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No Jab, No Pay

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No Jab No Pay is an Australian policy initiative begun in 2016 which withholds three state payments – Child Care Benefit, the Child Care Rebate and a portion of the fortnightly Family Tax Benefit part A per child – for parents of children under 20 years of age who are not fully immunised or on a recognised catch-up schedule.[1]

No Jab No Play is a related policy that disallows unvaccinated children from attending preschool and childcare centres, and imposes fines on childcare centres that admit unvaccinated children.[2][3] The system allows exemptions for children who cannot be safely vaccinated for medical reasons.

History

[edit]

The policies grew out of a campaign championed by News Limited,[4][5] in 2013.[6] It was boosted by parent activists representing children who had died of preventable disease, notably the families of Riley Hughes and Dana McCaffery,[4] infants who died of pertussis, leading to a backlash of harassment and trolling from anti-vaccination activists.[7][8] Far-right politician Pauline Hanson also opposed the policy, though she later gave in to political pressure and backed the policy,[9] and clarified that she supports vaccination.[10] The campaign was a response to a rise in "conscientious objections", which had reached record levels[11] particularly in the Sunshine Coast area of Queensland,[12] where early attempts to pass legislation were knocked back in 2014.[13] Efforts to circumvent the legislation included the founding of more fake religions, of which the best known, the "Church of Conscious Living", was promoted by anti-vaccine group the Australian Vaccination Network[14][15] (since renamed to Australian Vaccination-risks Network after legal action over its deceptive name),[16] and by anti-vaccination activist Stephanie Messenger.[17]

No Jab No Pay was legislated in 2015,[18] came into effect January 1, 2016, and was expanded in July 2018.[19][20] By July 2016, 148,000 children who had not previously been fully immunised, were meeting the new requirements.[21]

No Jab No Play was introduced at the state level, in New South Wales, Queensland and Victoria in 2017,[22] leading to an immediate though small rise in immunisation rates,[23] with Western Australia, which has some of the lowest vaccination rates in the country, following in December 2018.[24]

Impact

[edit]

Public health researchers have had mixed evaluations of No Jab, No Pay and No Jab, No Play. Removing non-medical exemptions from vaccine requirements have been questioned on ethical grounds, the potential for coercive policies to lead to an increase in anti-vaccination sentiment, and the inequity of policy based on welfare conditionality.[25][26][27] A study on the impact of removing conscientious objection from financial payments and childcare enrolments found that the policies led to a significant increase in childhood vaccination above the pre-intervention trend. The effect of the policies were larger in areas with lower socio-economic status, higher rates of government benefits, and higher pre-intervention coverage rates.[28] A study of adolescent catch-up vaccination found that No Jab No Pay resulted in a large rise in catch-up vaccination.[29] A 2022 study examined the effect of No Jab No Play policies on vaccine adherence with a study design that isolated the effect of No Jab No Play policies distinct from federal mandates found that childcare mandate policies had a small positive impact on uptake.[30]

