The national ‘No Jab, No Pay’ policy has been associated with substantial catch-up vaccination activity in lower socio-economic status areas in Australia, according to research published today by the Medical Journal of Australia.
Introduced on 1 January 2016, the ‘No Jab, No Pay” policy extended the existing vaccination requirements for receiving federal family assistance payments by removing non-medical (conscientious objection) exemptions and tightening guidelines for medical exemptions.
Researchers from the University of Sydney and the National Centre for Immunisation Research and Surveillance (NCIRS), analysed data from the Australian Immunisation Register on catch-up vaccination rates for:
They also examined catch-up vaccination rates for the second dose of measles–mumps–rubella vaccine (MMR2) in the latter two age groups:
The proportion of incompletely vaccinated children aged 5 to less than 7 years who received catch-up DTPa3:
Of 407 332 incompletely vaccinated adolescents aged 10 to less than 20 years:
“Our findings suggest that, while monetary sanctions are effective in promoting catch-up vaccination, their impact varies with socio-economic disadvantage,” concluded the authors, led by Dr Frank Beard, NCIRS Associate Director, Surveillance, Coverage, Evaluation and Social Science, and Senior Lecturer at the University of Sydney.
“Moreover, the lack of change in MMR1 catch-up activity in children aged 5 to less than 7 years suggests little impact on those who reject vaccination, and that expansion of age requirements was the more effective policy lever in this period.”said Dr Beard.
Co-author Professor Julie Leask, NCIRS Professorial Fellow and University of Sydney expert on vaccination attitudes and behaviour said:
“Many factors contribute to incomplete vaccination; a comprehensive suite of measures, particularly for reducing barriers to access and incorporating systematic reminders, is therefore essential for improving coverage. Requirements alone are not enough,”
“The full scope of consequences of strict vaccination requirements should be carefully examined by any country considering such measures. It may be possible to find a reasonable middle ground that increases catch-up while not disadvantaging certain families.”
Declaration: The authors have no conflicts of interest to declare. The National Centre for Immunisation Research and Surveillance is supported by the Australian Department of Health, the NSW Ministry of Health, and The Children’s Hospital at Westmead.