Effectiveness of the linkage of child care and maternity payments to childhood immunisation.

In 1998, Australia enacted comprehensive national legislation making receipt of the maternity immunisation allowance (MIA) and the child care benefit (CCB) conditional on evidence of age-appropriate immunisation. We assessed the impact of this policy on immunisation status using a nationally representative population-based case-control study of 589 fully immunised controls and 190 incompletely immunised cases, aged 28-31 months. Immunisation status was significantly associated with parent awareness of the MIA (adjusted odds ratio (aOR) = 3.34, 95% CI = 2.28 - 4.91) and CCB (aOR = 2.08, 95% CI = 1.30 - 3.34). Only 31% of the 219 control parents who were receiving the CCB reported that they could continue to afford child care without the assistance of the CCB. The use of legislated financial immunisation incentives for parents appears to be widely accepted among Australian parents and to have had an impact on immunisation uptake. The policy may serve as a model for other comparable countries.