The main street of Mullumbimby.(
ABC News: Bridget Judd
Mullumbimby has long been defined by its "live and let live" ethos. But for those left to grapple with the reality of lagging vaccination rates, this isn't a game of semantics it's life and death.
Take a trip to the Brunswick Valley, where the tiny town of Mullumbimby sits under the shadows of Mount Chincogan, and there's one topic that's met with a pause.
"Around here, vaccines are like politics or religion," says local Heidi Robertson.
"You just don't bring it up in conversation."
With childhood immunisation rates in northern New South Wales among the lowest in the country, this reticence is unsurprising.
ABC News: Bridget Judd
A hotbed for alternative medicine, the laidback community has long been defined by its "live and let live" ethos and with it, comes a familiar phrase.
"We're not anti-vaxx, we're just pro-choice."
But for those left to grapple with the reality of lagging vaccination rates, it isn't a game of semantics: it is, quite literally, life or death.
And they're determined to change the narrative.
"You mention to anyone Byron Bay, Mullumbimby or Nimbin, and the first thing that pops into their mind is the hippie culture," says Robertson from the Northern Rivers Vaccination Supporters, a grassroots group of parents, locals and healthcare providers trying to improve vaccination rates.
"And if you move here looking for that alternative lifestyle, being anti-vaccination is a part of that."
ABC News: Bridget Judd
Surrounded by dense farmland that gives way to sweeping views of the hinterland, the former timber town is far more nuanced than its banal stereotypes would suggest.
Amidst frustration with Australia's involvement in the Vietnam War, "draft dodgers", university students and 20-somethings who had tired of "the rat race" migrated to the region in the late 60s and early 70s, says local filmmaker, Sharon Shostak.
Brunswick Valley Historical Society/Sharon Stozak: Mullumbimby's Madness
Brunswick Valley Historical Society/Sharon Stozak: Mullumbimby's Madness
Brunswick Valley Historical Society/Sharon Shostak: Mullumbimby's Madness
Even before this, the region had experienced waves of settlement: first farmers, then "a wave of Chinese settlers, a wave of Italians", says Shostak, who documented the history of the town in her three-part series, Mullumbimby's Madness.
"Each time there was this wave of settlers coming through the town. So we're kind of used to weird, different, unusual, and are very accepting, there was this tradition of just integrating quite easily."
Now an eclectic mix of wellness stores, organics and small business, there is a communal sense of responsibility that underpins Mullumbimby: to the environment, to sustainability, and to one another.
But walk through the centre of town, and you'll come to understand why its reputation as a hippy-holdout just won't budge.
ABC News: Bridget Judd
By the local supermarket, a barefoot busker breaks from the group, retreating down an alleyway to light a joint. Nearby, people filter in and out of a crystal sanctuary and herbal dispensary offering naturopathic medicines and consultations.
And there, above a bespoke retail store on the town's main street, is a banner that hardly draws a second glance.
"NO FORCED INJECTIONS," it reads. "MY BODY MY CHOICE."
Step off the main street and into the GP's office, and you get a different story.
It's a sight Dr Chris Ingall will never forget. A four-week-old baby, bleeding from the mouth and nose.
"It's an awful, awful sight for a little bub like that," he says softly.
"Cerebral, pulmonary, bowel just haemorrhaging."
ABC News: Bridget Judd
It was 2010, and Ingall a paediatrician in nearby Lismore knew immediately the child was suffering from vitamin K deficiency bleeding (VKDB), a potentially life-threatening ailment in infants up to six months of age.
The natural deficiency killed more than a dozen babies per year in NSW in the late 1960s and early 70s, before vitamin K injections were widely adopted.
"This mum had been told by a healthcare provider, who was actually on the state payroll in Byron, the vitamin K was a 'vaccine', and that it was not necessary," Ingall says.
"I tried to explain to her at the time the baby's coagulation profile was that of a child who was in need of vitamin K. But it was too late. They'd passed away."
"She did not want to face the fact that it was connected."
ABC News: Bridget Judd
ABC News: Bridget Judd
Though a harrowing scenario, it is not unprecedented.
Research into incidents of VKDB in Australian infants between 1993 and 2017, published in the BMJ, found the number of recorded cases following parental refusals "doubled in the second half of the study and further increased in the last five years" of it.
Of the 14 cases of VKDB reported between 2013 and 2017, 71 per cent (10) did not receive vitamin K because their parents refused consent.
The study found 39 per cent of cases following parental refusal occurred in northern NSW and south-east Queensland, "areas where immunisation refusal rates are highest in Australia".
"The [baby] could have had a great life," Ingall says. "But they were denied that, just through a piece of information, which was wrong and believed."
For most, it is an unfathomable contradiction.
How can someone want what is best for their child, while simultaneously rejecting the medical advice that could save their life?
It's "not a deficit in knowledge that's the problem", Robertson says.
"Your level of education or level of intelligence makes no difference," she says. "It's far more complicated than that."
Source: NSW Health
Across the Byron shire, which takes in Mullumbimby, just 63.6 per cent of children aged two were fully immunised as of June last year significantly below the state average of 91.4 per cent.
At five years, that figure increases to 73.9 per cent (compared to the state average of 94.2 per cent). But for those frustrated by the region's vaccination rates, these aren't just numbers they're decisions that carry real and sometimes fatal consequences for those most vulnerable.
During a whooping cough outbreak that swept through NSW in 2009, a four-week-old baby girl lost her life.
