No Jab, No Pay Explained

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

The policies grew out of a grassroots 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, 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

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

Notes and References

  1. Web site: No Jab No Pay new requirements fact sheet . Health . Australian Government Department of . 18 December 2017 . 3 February 2019 . en.
  2. News: 'No Jab, No Play': How Australia Is Handling the Vaccination Debate . Baidawi . Adam . 24 July 2017 . The New York Times . 3 February 2019 . en-US . 0362-4331.
  3. Web site: No Jab No Play, No Jab No Pay . National Centre for Immunisation Research and Surveillance . 19 August 2021.
  4. News: Retreating to the Church of Anti-Vaccination – CSI . 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 . en . 181 . 1 . 103–119 . 10.1177/1329878X20975786 . 1329-878X.
  6. News: No jab, no play campaign launched to ban unvaccinated kids from childcare centres and preschools . Hansen . Jane . 3 February 2019.
  7. News: Anti-vaccination lobby stoops to a new low . 16 September 2015 . 3 February 2019 . en.
  8. News: Sick anti-vax trolls attack grieving mum . 25 April 2015 . 3 February 2019 . en.
  9. News: 'I was wrong': Pauline Hanson apologises for vaccination test claims . Guardian Staff . 8 March 2017 . The Guardian . 3 February 2019 . en-GB . 0261-3077.
  10. News: Pauline Hanson defends vaccination comments as 'personal opinion' . editor . Katharine Murphy Political . 6 March 2017 . The Guardian . 3 February 2019 . en-GB . 0261-3077.
  11. News: Vaccine objectors rise as parents skirt 'no jab, no play' law . Ngo . Cindy . 10 January 2014 . 3 February 2019 . en.
  12. News: Revealed: Worst child vaccination regions . 26 August 2014 . 3 February 2019 . en.
  13. News: Vaccination: Yes or no? Debate continues as rates plummet . 3 February 2019 . en.
  14. News: Anti-vacc zealots form sham church . 29 May 2013 . 3 February 2019 . en.
  15. News: Anti-vaccination group encourages parents to join fake church . Medew . Julia . 28 January 2015 . 3 February 2019 . en.
  16. News: Anti-vaccination group loses appeal . 26 November 2013 . 3 February 2019 . en.
  17. News: Anti-vaccination campaigner Sherri Tenpenny cancels Australian tour . Davey . Melissa . 28 January 2015 . The Guardian . 3 February 2019 . en-GB . 0261-3077.
  18. Web site: 'No Jab No Pay' and other immunisation measures . corporateName=Commonwealth Parliament; address=Parliament House . Canberra . en-AU . 3 February 2019.
  19. News: No Jab, No Pay changes . 4 May 2017 . 3 February 2019 . en.
  20. News: No Jab, No Pay 2018: Changes to vaccination laws begin July 1 . 3 February 2019.
  21. News: 'No jab, no pay': thousands immunise children to avoid family payment cuts . Guardian Staff . 30 July 2016 . The Guardian . 3 February 2019 . agencies . en-GB . 0261-3077.
  22. News: Victoria flags tougher 'No Jab No Play' childcare vaccine laws . Lillebuen . Steve . 14 November 2017 . 3 February 2019 . en.
  23. News: Anti-vax welfare cut leads to increase in vaccinations . Sati . Wiriya . 13 September 2018 . 3 February 2019 . en-AU.
  24. News: WA proceeds with 'no jab, no play' laws . 3 February 2019 . en.
  25. Curchin . K . The Illiberalism of Behavioural Conditionality: A Critique of Australia's 'No Jab, No Pay' Policy . Journal of Social Policy . 2019 . 48 . 4 . 789–805 . 10.1017/S0047279418000879. 149897863 .
  26. Beard . Frank H . Leask . Julie . McIntyre . Peter . No Jab, No Pay and vaccine refusal in Australia: the jury is out . Medical Journal of Australia . 2017 . 206 . 9 . 381–383 . 10.5694/mja16.00944 . 28490296. 27439974 .
  27. Leask . Julie . Danchin . Margie . Imposing penalties for vaccine rejection requires strong scrutiny. . Journal of Paediatrics and Child Health . 2017 . 53 . 5 . 439–444 . 10.1111/jpc.13472. 28168768 . free . 11343/292416 . free .
  28. Li . Ang. . Toll . Mathew. . Removing conscientious objection: The impact of 'No Jab No Pay' and 'No Jab No Play' vaccine policies in Australia . Preventive Medicine . 2020 . 145 . 106406 . 10.1016/j.ypmed.2020.106406 . 0091-7435 . 33388333 . 230489130 .
  29. Hull . Brynley P . Beard . Frank H . Hendry . Alexandra J . Dey . Aditi . Macartney . Kristine . "No jab, no pay": catch‐up vaccination activity during its first two years . Med J Aust . 2020 . 213 . 8 . 364–369 . 10.5694/mja2.50780. 32951230 . 7692886 . free .
  30. Toll . Mathew . Li . Ang . Vaccine mandates on childcare entry without conscientious objection exemptions: A quasi-experimental panel study . Vaccine . 2022 . 40 . 51 . 7440–7450 . 10.1016/j.vaccine.2022.03.071 . 35501181 . 248455593 .

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