Raffaela Armiento1, Monsurul Hoq2, Eugene Kua3, Nigel Crawford4, Kirsten P Perrett5, Sonja Elia3, Margie Danchin5. 1. Department of General Medicine, The Royal Children's Hospital, Australia. Electronic address: raffaela.armiento@rch.org.au. 2. Murdoch Children's Research Institute, Australia; The University of Melbourne, Australia. 3. Department of General Medicine, The Royal Children's Hospital, Australia. 4. Department of General Medicine, The Royal Children's Hospital, Australia; Murdoch Children's Research Institute, Australia. 5. Department of General Medicine, The Royal Children's Hospital, Australia; Murdoch Children's Research Institute, Australia; The University of Melbourne, Australia.
Abstract
INTRODUCTION: 'No Jab, No Play' and 'No Jab, No Pay' mandatory immunisation policies were introduced in the state of Victoria and Australia-wide, respectively, in January 2016. They restrict access to childcare/kindergarten and family assistance payments respectively, for under-vaccinated children. We aimed to describe the proportion of attendees to immunisation services of a tertiary hospital, the Royal Children's Hospital Melbourne (RCH), who were motivated by the policies to discuss or catch-up vaccination. We explored the association between motivation by policies, vaccine hesitancy (VH) and intent to seek medical exemption, with vaccine-uptake. METHODS: Parents/Guardians and clinicians completed surveys October 2016-May 2017 from the nurse-led immunisation Drop in Centre (DIC) or physician-led Specialist Immunisation Clinic (SIC). Vaccine-uptake was measured using the Australian Immunisation Register (AIR) at baseline, 1 and 7 months post-attendance. The association between vaccine-uptake, motivation by policies and VH was explored by logistic regression. RESULTS: Of 607 children, 393 (65%) were from the DIC and 214 (35%) SIC. 74 (12%) parents were motivated by the policies to attend immunisation services and 19% were VH. Only 50% of VH parents planned to catch-up vaccination for enrolment to childcare/kindergarten. Seven months post-attendance there was no association between motivation by policies and full vaccination status (difference 10%, OR 0.42, CI 0.17-1.1, p 0.08). Fewer children were fully immunised at 7 months if their parents were VH (difference 18%; OR 0.24, CI 0.1-0.54, p < 0.001) or seeking medical exemption (difference 33%, OR 0.08, CI 0.01-0.6, p 0.015). CONCLUSION: The 'No Jab' policies motivated attendance to a tertiary immunisation service. However, children of vaccine hesitant parents and those seeking medical exemption to immunisation were less likely to be fully immunised after attendance, than at baseline. The 'No Jab' policies may not be changing vaccination behavior as intended for vaccine hesitant parents who are one of the key target groups, with further evaluation required. Crown
INTRODUCTION: 'No Jab, No Play' and 'No Jab, No Pay' mandatory immunisation policies were introduced in the state of Victoria and Australia-wide, respectively, in January 2016. They restrict access to childcare/kindergarten and family assistance payments respectively, for under-vaccinated children. We aimed to describe the proportion of attendees to immunisation services of a tertiary hospital, the Royal Children's Hospital Melbourne (RCH), who were motivated by the policies to discuss or catch-up vaccination. We explored the association between motivation by policies, vaccine hesitancy (VH) and intent to seek medical exemption, with vaccine-uptake. METHODS: Parents/Guardians and clinicians completed surveys October 2016-May 2017 from the nurse-led immunisation Drop in Centre (DIC) or physician-led Specialist Immunisation Clinic (SIC). Vaccine-uptake was measured using the Australian Immunisation Register (AIR) at baseline, 1 and 7 months post-attendance. The association between vaccine-uptake, motivation by policies and VH was explored by logistic regression. RESULTS: Of 607 children, 393 (65%) were from the DIC and 214 (35%) SIC. 74 (12%) parents were motivated by the policies to attend immunisation services and 19% were VH. Only 50% of VH parents planned to catch-up vaccination for enrolment to childcare/kindergarten. Seven months post-attendance there was no association between motivation by policies and full vaccination status (difference 10%, OR 0.42, CI 0.17-1.1, p 0.08). Fewer children were fully immunised at 7 months if their parents were VH (difference 18%; OR 0.24, CI 0.1-0.54, p < 0.001) or seeking medical exemption (difference 33%, OR 0.08, CI 0.01-0.6, p 0.015). CONCLUSION: The 'No Jab' policies motivated attendance to a tertiary immunisation service. However, children of vaccine hesitant parents and those seeking medical exemption to immunisation were less likely to be fully immunised after attendance, than at baseline. The 'No Jab' policies may not be changing vaccination behavior as intended for vaccine hesitant parents who are one of the key target groups, with further evaluation required. Crown