No Jab No Pay is an Australian policy initiative 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 grassroots campaign championed by News Limited,[4] in 2013.[5] 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.[6][7] Far-right politician Pauline Hanson also opposed the policy, though she later gave in to political pressure and backed the policy.[8] and clarified that she supports vaccination.[9] The campaign was a response to a rise in "conscientious objections", which had reached record levels[10] particularly in the Sunshine Coast area of Queensland,[11] where early attempts to pass legislation were knocked back in 2014.[12] 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[13][14] (since renamed to Australian Vaccination-risks Network after legal action over its deceptive name),[15] and by anti-vaccination activist Stephanie Messenger.[16]

No Jab No Pay was legislated in 2015,[17] came into effect January 1, 2016, and was expanded in July 2018.[18][19] By July 2016, 148,000 children who had not previously been fully immunised, were meeting the new requirements.[20]

No Jab No Play was introduced at the state level, in New South Wales, Queensland and Victoria in 2017,[21] leading to an immediate though small rise in immunisation rates,[22] with Western Australia, which has some of the lowest vaccination rates in the country, following in December 2018.[23]

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.[24][25][26] 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.[27] A study of adolescent catch-up vaccination found that No Jab No Pay resulted in a large rise in catch up vaccination.[28] 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.[29]

See also edit

References edit

  1. ^ Health, Australian Government Department of (18 December 2017). "No Jab No Pay new requirements fact sheet". 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. ^ a b "Retreating to the Church of Anti-Vaccination – CSI". Retrieved 3 February 2019.
  5. ^ Hansen, Jane. "No jab, no play campaign launched to ban unvaccinated kids from childcare centres and preschools". Retrieved 3 February 2019.
  6. ^ "Anti-vaccination lobby stoops to a new low". 16 September 2015. Retrieved 3 February 2019.
  7. ^ "Sick anti-vax trolls attack grieving mum". 25 April 2015. Retrieved 3 February 2019.
  8. ^ Guardian Staff (8 March 2017). "'I was wrong': Pauline Hanson apologises for vaccination test claims". The Guardian. ISSN 0261-3077. Retrieved 3 February 2019.
  9. ^ editor, Katharine Murphy Political (6 March 2017). "Pauline Hanson defends vaccination comments as 'personal opinion'". The Guardian. ISSN 0261-3077. Retrieved 3 February 2019. {{cite news}}: |last= has generic name (help)
  10. ^ Ngo, Cindy (10 January 2014). "Vaccine objectors rise as parents skirt 'no jab, no play' law". Retrieved 3 February 2019.
  11. ^ "Revealed: Worst child vaccination regions". 26 August 2014. Retrieved 3 February 2019.
  12. ^ "Vaccination: Yes or no? Debate continues as rates plummet". Retrieved 3 February 2019.
  13. ^ "Anti-vacc zealots form sham church". 29 May 2013. Retrieved 3 February 2019.
  14. ^ Medew, Julia (28 January 2015). "Anti-vaccination group encourages parents to join fake church". Retrieved 3 February 2019.
  15. ^ "Anti-vaccination group loses appeal". 26 November 2013. Retrieved 3 February 2019.
  16. ^ Davey, Melissa (28 January 2015). "Anti-vaccination campaigner Sherri Tenpenny cancels Australian tour". The Guardian. ISSN 0261-3077. Retrieved 3 February 2019.
  17. ^ corporateName=Commonwealth Parliament; address=Parliament House, Canberra. "'No Jab No Pay' and other immunisation measures". Retrieved 3 February 2019.{{cite web}}: CS1 maint: multiple names: authors list (link)
  18. ^ "No Jab, No Pay changes". 4 May 2017. Retrieved 3 February 2019.
  19. ^ "No Jab, No Pay 2018: Changes to vaccination laws begin July 1". Retrieved 3 February 2019.
  20. ^ Guardian Staff; agencies (30 July 2016). "'No jab, no pay': thousands immunise children to avoid family payment cuts". The Guardian. ISSN 0261-3077. Retrieved 3 February 2019.
  21. ^ Lillebuen, Steve (14 November 2017). "Victoria flags tougher 'No Jab No Play' childcare vaccine laws". Retrieved 3 February 2019.
  22. ^ Sati, Wiriya (13 September 2018). "Anti-vax welfare cut leads to increase in vaccinations". Retrieved 3 February 2019.
  23. ^ "WA proceeds with 'no jab, no play' laws". Retrieved 3 February 2019.
  24. ^ 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.
  25. ^ 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.
  26. ^ 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.
  27. ^ 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.
  28. ^ 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". Med J Aust. 213 (8): 364–369. doi:10.5694/mja2.50780. PMC 7692886. PMID 32951230.
  29. ^ 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.