents. "My dad had dementia and we wanted to get him out of the city, and my older brother was already living up here," she says. She immediately fell in love with the place. "There's such a colourful mix of people, and the fact we can live so close to the beaches, which in Sydney would have meant a day of car travel." After her second son was born, however, she went to a medical centre to get him vaccinated. "The first thing the doctor did was question me about my decision," she tells me. "He said, 'Have you researched it? Are you sure you want to do it, or are you only doing it because other people are doing it?' At the time," she says, "it struck me as unusual." But she went ahead and got the vaccination. Only 3600 people live in Mullum, as it's known by locals. There is one main street, some small but exceptionally good restaurants, a still functioning courthouse and a 115-year-old tin-roofed hotel called The Middle Pub. It's the kind of place where strangers call you "sweetheart". At sunset, the air seethes with the ecstatic screeching of the resident lorikeets, which gather by their thousands in the palm trees to feed. Part of the town's charm is the fact that there is no single big employer – no McDonald's or Hungry Jacks. As with Byron Bay and Bangalow, what really draws visitors and provides most of the jobs here is the alternative-health and wellness market, an area that has grown from a fringe enterprise into a sprawling, self-sustaining industry that involves natural therapies, organic food, the free-birthing movement and a constantly evolving suite of experimental treatments, from whalesong healing modalities to shamanic frog poison cleanses. People here pride themselves on living outside the paradigm: they get their medicines from Mullumbimby Herbals, a naturopathic dispensary in Stuart Street; they conduct reiki sessions on sick trees. As Jeffery put it to me: "There are more yogis in Byron Bay than anywhere outside India." The commitment to "living consciously", together with an unbending progressivism, have fostered an odd kind of group-think, an ideological microclimate that can, paradoxically, be antithetical to dissent. "People here can be so tunnel-visioned," the woman in the cafe had told me. "Mullum is meant to be a lovely, mellow, hippie town where everyone is so accepting. But people can eat you alive." Mullumbimby is meant to be a lovely, mellow, hippie town where everyone is so accepting. But people can eat you alive.

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