“No jab, no pay” policy has the greatest impact in the lowest SES area

The country’s “no jab, no pay” policy is associated with substantive catch-up vaccination activity, with the greatest changes in regions with the lowest socioeconomic status and indigenous Australians.Researchers at the University of Sydney and the National Center for Immunization Research and Monitoring (NCIRS) Australian Medical Journal..

This policy was introduced on January 1, 2016 to remove the non-medical (conscientious objector refusal) exemption and strengthen the guidelines for medical exemption to obtain existing vaccinations for federal family support payments. Expanded requirements.

The current study analyzed data on catch-up vaccination rates from Australian vaccination registries.

  • Children between the ages of 5 and 7 (January 2013-December 2014, baseline) and the first two years of No Jab, No Pay (December 2015-December 2017).And
  • Children between the ages of 7 and 10 and young people between the ages of 10 and 20 (no jabs, no payment period).

Researchers found a second dose of measles-mumps-rubella vaccine (MMR2), indigenous and socioeconomic status, and a third dose of diphtheria-mumps-pertussis vaccine in the latter two age groups. Catch-up of vaccination We investigated the vaccination rate. (DTPa3) and measles-mumps-rubella vaccine (MMR1) for children under 5 to 7 years of age, before and after the introduction of nojab and nopay.

The proportion of incompletely vaccinated children between the ages of 5 and 7 who received catch-up DTPa3 was higher in no-jab and no-pay than during the baseline period (15.5% vs. 9.4%). However, there was also a slight decrease in MMR1 catch-up (13.6% vs. 12.9%).

Of the 407,332 adolescents aged 10 to under 20 who were incompletely vaccinated, 71,502 (17.6%) received catch-up MMR2 during the first two years of nojab and nopay.

This increased the overall coverage of this age group from 86.6% to 89.0%. MMR2 catch-up activity in this age group is greater in areas with the lowest socioeconomic status than in areas with the highest socioeconomic status (29.1% vs. 7.6%) and is more indigenous compared to non-indigenous Australians. If (35.8% vs 17.1%).

“Our findings suggest that monetary sanctions are effective in promoting catch-up vaccination, but their impact depends on socio-economic disadvantages,” said NCIRS Associate Director, Surveillance. The author, led by Dr. Frank Beard in Coverage, Evaluation, and Social Sciences, concluded. , And a senior lecturer at the University of Sydney.

“Furthermore, the unchanged MMR1 catch-up activity in children aged 5 to under 7 suggests that there is little impact on those who refuse vaccination, and the expansion of age requirements during this period. It was a more effective policy tool, “said Dr. Beard.

Co-authors Professor Julie Leesk, Professor Fellow of NCIRS, and experts in vaccination attitudes and behaviors at the University of Sydney said: Therefore, a comprehensive set of measures, especially to reduce access barriers and incorporate systematic reminders, is essential to improve coverage. Requirements alone are not enough.

“The full range of consequences of strict immunization requirements should be carefully considered by the countries considering such measures. A reasonable midpoint to increase catch-up without penalizing a particular family. It may be possible to find it. “

Image Credit: © / au / goodluz

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