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No Jab, No Pay unproductive: paper

“We’re extremely strong advocates for vaccination … and we both recognise that vaccine rejection is an ongoing problem in Australia … and there’s actually very limited evidence on the best way to address vaccine rejection.”

Dr Margie Danchin of the Vaccine and Immunisation Research Group at Murdoch Childrens Research Institute, together with associate professor Julie Leask of the University of Sydney, is questioning whether the government’s nascent ‘No Jab, No Pay’ policy is both firm and fair.

Danchin and Leask have penned a paper, published in the Journal of Paediatrics and Child Health that makes a strong case that the policy – an attempt to increase vaccination rates – isn’t the right fit for the problem.

No jab, no worries?

‘No Jab, No Pay’, introduced in January last year, removes the right to object to vaccination on moral grounds and withholds child care and family tax benefit subsidies from families who fail to vaccinate their children.

But Danchin reveals that wealthy parents are twice as likely to oppose vaccination as other parents. Therefore, Danchin claims, withholding subsidies is a weak vaccination incentive, as these parents aren’t likely to receive welfare payments in the first place.

Also, registered ‘anti-vaxxers’ form only 1.8 per cent of Australian parents.  With 80 per cent of this cohort reported to be unmoved by ‘No Jab, No Pay’, its efficacy with this group is questionable.

The authors propose the majority of non-immunisations occur due to access or logistical issues, or apathy.

Though ‘No Jab, No Pay’ has seen vaccination rates increase by a minuscule 0.94 per cent over a year, its drawbacks, according to Danchin, are manifold.

“We believe there are potentially better ways to improve vaccination rates than punitive policies,” she says.

“We’re concerned about not compounding the disadvantage for children in these families.”

What would work?

Danchin and Leask advocate supportive policies to increase vaccination rates, as evidence suggests these are more effective.

For starters, regular vaccination reminders could help. Then there are more complex solutions, like policies to support companies to give parents time off work to get their child vaccinated.

To encourage the most intransigent non-vaccinating subset, the anti-vaxxers, to change their views, the authors recommend forcing them to register their status with their healthcare provider, in person, every year. This would allow regular opportunities for potentially stance-altering discussions and minimise alienation from healthcare for the child.

And, to allay anti-vaxxers’ fears of very rare but serious vaccination side effects, a government no-fault compensation scheme could be established, as has been done in many other countries.

The authors also offer that healthcare providers, like GPs, need further support, as they are, in Danchin’s words, “swamped with parents presenting their kids for catch-up vaccines or to start a vaccination schedule”.

Danchin stresses that new policies need continual evaluation. In a subtle nod to ‘No Jab, No Pay’, she says this is especially vital before claiming they are successful.

Ultimately, success is what Danchin and Leask are seeking. Only 92 per cent of Australian children are fully vaccinated. They would like to see this figure hit 100.

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