Research suggests ‘No Jab, No Play’ is a partly effective way to boost vaccination rates.

The national ‘No Jab, No Pay’ policy has been associated with substantial catch-up vaccination activity in lower socio-economic status areas in Australia, according to new research.

Introduced on 1 January 2016, the policy extended the existing vaccination requirements for receiving federal family assistance payments by removing non-medical (conscientious objection) exemptions and tightening guidelines for medical exemption.

Experts from the National Centre for Immunisation Research and Surveillance (NCIRS) have analysed data on children from the Australian Immunisation Register.

It shows that the proportion of incompletely vaccinated children aged 5 to less than 7 years who received catch-up diphtheria–tetanus–pertussis vaccine (DTPa3) was about 6 per cent higher under “No Jab, No Pay” than during the baseline period.

The researchers found a 0.7 per cent reduction in MMR1 catch-up vaccinations, but a 2.4 per cent increase in catch-up MMR2 shots.

The researchers say it is evidence of limited success. The ‘No Jab, No Play’ policy has done little to reverse peoples’ opposition to vaccines.

“Our findings suggest that, while monetary sanctions are effective in promoting catch-up vaccination, their impact varies with socio-economic disadvantage,” concluded the authors, led by Dr Frank Beard.

“Moreover, the lack of change in MMR1 catch-up activity in children aged 5 to less than 7 years suggests little impact on those who reject vaccination, and that expansion of age requirements was the more effective policy lever in this period.”

Co-author Professor Julie Leask, and expert on vaccination attitudes and behaviour, says “many factors contribute to incomplete vaccination.”

“A comprehensive suite of measures, particularly for reducing barriers to access and incorporating systematic reminders, is therefore essential for improving coverage. Requirements alone are not enough,” she said.

“The full scope of consequences of strict vaccination requirements should be carefully examined by any country considering such measures. It may be possible to find a reasonable middle ground that increases catch-up while not disadvantaging certain families.”

The study is accessible here.