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,[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
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]
^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. S2CID149897863.
^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. PMID28490296. S2CID27439974.