Financial incentives for childhood immunisation — a unique but changing Australian initiative

Ward, Kirsten; Hull, Brynley P; Leask, Julie

doi:10.5694/mja12.10820

Cited by 21 publications

(22 citation statements)

References 3 publications

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“…4,9 Contrary to frequent claims in the media, this suggests that overall levels of objection (registered and unregistered) have not changed, and increases in registered objection may have been driven by increased awareness that registration preserved eligibility for family assistance payments, which rose in value during this period. 10 Among the 5.8% of children in 2013 who were incompletely vaccinated but with no recorded objection, potential explanatory factors include unregistered objection, reporting and recording errors, and problems of access, opportunity and logistics.…”

Section: Discussionmentioning

confidence: 99%

Trends and patterns in vaccination objection, Australia, 2002–2013

Beard

Hull

Leask

et al. 2016

Medical Journal of Australia

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Objectives: To examine geographic and demographic trends in objection to vaccination in Australia. Design: Cross‐sectional analysis of Australian Childhood Immunisation Register (ACIR) data (2002–2013) for children aged 1–6 years. Main outcome measures: Immunisation status according to whether an objection had been registered, and remoteness and socio‐economic status of area of residence. Registration of children with Medicare after 12 months of age was used as a proxy indicator of being overseas‐born. Results: The proportion of children affected by a registered vaccination objection increased from 1.1% in 2002 to 2.0% in 2013. Children with a registered objection were clustered in regional areas. The proportion was lower among children living in areas in the lowest decile of socio‐economic status (1.1%) than in areas in the highest socio‐economic decile (1.9%). The proportion not affected by a recorded objection but who were only partly vaccinated for vaccines due at 2, 4 and 6 months of age was higher among those in the lowest decile (5.0% v 3.4%), suggesting problems of access to health services, missed opportunities, and logistic difficulties. The proportion of proxy overseas‐born for whom neither vaccinations nor an objection were recorded was 14 times higher than for other children (17.1% v 1.2%). These children, who are likely to be vaccinated although this is not recorded on the ACIR, resided predominantly in major cities. Conclusions: There was a small increase in registered objection rates since 2002. We estimate that 3.3% of children are affected by registered or presumptive (unregistered) vaccination objection, which suggests that the overall impact of vaccination objection on vaccination rates has remained largely unchanged since 2001. Incomplete records, barriers to access, and missed opportunities are likely to be responsible for most other deficiencies in vaccination coverage.

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Section: Discussionmentioning

confidence: 99%

Trends and patterns in vaccination objection, Australia, 2002–2013

Beard

Hull

Leask

et al. 2016

Medical Journal of Australia

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“…Vaccine coverage, as measured by the ACIR, increased markedly over the late 1990s and has remained stable at above 90% since the early 2000s 8 . While there was a ninefold increase in recorded conscientious objection between 1999 and 2014, from 0.2% to 1.8%, 9 this increase was likely driven in part by increasing awareness over time that registered objection preserved eligibility for applicable family assistance payments 2 , 10 . Our recent study estimated that around 3.3% of children aged 1–6 years in 2013 were affected by registered and unregistered objection combined — not much more than in a previous national survey from 2001, which estimated 2.5–3.0% 10 .…”

Section: Recent Vaccination Refusal In Australiamentioning

confidence: 99%

“…The first Australian National Immunisation Strategy in 1993 specifically ruled out compulsory vaccination and recommended that conscientious objection be accepted grounds for not vaccinating 7 . In 1997, the Immunise Australia Program with its Seven Point Plan was introduced and included, for the first time, the notion of linking eligibility for family assistance payments to vaccine receipt 2 . The Australian Childhood Immunisation Register (ACIR) was established in 1996 to collect data on vaccination rates in children under 7 years of age.…”

Section: Recent Vaccination Refusal In Australiamentioning

confidence: 99%

“…It removed an exemption, which previously allowed parents whose children were not fully vaccinated, to remain eligible for family assistance payments if a health practitioner certified that they were conscientious objectors to vaccination. The requirement to be fully immunised for age to retain eligibility for family assistance payments commenced in the late 1990s 2 . At state level, No Jab, No Play legislation, which requires children attending childcare centres to be immunised, has been tightened in New South Wales and passed in Queensland and Victoria.…”

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confidence: 99%

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No Jab, No Pay and vaccine refusal in Australia: the jury is out

Beard

Leask

McIntyre

2017

Medical Journal of Australia

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SAGE Deliverable: Define vaccine hesitancy and its scopeThe Working Group reviewed vaccine hesitancy definitions and models, discussed the nuances of demand versus hesitancy and the role of communication in hesitancy, and determined that: Definition: Vaccine HesitancyVaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as complacency, convenience and confidence.

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“…In recent years, there has been increasing attention on parents who actively refuse to vaccinate their children. Successive federal governments have increased the amount of family assistance payments at stake for those who do not vaccinate, and removed most incentives for providers to vaccinate 1 . In 2016, the federal government removed vaccine objection as an alternative to vaccination for eligibility to receive family assistance payments.…”

mentioning

confidence: 99%