Financial Interventions to Increase Vaccine Coverage

Abstract

BACKGROUND: Recent vaccine mandates in Australia, as in other high income settings, have sought to change the behavior of parents, including those who would otherwise access nonmedical exemptions. Since 2014, Australian state governments have introduced and progressively tightened policies restricting the access of unvaccinated children to early education and child care. In 2016, the Federal Government removed financial entitlements and subsidies from nonvaccinating families. We sought to ascertain the impact of these policies on vaccine coverage rates by state, and also to consider their impact on communities with high numbers of registered refusers. METHODS: Interrupted time series models were fitted by using the Autoregressive Integrated Moving Average framework to test for changes in trend in vaccination rates following implementation of government policies. RESULTS: Australian vaccine coverage rates were rising before the vaccine mandates and continued to do so subsequently, with no statistically significant changes to coverage rates associated with the interventions. The exception was New South Wales, where vaccine coverage rates were static before the policy intervention, but were increasing at an annual rate of 1.25% after (P