In Response to ‘Riding Free’ by Christopher Reside

Mr Reside’s comment piece about the Abbott Government’s recent “No Jab, No Pay” policy fundamentally fails to conceive of who this policy actually targets. Mr Reside fails to conceptualise the reasons why a child may not be up to date with vaccinations. Furthermore, he fails to understand the significant difference between the majority of anti-vaccination campaigners, who are classed as “conscientious objectors” and the typically low income, rural and disadvantaged families who this policy will actually affect.

Much of “Riding Free” is concerned with “free riders” who, according to the author take advantage of herd immunity for selfish reasons such as avoiding subjecting their child to “the discomfort of a jab.” While he is right to suggest that such people exist, and this is the reasoning of some anti-vaccination campaigners, these people are not the people whom this policy affects. The parents involved in the anti-vaccination movement are typically affluent middle to upper class white people, residing in high SES areas such as Sydney’s Eastern Suburbs and Lower North Shore.[1] These people are not the same people who receive welfare payments in the first place, and as such the policy provides no disincentive for them to vaccinate their children. Furthermore, urban areas of Australia that have low to middle SES for the most part have higher rates of vaccination than these higher SES areas.[2]

Even if a person who is a conscientious objector falls into a lower income bracket, the Government, after the initial announcement of the policy, removed “conscientious objection” from the ground on which a parent could prevent their child being vaccinated. Even if this had not been the case, medical professionals such as Associate Professor Julie Leask from the University of Sydney have recognised that this group of people are very unlikely to change their beliefs even when threatened with something such as a reduction or restriction on welfare benefits; instead, anti-vaccination groups are likely to be further alienated from government and society.[3] This may lead to children being excluded from school, childcare and healthcare, a key concern of Dr Brian Owler, President of the Australian Medical Association.[4]

The real people that this policy affects are the people who cannot access vaccination and whose behaviour will not be changed by the policy. These are people living in very remote areas of Australia, where cost and geographic distance are significant prohibitions to access to vaccinations and other medical services. While the Abbott government may assert that living in rural Australia is a “lifestyle choice”[5] and as such should not be a consideration in health policy, the reality is that almost a third of Australians live in rural or remote areas,[6] and this is unlikely to change in the near future. As such, we should focus not on further (harming) the health outcomes of rural Australians by punishing them for something that is not their fault, but instead ensure that every Australian has adequate access to healthcare and vaccinations regardless of where they live.

“Vaccine contingent welfare” not only does not target the true “free riders”, as Mr Reside would like to characterize them, thereby not solving the problem it sets out to, but also punishes those who are systematically disadvantaged by inadequate rural healthcare services for whom not vaccinating their children is not a selfish choice, as Mr Reside would like to assert. Whilst the Abbott government has honourable intentions trying to increase vaccination rates in Australia, and Mr Reside is correct in emphasising the need to protect the community at large by promoting vaccination, this policy will not solve the issue of declining vaccination rates in some areas, and instead further disadvantages those in society who face significant barriers to accessing healthcare.

[1] http://www.sbs.com.au/news/map/immunisation
[2] Penrith, in Sydney’s outer west, has one of the highest immunization rates in Sydney at 94.1%, while North Sydney – Mosman area has one of the lowest rates at 83.4% http://www.sbs.com.au/news/map/immunisation
[3] http://www.theguardian.com/society/2015/apr/13/coalitions-no-jab-no-pay-policy-elicits-mixed-feelings-in-health-professionals; https://julieleask.wordpress.com/
[4] http://www.skynews.com.au/news/top-stories/2015/04/12/no-jabs–no-childcare-rebate-plan.html
[5] http://www.theaustralian.com.au/national-affairs/indigenous/remote-communities-a-lifestyle-choice-tony-abbott/story-fn9hm1pm-1227257611488
[6] http://www.aifs.gov.au/institute/pubs/factssheets/2011/fs201103.html