See also

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References

[edit]
  1. "No Jab No Pay new requirements fact sheet". Australian Government Department of Health. 18 December 2017. Archived from the original on 21 March 2018. Retrieved 3 February 2019.
  2. Baidawi, Adam (24 July 2017). "'No Jab, No Play': How Australia Is Handling the Vaccination Debate". The New York Times. ISSN 0362-4331. Retrieved 3 February 2019.
  3. "No Jab No Play, No Jab No Pay". National Centre for Immunisation Research and Surveillance. Retrieved 19 August 2021.
  4. 1 2 Kylie Sturgess (3 June 2013). "Retreating to the Church of Anti-Vaccination". Committee for Skeptical Inquiry. Retrieved 3 February 2019.
  5. Ward, Sean; Budarick, John (2021). "Adapting to the postmodern medical paradigm: how The Daily Telegraph used emotion and anecdote to legitimise vaccination". Media International Australia. 181 (1): 103–119. doi:10.1177/1329878X20975786. ISSN 1329-878X.
  6. Hansen, Jane (5 May 2013). "No jab, no play campaign launched to ban unvaccinated kids from childcare centres and preschools". news.com.au. News Corp Australia. Retrieved 3 February 2019.
  7. Cathy O'Leary (16 September 2015). "Anti-vaccination lobby stoops to a new low (Opinion)". The West Australian. Southern Cross Media Group. Retrieved 3 February 2019.
  8. Jane Hansen (25 April 2015). "Sick anti-vax trolls attack grieving mum". The Daily Telegraph (Sydney). Nationwide News, News Corp Australia. Retrieved 3 February 2019.
  9. "'I was wrong': Pauline Hanson apologises for vaccination test claims". The Guardian. 8 March 2017. ISSN 0261-3077. Retrieved 3 February 2019.
  10. Katharine Murphy (6 March 2017). "Pauline Hanson defends vaccination comments as 'personal opinion'". The Guardian. ISSN 0261-3077. Retrieved 3 February 2019.
  11. Ngo, Cindy (10 January 2014). "Vaccine objectors rise as parents skirt 'no jab, no play' law". The Sydney Morning Herald. Nine Entertainment. Retrieved 3 February 2019.
  12. Laura Chalmers (26 August 2014). "Revealed: Worst child vaccination regions". The Courier-Mail. News Corp Australia. Retrieved 3 February 2019.
  13. Megan Hughes (15 February 2014). "Vaccination: Yes or no? Debate continues as rates plummet". The Gladstone Observer. APN News & Media. Archived from the original on 4 February 2019. Retrieved 3 February 2019.
  14. Alicia Wood (29 May 2013). "Anti-vacc zealots form sham church". The Daily Telegraph (Sydney). Nationwide News, News Corp Australia. Retrieved 3 February 2019.
  15. Medew, Julia (28 January 2015). "Anti-vaccination group encourages parents to join fake church". The Sydney Morning Herald. nine Entertainment. Retrieved 3 February 2019.
  16. Jane Hansen (26 November 2013). "Anti-vaccination group loses appeal". The Daily Telegraph (Sydney). Nationwide News, News Corp Australia. Retrieved 3 February 2019.
  17. Davey, Melissa (28 January 2015). "Anti-vaccination campaigner Sherri Tenpenny cancels Australian tour". The Guardian. ISSN 0261-3077. Retrieved 3 February 2019.
  18. "'No Jab No Pay' and other immunisation measures". Parliament of Australia. Archived from the original on 30 November 2019. Retrieved 3 February 2019.
  19. "No Jab, No Pay changes". Australian Medical Association. 4 May 2017. Archived from the original on 3 February 2019. Retrieved 3 February 2019.
  20. Tory Shepherd (2 July 2018). "No Jab, No Pay 2018: Changes to vaccination laws begin July 1". news.com.au. News Corp Australia. Retrieved 3 February 2019.
  21. "'No jab, no pay': thousands immunise children to avoid family payment cuts". The Guardian. 30 July 2016. ISSN 0261-3077. Retrieved 3 February 2019.
  22. Lillebuen, Steve (14 November 2017). "Victoria flags tougher 'No Jab No Play' childcare vaccine laws". The Age. nine Entertainment. Retrieved 3 February 2019.
  23. Sati, Wiriya (13 September 2018). "Anti-vax welfare cut leads to increase in vaccinations". ABC News (Australia). Retrieved 3 February 2019.
  24. "WA proceeds with 'no jab, no play' laws". Special Broadcasting Service. 14 December 2018. Retrieved 3 February 2019.
  25. Curchin, K (2019). "The Illiberalism of Behavioural Conditionality: A Critique of Australia's 'No Jab, No Pay' Policy". Journal of Social Policy. 48 (4): 789–805. doi:10.1017/S0047279418000879. S2CID 149897863.
  26. Beard, Frank H; Leask, Julie; McIntyre, Peter (2017). "No Jab, No Pay and vaccine refusal in Australia: the jury is out". Medical Journal of Australia. 206 (9): 381–383. doi:10.5694/mja16.00944. PMID 28490296. S2CID 27439974.
  27. Leask, Julie; Danchin, Margie (2017). "Imposing penalties for vaccine rejection requires strong scrutiny". Journal of Paediatrics and Child Health. 53 (5): 439–444. doi:10.1111/jpc.13472. hdl:11343/292416. PMID 28168768.
  28. Li, Ang.; Toll, Mathew. (2020). "Removing conscientious objection: The impact of 'No Jab No Pay' and 'No Jab No Play' vaccine policies in Australia". Preventive Medicine. 145 106406. doi:10.1016/j.ypmed.2020.106406. ISSN 0091-7435. PMID 33388333. S2CID 230489130.
  29. Hull, Brynley P; Beard, Frank H; Hendry, Alexandra J; Dey, Aditi; Macartney, Kristine (2020). ""No jab, no pay": catch‐up vaccination activity during its first two years". Medical Journal of Australia. 213 (8): 364–369. doi:10.5694/mja2.50780. PMC 7692886. PMID 32951230.
  30. Toll, Mathew; Li, Ang (2022). "Vaccine mandates on childcare entry without conscientious objection exemptions: A quasi-experimental panel study". Vaccine. 40 (51): 7440–7450. doi:10.1016/j.vaccine.2022.03.071. PMID 35501181. S2CID 248455593.