How one hippie town became the anti-vaxxer capital of Australia

How one hippie town became the anti-vaxxer capital of Australia

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".

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 reporterEve 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 Woolies, 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.

Perhaps the best example of this is the so-called Octopus Salad Incident. In 2017, a local horticulture teacher name Di Hart posted a recipe for octopus salad on Mullumbytes, the community Facebook page. "I'd just read how people with multiple sclerosis could benefit from eating more seafood," says Hart. "But seafood is expensive, so I put up this recipe with octopus, which is pretty cheap." Within two minutes, the first comment had come through: "Murderer." Then came more messages, mostly from vegans, including photos of what appeared to be a human foetus in a bowl and shots of slaughtered animals. "They just kept coming, until the administrator sent me a message saying he was taking the post down."

That night, Hart thought it over. "I'd always believed that Mullumbytes was a site for the open exchange of ideas." So the next morning, she wrote a piece on the site about freedom of speech, and re-posted the recipe. "All hell broke loose," Hart says. "Soon, there were 840 comments. In the end, there were these two guys arguing about Israel and Palestine saying they wanted to meet up in a dark alley and sort it out."

Hart gained a certain renown. "I remember going to my ukulele lesson and one of the women saying to me, 'Oh my god, you're the Octopus Lady!'" Hart admires the locals' sense of engagement. "They care passionately about things. But a little bit of knowledge can be a dangerous thing here."

One cloudless afternoon, I drive down the narrow, winding road that connects Mullumbimby to Byron Bay, where I have an appointment in a cafe with a woman who I'll call Helen. (Like so many people I talk to for this story, Helen doesn't want me to use her real name. "People can be very judgy about anti-vaxxers," she says.) Helen is in her mid-50s, with hazel eyes and honey-coloured hair, and an air of tranquillity so profound that she puts me immediately at ease, like a non-pharmaceutical calmative. Helen has brought to the cafe some reading material, books on natural mothering and the like. She says caring for her kids has always been the most important thing in her life. "I just wanted to be the best mum and wife I could be. If the mother in the family isn't nourished, then it all goes to shit." She has mostly been a stay-at-home mum, but is now a trained doula, a non-medical assistant to pregnant women.

Helen has been against vaccination since her youngest son had a violent reaction to a diphtheria shot 18 years ago. She consulted her homeopath, who gave her a copy of Vaccination Roulette, a manual produced by the then Australian Vaccine Network (now known as the AntiVaccination-risks Network), a virulently antivax group founded by local woman Meryl Dorey. "I read the book, and I went, 'Right, no more vaccines!'" When her other kids were due their booster shots, Helen either kept them home or said they weren't well enough. "Vaccines are poisons," Helen says. "There's just so much sickness around. Cancer, autoimmune diseases, diabetes. I question that." At the same time, "I'm not evangelical about it. I don't tell people not to vaccinate, especially mothers. Mothers get enough judgment as it is."

Experts in vaccine hesitancy often talk about how, for some people, not vaccinating their children is a form of posturing, a sign of superior parenting. But Helen is not like that. "In a perfect world I'd prefer it if people didn't vaccinate, but that's not the world we live in," she says. "As soon as you become rigid, you aren't being compassionate to others. That's what I'm trying to do – accept things for what they are. But I'm not there yet." Recently, Helen endured an extremely traumatic experience, the details of which she'd prefer not to go into. It's been an awful time for her and the family, but things are getting better. "Byron's good that way," she says. "It's a healing centre. I've heard that there's an obsidian black rock under the earth that goes from Mt Warning to Wategos Beach, that absorbs all the negative energy. I really believe that. It helps me a lot."

Mullumbimby’s street scene.Credit:Paul Harris

One of the things you often hear in Mullumbimby is that if you eat organic food and exercise regularly, you will stay healthier and therefore won't need vaccines. A woman I talk to in The Patch cafe, diagonally opposite the Middle Pub, tells me that ever since moving up from Sydney four years ago, she has become much more aware of what she puts in her body. "I don't take any pharmaceuticals at all," she says. "Not even antibiotics. And I haven't even taken one headache pill since I've been here." When she gets sick – colds, coughs – she simply "fights it off".

The idea of developing "natural immunity" has huge appeal. Many locals believe that not vaccinating has made the whole community healthier. (This is incorrect: figures from the Australian Institute of Health and Welfare show that life expectancy, child mortality and rates of all cancers are worse in this region than the national averages.) People used to hold "pox parties", where parents would deliberately expose their children to infection, so as to "build up their resistance". In the Northern Rivers, there are still Facebook groups – most of them members-only – where parents encourage one another to visit their chickenpox-infected friends.