In the same week she passed away in Lismore Base Hospital, two other babies had to be airlifted to Brisbane for emergency treatment.
Robertson says the family of the baby who died "were absolutely slammed and vilified on social media by anti-vaccination people who said they were lying about their baby having even had whooping cough".
"Some people said 'your baby didn't even exist'."
While a scepticism to vaccines was almost the "default clause" when Ingall first moved to the region in the 1980s, he believes anti-vaccination campaigners were galvanised by global controversy over the pertussis whole-cell vaccines, which were used to prevent whooping cough before being phased out in Australia a decade later in favour of the acellular vaccine.
And on that, he is candid: "We gave them a platform".
At the turn of the 1980s, global confidence in the whole-cell vaccine had begun to wane. Reports had emerged from the United Kingdom about alleged neurological reactions, while concerns over the use of whole-cell vaccines in the United States led to lawsuits against vaccine manufacturers, pushing up prices and prompting some companies to cease production.
Back home, side-effects like fever and irritability had been reported in children, but some within the community felt "marginalised and silenced" by doctors, says Ingall, creating "a situation where people no longer trusted it".
Confused about Australia's vaccine rollout? We've tracked down the answers to the questions you've been asking.
During a debate at the town hall in the late 1980s, he recalls a "visceral howl" from the audience when a doctor took to the stage to try to calm their concerns.
"They'd taken their children along for vaccination, they'd had these reactions, and they've been told, 'Oh no, it's just a cold', or 'it's just this' or 'just that'," he says.
"And we've got to be really open about that, because these events will come up again.
"We gave them a platform, a platform that they had been marginalised and silenced."
Trust, or rather, a lack thereof: it's a familiar theme that emerges in Mullumbimby's relationship with mainstream medicine.
As the region's reputation as a counter-culture hub was beginning to take hold in the 70s, Shostak notes, a natural "evolution of wellness" was emerging.
Brunswick Valley Historical Society/Sharon Stozak: Mullumbimby's Madness
"People weren't just willing to accept what they were given or what they were told to do," she says.
Brunswick Valley Historical Society/Sharon Stozak: Mullumbimby's Madness
"I think a big, big factor in the settlement was people looking for alternatives."
In what some view asan inexorable legacy of thecommunity's early search forhealth and wellbeing, the useof naturopaths and homeopaths asprimary healthcare providers isnot unusual.
Scan the health notices inthe local paper, Shostak says, and "it's just like an encyclopedia of alternative therapies" something she sees as a positive that has"given people a chance toexperiment".
But Robertson is concerned bytheir level of influence. "They are big swayer ofopinion in this region,"she says.
"The naturopaths and homeopathsand the chiropractors, [some will say] they cankeep your immune system healthyand you don't need vaccinations," she says.
Source: NSW Health
"We've even got homeopaths here selling 'alternatives to vaccination' under the counter. It's against the law to do that ... But everyone knows that they do."
According to the National Centre for Immunisation Research and Surveillance, the Australian Homoeopathic Association has "strict guidelines in place regarding the use of homoeopathic 'immunisation'".
That includes a "compulsory consent form stating the treatment is not an immunisation, that no prophylactic treatment guarantees immunity from infectious disease, and that the evidence for the efficacy of homoeopathic 'immunisation' is limited".
Asked about its policy on immunisations and how it's enforced, AHA president Gerry Dendrinos said homeopathic prophylaxis was "not a substitute for vaccinations", adding that practitioners are "not allowed to advise on vaccination and certainly not allowed to dissuade people".
"Practitioners that do that are in breach of the code of conduct, and we do have a compliance pathway where those complaints in the public are dealt with, where we can look at practitioners who have exceeded the scope of practice."
When it comes to tackling misinformation around vaccines, Ingall is candid: "It's a bit like Scott Morrison presenting at a Labor lunch".
"He might have the absolute best logic and reasoning behind what he's saying, but he's not going to sway too many true believers."
With the coronavirus vaccine rollout beginning, those on the frontline are acutely aware of the challenges they face in the region.
In an alcove beside the building where an anti-vaccination banner hangs, a man who identifies himself as David mills by a microphone stand, his guitar case lined with flyers about vaccines and 5G.
ABC News: Bridget Judd
"They want to make more money," he says of the vaccine. "If it's mandatory, then more people get the vax."
The federal government has been clear that the vaccine will not be mandatory and Robertson says there are some who simply "will not get it under any circumstances because they're completely anti-vaccination".
But she points to another growing demographic: the "maybes" or "fence sitters", who are hesitant about getting such a new vaccine.
This reticence is not limited to the coronavirus rollout. Across the wider vaccination divide, Robertson says, "I hear, 'I'm not so much anti-vaccination, but I just can't get past giving my baby a whole bunch of vaccinations'".
It's groups like these that her network hope to reach by "listening to what their concerns are, and then addressing them", one cup of tea at a time.
"It doesn't happen in one conversation," she says. "We have the '1,000 cups of tea' approach, because you just can't expect it to [happen immediately]."
ABC News: Bridget Judd
ABC News: Bridget Judd
ABC News: Bridget Judd
Alongside a team of doctors from across the region, Ingall is determined to do his part to change the narrative around vaccinations.
Having witnessed the needless death of young children, he doesn't mince words: "I will say to [parents], I have watched babies die. I don't want your baby to be one of those babies'."
"These things happen. Join the dots," he says.
"This is real, and what you're being told is not as real as this."
Words and photography: Bridget Judd
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