Graduate School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia.
Health Soc Care Community. 2022 Jan;30(1):353-359. doi: 10.1111/hsc.13408. Epub 2021 May 10.
Vaccination is a vital health care initiative to prevent individual and population infection. To increase vaccination rates the federal government implemented the 'No Jab, No Pay' policy, where eligibility for several government benefits required children to be fully vaccinated by removing 'conscientious objections' and expanding the age range of children whose families receive benefits. This study assesses the impact of this policy at a local area within a single medical practice community in NSW, Australia. A retrospective clinical audit was performed between 2012 and 2017 on a single general practice's vaccination records for children ≤19 years. Catch-up vaccinations were assessed based on age at vaccination. Incidence of catch-up vaccinations was assessed for each of four years before and two years after the implementation of the 'No Jab, No Pay' policy in January 2016, along with the age of children and vaccination(s) given. Catch-up vaccinations were assessed temporally either side of implementation of 'No Jab, No Pay'. Comparing the average annual vaccination catch-up incidence rate of 6.2% pre-implementation (2012-2015), there was an increase to 9.2% in 2016 (p < .001) and 7.8% in 2017 (p = .027). Secondary outcome measurement of catch-up vaccination incidence rates before (2012-2015) and after (2016-2017) 'No Jab, No Pay' implementation showed statistically significant increases for children aged 8-11 years (3.2%-5.6%, p = .038), 12-15 years (7.5%-14.7%, p < .001) and 16-19 years (3.3%-10.2%, p < .001) along with a statistically significant reduction in children aged 1-3 years (11.4%-6.2%, p = .015). Also, catch-up rates for DTPa significantly increased after program implementation. This study demonstrates that the Australian federal government vaccination policy 'No Jab, No Pay' was coincident with an increase in catch-up vaccinations within a rural NSW community served by one medical practice, especially for older children.
疫苗接种是预防个人和人群感染的重要医疗保健措施。为了提高疫苗接种率，联邦政府实施了“无针无薪”政策，该政策取消了“出于良心拒接”的规定，并扩大了受益家庭中儿童的年龄范围，以确保儿童完全接种疫苗。本研究评估了该政策在澳大利亚新南威尔士州一个单一医疗实践社区的局部地区的影响。对 2012 年至 2017 年期间一家普通诊所儿童（≤19 岁）的疫苗接种记录进行了回顾性临床审计。根据接种年龄评估补种疫苗情况。在 2016 年 1 月“无针无薪”政策实施前四年和后两年，评估了每四年一次的补种疫苗发生率，以及儿童年龄和接种疫苗情况。在实施“无针无薪”政策前后，对疫苗接种情况进行了时间上的评估。在实施前（2012-2015 年），平均每年补种疫苗接种率为 6.2%，而在 2016 年增加到 9.2%（p<.001），2017 年增加到 7.8%（p=.027）。“无针无薪”政策实施前后（2016-2017 年）补种疫苗接种率的次要测量结果显示，8-11 岁（3.2%-5.6%，p=.038）、12-15 岁（7.5%-14.7%，p<.001）和 16-19 岁（3.3%-10.2%，p<.001）儿童的接种率有统计学显著增加，而 1-3 岁儿童（11.4%-6.2%，p=.015）的接种率有统计学显著下降。此外，DPTa 疫苗的补种率在项目实施后显著增加。本研究表明，澳大利亚联邦政府的疫苗接种政策“无针无薪”与农村新南威尔士州一个医疗实践服务社区的补种疫苗接种率增加有关，尤其是在大龄儿童中。
