Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia.
Telethon Kids Institute, Perth, WA 6102, Australia.
Int J Environ Res Public Health. 2023 Jun 24;20(13):6219. doi: 10.3390/ijerph20136219.
Australia has a long history of population-based immunisation programs including legislations. This paper reports on a review of evaluations of the impact of the federal No Jab No Pay (NJNPay) and state implemented No Jab No Play (NJNPlay) legislations on childhood immunisation coverage and related parental attitudes. Five databases were searched for peer-review papers (Medline (Ovid); Scopus; PsycInfo; ProQuest; and CINAHL). Additional searches were conducted in Google Scholar and Informit (Australian databases) for grey literature. Studies were included if they evaluated the impact of the Australian NJNPay and/or NJNPlay legislations. Ten evaluations were included: nine peer-review studies and one government report. Two studies specifically evaluated NJNPlay, five evaluated NJNPay, and three evaluated both legislations. Findings show small but gradual and significant increases in full coverage and increases in catch-up vaccination after the implementation of the legislations. Full coverage was lowest for lower and higher socio-economic groups. Mandates are influential in encouraging vaccination; however, inequities may exist for lower income families who are reliant on financial incentives and the need to enrol their children in early childhood centres. Vaccine refusal and hesitancy was more evident among higher income parents while practical barriers were more likely to impact lower income families. Interventions to address access and vaccine hesitancy will support these legislations.
澳大利亚拥有悠久的基于人群的免疫计划历史，包括立法。本文报告了对联邦“不接种就不付费”（No Jab No Pay，NJNPay）和州实施的“不接种就不玩耍”（No Jab No Play，NJNPlay）立法对儿童免疫接种覆盖率及相关父母态度影响的评估。在五个数据库中搜索了同行评议论文（Medline（Ovid）；Scopus；PsycInfo；ProQuest；和 CINAHL）。在 Google Scholar 和 Informit（澳大利亚数据库）中还对灰色文献进行了额外搜索。如果研究评估了澳大利亚 NJNPay 和/或 NJNPlay 立法的影响，则将其纳入研究。共纳入了 10 项评估：9 项同行评议研究和 1 项政府报告。有两项研究专门评估了 NJNPlay，五项评估了 NJNPay，三项评估了这两项立法。研究结果表明，在立法实施后，完全接种率逐渐略有增加，补种疫苗也有所增加。较低和较高社会经济群体的完全接种率最低。强制接种疫苗具有鼓励接种的作用；然而，对于依赖经济激励措施和需要让孩子入读幼儿中心的低收入家庭来说，可能存在不平等现象。较高收入的父母更明显地表现出疫苗拒绝和犹豫不决，而较低收入的家庭则更有可能受到实际障碍的影响。解决获取疫苗和犹豫不决问题的干预措施将支持这些立法。
