Immunisation coverage and socioeconomic status – questioning inequity in the ‘No Jab, No Pay’ policy

Fielding, James E; Bolam, Bruce; Danchin, Margie

doi:10.1111/1753-6405.12676

Cited by 17 publications

(13 citation statements)

References 5 publications

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“…Also in agreement with our study, a study in Ecuador found a direct association between higher educational level of the head of the household and the greater occurrence of measles [38]. In Australia, a study in 2017 showed that immunisation gaps existed in areas with low and high socioeconomic status but the underlying reasons were different, possibly including, respectively, less access to healthcare and more concerns about vaccines [42]. Finally, the relation between individual socioeconomic status and occurrence of vaccine hesitancy also needs to be better understood.…”

Section: Discussionsupporting

confidence: 90%

Spatiotemporal distribution and determinants of measles incidence during a large outbreak, Italy, September 2016 to July 2018

et al. 2019

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Background Measles is still endemic in Italy and outbreaks are frequent. From 2016 to 2018, more than 7,000 measles cases were reported to the national integrated measles and rubella surveillance system, the largest outbreak since implementation of this system. Aim We aimed to describe the characteristics and spatiotemporal distribution of measles cases in Italy and explore determinants of incidence at municipality level. Methods We performed a retrospective observational study, mapping by municipality all measles cases reported to the national surveillance system with symptom onset between 1 September 2016 and 31 July 2018. We also analysed measles–mumps-rubella (MMR) vaccination coverage (VC) data (2000–2017) for the first and second dose, collected from the Ministry of Health. We used regression analysis to explore factors associated with measles incidence at municipality level. Results We analysed 7,854 cases, 3,927 (50%) female. Median age was 26 years; 475 cases (6%) were younger than 1 year. The outbreak occurred in two epidemic waves. The first started in central/northern regions (end of 2016), the second (mostly within 2018) was concentrated in southern regions. In 2016 and 2017, national VC was below 95% for both MMR doses. In 2017, only one region reported VC above 95% for the first dose. At municipality level, incidence was associated with higher urbanisation, less deprivation and fewer adults. Conclusion The spread of measles between September 2016 and July 2018 in Italy indicates the need to improve VC and to explore further how societal and other parameters might be linked to incidence.

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Section: Discussionsupporting

confidence: 90%

Spatiotemporal distribution and determinants of measles incidence during a large outbreak, Italy, September 2016 to July 2018

et al. 2019

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“…Economic, educational, and social barriers also contribute to vaccine hesitancy in Australia (Paxton et al, 2016), however, coverage encourages ignorance of these factors. If these were realised in coverage, then punitive measures may seem inadequate at addressing the roots of the problem (Beard et al, 2017; Fielding et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…This ignores cultural, social, and economic barriers that may inhibit coverage, and makes no effort to improve vaccine access (Paxton et al, 2016). Critics also highlight that it disproportionately burdens low-income families (Fielding et al, 2017) and restrictions on childcare access have potential for adverse social and developmental consequences in affected children (Beard et al, 2017). However, recent surveys indicate widespread public support for the measures, even among those who rely on such payments (Trent et al, 2019).…”

Section: Australia’s No Jab No Pay(play) Legislationmentioning

confidence: 99%

Adapting to the postmodern medical paradigm: how The Daily Telegraph used emotion and anecdote to legitimise vaccination

Ward

Budarick

2020

Media International Australia

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The postmodern medical paradigm is becoming increasingly relevant to vaccine communication. Government and health authorities pushing a pro-vaccine position often fall short in this climate due to a reliance unemotional and fact-based communication. The news media, however, often deviate from this norm by incorporating emotionality to legitimise vaccination. This article analyses how such emotionality manifests in pro-vaccination communication. Van Leeuwen’s typology of discursive legitimation strategies and Van Dijk’s ideological square were used to analyse The Daily Telegraph’ s No Jab No Pay(Play) campaign. The findings demonstrate a primary intention to polarise, as this may justify financial sanctions against vaccine-hesitant parents. However, several identified strategies could be effective at reducing hesitancy in a postmodern medical discourse if adapted under such an intention. Notably, in generating concern through parental and motherhood figures rather than expert authorities, naturalising safety through evaluations rather than counter-rationalisations, and communicating risk through stories that provoke immediate visceral reactions.

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“…Variables associated with the primary outcome were first assessed using univariate logistic regression models. The reference categories were selected based on normative groups that have been identified in the literature as not having a tendency towards vaccination hesitancy (e.g., previous studies have identified that parents of higher socioeconomic status are more likely to be hesitant, so low socioeconomic status was chosen as the reference category) [ 40 , 41 , 42 ]. Based on this literature, we selected reference categories of inner regional for remoteness, low socioeconomic status postcodes, and higher proportion of English as a second language background, and larger schools.…”

Section: Methodsmentioning

confidence: 99%

School-Level Variation in Coverage of Co-Administered dTpa and HPV Dose 1 in Three Australian States

et al. 2021

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Background: Australian adolescents are routinely offered HPV and dTpa (diphtheria, tetanus, pertussis) vaccines simultaneously in the secondary school vaccination program. We identified schools where HPV initiation was lower than dTpa coverage and associated school-level factors across three states. Methods: HPV vaccination initiation rates and dTpa vaccination coverage in 2016 were calculated using vaccine databases and school enrolment data. A multivariate analysis assessed sociodemographic and school-level factors associated with HPV initiation being >5% absolute lower than dTpa coverage. Results: Of 1280 schools included, the median school-level HPV initiation rate was 85% (interquartile range (IQR):75–90%) and the median dTpa coverage was 86% (IQR:75–92%). Nearly a quarter (24%) of all schools had HPV vaccination initiation >5% lower than dTpa coverage and 11 % had >10% difference. School-level factors independently associated with >5% difference were remote schools (aOR:3.5, 95% CI = 1.7–7.2) and schools in major cities (aOR:1.8, 95% CI = 1.0–3.0), small schools (aOR:3.3, 95% CI = 2.3–5.7), higher socioeconomic advantage (aOR:1.7, 95% CI = 1.1–2.6), and lower proportions of Language-background-other-than-English (aOR:1.9, 95% CI = 1.2–3.0). Conclusion: The results identified a quarter of schools had lower HPV than dTpa initiation coverage, which may indicate HPV vaccine hesitancy, and the difference was more likely in socioeconomically advantaged schools. As hesitancy is context specific, it is important to understand the potential drivers of hesitancy and future research needs to understand the reasons driving differential uptake.

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Immunisation coverage and socioeconomic status – questioning inequity in the ‘No Jab, No Pay’ policy

Cited by 17 publications

References 5 publications

Spatiotemporal distribution and determinants of measles incidence during a large outbreak, Italy, September 2016 to July 2018

Spatiotemporal distribution and determinants of measles incidence during a large outbreak, Italy, September 2016 to July 2018

Adapting to the postmodern medical paradigm: how The Daily Telegraph used emotion and anecdote to legitimise vaccination

School-Level Variation in Coverage of Co-Administered dTpa and HPV Dose 1 in Three Australian States

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