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Further implications
The following questions and answers have been taken from Human factor, the blog of Julie Leask, Associate Professor at the University of Sydney, School of Public Health and the National Centre for Immunisation Research & Surveillance.
The full text can be accessed at https://julieleask.wordpress.com/2015/04/11/will-stopping-vaccine-objectors-from-accessing-payments-have-its-desired-impact/?hc\_location=ufi
Should parents who fail to abide by the social contract not get benefits?
The payments were not introduced as a vaccination incentive originally. They were introduced with the express purpose of supporting Australian families and were later linked to vaccination. Child care payments support the participation of women in the workforce. No other health behaviours are linked to welfare payments. The vaccine incentives system we have now works well - maximising procedural complexity for non-vaccinators while encouraging all parents to be up to date. It is fair and reasonable.
What would need to be considered if we did have a form of mandatory vaccination?
Vaccination is different to other public health measures where mandates have been successfully imposed. Vaccination is a more invasive intervention that comes with common and minor, and rare serious side effects. Because of these risks, governments that mandate vaccination are obliged to bring in a no fault vaccine injury compensation system. However, there are no indications this will occur.
What is happening to vaccination rates?
They are holding steady at around 92% and have done so for years. The false reporting of our childhood immunisation rates as being on the decline is harmful if it influences parents to believe that this is a trend. Regardless, the gap between ideal and actual vaccination rates has persisted and needs to be addressed.
Vaccine objectors cluster in regions. What can we do about this?
This clustering is a persistent problem, creating a critical mass for outbreaks to be more likely and sustained. Non-vaccination travels with other social norms and group identities. Public health needs to better understand and engage with these communities. Punitive policies will almost certainly make that job more difficult, as they further alienate such communities from the government and medical system.
If this policy won't do much for vaccination rates, what will?
The following actions would bring bigger marginal returns than penalties:
* enhanced support for doctors, nurses and Aboriginal Community Controlled Health Services providing vaccines
* implement quality control measures in the ACIR to identify and detect recording errors
* having a national vaccine reminder system
* home visiting programs for homebound families
* funding for migrant and refugee catch up programs
* enhancing the cultural respect of immunisation services.
We could also focus on adult vaccination rates, which can be very low. A whole of life register would enable providers to know if the person sitting in front of them is due for a vaccine and adults to keep track of their own vaccinations.