“Homeopathic vaccine” distributor Isaac Golden. Credit:Michael Copp

Nosodes, or "homeopathic vaccines", have also become popular. The go-to man for nosodes, which are taken orally, is Isaac Golden, a homeopath in Gisborne, north-west of Melbourne. (Golden mails his nosode kits to clients around Australia.) According to his website, Golden began investigating alternatives to traditional vaccines after a vaccine injured one of his daughters in the late 1970s. He has since become a "world authority" on homeoprophylaxis.

At a talk in Sunbury, Victoria, in 2015, Golden told an audience that it was important to get a nosode booster before going to Byron Bay, which he described as the "whooping cough capital of Australia". He also claimed that diseases like mumps, rubella, chickenpox and rotavirus are "very easily dealt with" by homeopathic treatments.

One afternoon, while enjoying a Dancing Unicorn smoothie at the Rainbow Kitchen cafe in Mullum, I phone Golden to ask him about the ingredients of his kits and their price, neither of which are mentioned on his website. He says to email him some questions. When I do so, he writes back to tell me that he can't answer my questions as this would constitute advertising homeoprophylaxis, which is prohibited by the Therapeutic Goods Administration. I then head to Mullumbimby Herbals to ask if they have any nosodes available. A woman there says she doesn't want to comment, because she's not the owner and also because vaccinations are "a very controversial issue". She takes my number and says she'll pass it onto the owner, but I never hear back.

Controversial anti-vax activist Meryl Dorey.Credit:Naz Mulla

Vaccine hesitancy experts make a distinction between ordinary anti-vaxxers – like Helen, in Byron Bay, and Eve Jeffery, at The Echo – and professional anti-vaxxers, who actively campaign against vaccinations. There is a long list of professional anti-vaxxers in Australia, including Tay Winterstein, wife of rugby league player Frank Winterstein, who charges $200 a head for her anti-vax workshops, and academic Judy Wilyman, who has promoted the theory that the WHO and the pharmaceutical industry have conspired to create panic around diseases in order to sell more vaccines. Wilyman has also appeared in court as an expert witness for parents who do not wish to vaccinate their children.

But perhaps the most active, and controversial, anti-vaxxer is Meryl Dorey. Dorey, who is 60, was raised in Brooklyn, New York. In 1988, she moved to Australia after marrying a macadamia nut farmer from Newrybar, a small town just south of Mullumbimby. A year later they had their first child, a boy, who, according to Dorey, had a serious reaction to a vaccination for diphtheria, tetanus and pertussis. "He was arching his back, screaming, and he stopped feeding," says Dorey, who I meet over coffee in Bangalow.

Dorey's son recovered, but her anti-vax fire had been well and truly lit. In 1994, she started the Australian Vaccination Network, an advocacy group for people who believed they had been injured by vaccines. (In 2013, the Administrative Decisions Tribunal found that the name Australian Vaccination Network was misleading, and ordered Dorey to change it, which she did, renaming her group the Australian Vaccination-risks Network. The group still goes by the acronym AVN.)

The AVN lobbies government, and provides what they call "buddies" who accompany people to doctor appointments to make sure they don't get bullied into being vaccinated against their will. These days, it maintains several websites and Facebook pages that sell anti-vax books by Judy Wilyman, among others, pamphlets on homeopathy and colon hydrotherapy, and of course, AVN memberships, for $25 a year. (The AVN has 1500 financial members and 20,000 on its mailing list.) Financial records show that the AVN has, in years past, brought in as much as $160,000 in donations, memberships, and book sales.

Dorey is unfailingly polite, with a vaguely hangdog expression that suggests a weary equanimity in the face of great odds. (One of Dorey's websites suggests that anti-vaxxers are the new Jews, persecuted for their beliefs.) But once she gets going, she is all but unstoppable, methodically reciting a rap sheet of reality-free anti-vax assertions including, for example, that all vaccines are contaminated; that kids who are not vaccinated are healthier than those who are; and that anti-vax "whistleblowers" are routinely silenced by Big Pharma and the medical establishment. She also tells me that vaccines cause autism, but that I will not be able to report this because The Sydney Morning Herald and The Age are owned by James Packer (which they aren't), and that Packer is "deeply involved in the pharmaceutical industry" (which he isn't).

According to Dr David Hawkes, director of Microbiology at the Victorian Cytology Service and spokesperson for Stop the AVN (SAVN), a group that campaigns against "anti-vaccine cranks", Dorey has done more than almost anybody to popularise anti-vaxxer myths through her writing and speaking engagements, and by denigrating vaccination advocates, who she has called "rabid" and "vicious".

