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] 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

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

• Northern Rivers Vaccination Supporters
• Vaccine policy
• Vaccine hesitancy

References