In 2009, Dorey unsuccessfully attempted to gain access to the medical records of Dana McCaffery, the four-week-old girl from Lennox Head who died of whooping cough. (Dana had been too young to get vaccinated.) Following their daughter's death, the McCafferys pushed for greater vaccination awareness, which is when Dorey accused them of making Dana a "martyr because she supposedly died from whooping cough". The McCafferys have subsequently been attacked as "whining" liars and "media whores"; one message recently posted on Dana's memorial page expressed the hope that they "or their loved ones" suffer "some form of catastrophic vaccine injury … The sooner the better."

Dorey is now so controversial a figure that three of the most highly qualified specialists in vaccine hesitancy refused to take part in this story if I mentioned her name. And yet she is, inevitably, a contact point for other, more moderate voices in the anti-vax space, one of whom is Kerry-Anne Manning. Manning, who is 63, lives in Ballina, south of Mullumbimby, with her 20-something daughter Leah, in an immaculately kept home with clipped hedges out the front and family photos in the hallway. For reasons I can't quite ascertain, Dorey has invited herself to the interview, which she insists on recording.

Manning trained as a nurse but now works as a long-haul flight attendant. Her troubles began in 2011 when Leah, then 14, received Gardasil, a vaccine that protects young women from the human papilloma virus (HPV), which is known to cause cervical cancer. "Within a few weeks, Leah started complaining about stomach pains, dizziness, nausea," says Manning, sitting on a couch in the formal lounge, her springer spaniel, Zoe, at her feet. Manning thought it might be an inner-ear issue, and took Leah to an ear, nose and throat specialist. "He told us that Leah was probably just attention-seeking," she says. The minute Leah walked out, she burst into tears.

So began a medical merry-go-round, with Manning and Leah shunted from specialist to specialist, before finally receiving a diagnosis of postural orthostatic tachycardia syndrome (POTS), a condition that affects circulation, and lupus, an inflammatory autoimmune disease. What had caused these conditions was unclear. Then one day, Manning was in Los Angeles on a work trip, researching POTS online when she came across a comment on a Facebook page about the condition being linked to Gardasil. "All the hairs on my arms stood up," Manning says. "I thought, 'What have I done?'"

Gardasil has been associated with short-term adverse reactions, such as dizziness and stomach aches. But several studies, including one by the European Medicines Agency, in 2015, have found no connection between the vaccine and POTS. Still, Manning remains convinced of a link between Gardasil and Leah's condition. "We only have one child, and she had dreams, and all those have been taken away."

Manning doesn't consider herself an anti-vaxxer. "I'm pro-choice." And she regrets that vaccination has become so contentious. "I know people in Brisbane who haven't vaccinated, but they don't tell anyone because they know they'll get grief."

Manning is not a conspiracist. She is careful, considered and well-read, way too smart to be co-opted by anyone. Yet she finds herself shoulder-to-shoulder with the likes of Dorey and the AVN, on what two centuries of science have shown to be the wrong side of the issue.

In 2015, the federal government introduced the "No Jab, No Pay" policy, which blocks welfare payments to parents who refuse to vaccinate their children. (The policy also abolished conscientious objection as an excuse for not vaccinating.) This was followed, in 2017, by state-based "No Jab, No Play" provisions, which ban unvaccinated children from being enrolled in preschool. The measures have upped the stakes: I have been told more than once about marriages breaking down when couples couldn't agree on whether to vaccinate their children. I also hear about people setting up "renegade" daycare centres where non-vaccinating parents can place their kids.

The government measures have been a success: as of 2018, vaccination rates across Australia have risen 1 to 2 per cent. There are no specific figures for the Northern Rivers, but if you speak to medical practitioners in the area, there appears to be a backlog of people who are now catching up on their vaccination schedules. "For some of these people, I think what No Jab, No Pay has shown is that, when push comes to shove, most vaccine-hesitant people don't feel strongly enough about it to actually sacrifice financially," says the Victorian Cytology Service's David Hawkes.

In some instances, however, the governments' policies have provided yet another reason not to vaccinate. At Mullumbimby's Friday Farmers Market, I meet a 38-year-old woman who works as a teacher at a local high school. She is not against vaccination per se: indeed, both her children have received their vaccinations, except for Gardasil. She is, however, against compulsory vaccination, which is "using the welfare system to punish people. It's unfair. If you're rich, and not dependent on welfare, it won't impact you." It all goes back to paternalism, and the government's neo-liberal agenda, she says. "It's freedom through property ownership and asset wealth. That's what gives you the freedom to make your own choices."

There is something in this: even some experts have said that No Jab, No Pay unfairly impacts the poor. Either way, when it comes to challenging such deeply held beliefs, education, not coercion, is the key. "We like to say that 'Minds will be changed over a thousand cups of tea,'" says Rachel Heap, from the Northern Rivers Vaccination Supporters group. "That's how long the conversations go for. Sometimes we change minds. Not always. Because you can't overload people with facts – you have to really listen first. And that doesn't happen in a short period of time."

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