LAUSR

BACKGROUND In 2016, Australia introduced the "No Jab, No Pay" legislation, which removed the option of non-medical exemptions from the vaccination requirements to receive certain family and child care tax benefits. We aimed to gauge parental support for "No Jab, No Pay" and explore how it has impacted parental attitudes towards vaccination, particularly among families that are reliant on the tax benefits linked to vaccination under "No Jab, No Pay". METHODS An online survey distributed to parents with children under 5 in Australia assessed parental knowledge and opinions towards childhood vaccination and the "No Jab, No Pay" policy. RESULTS A total of 411 parents completed the survey. The majority of parents reported their child was either fully vaccinated or they intended to fully vaccinate. Eighty-two percent of parents were in favour of "No Jab, No Pay." The belief that vaccine-preventable diseases are a significant risk to unvaccinated children was a predictor of supporting the "No Jab, No Pay" policy (AOR = 5.95, 95% CI = [3.60, 10.94], p < 0.001). Parents that depend on the financial benefits associated with "No Jab, No Pay" and parents that utilize child care services were significantly more likely to reconsider vaccination, if they previously hesitated or objected, because of the policy (AOR = 9.66, 95% CI = [4.98, 18.72], p < 0.001 and AOR = 2.09, 95% CI = [1.04, 4.17], p = 0.04). CONCLUSION We found that there is widespread support for "No Jab, No Pay" among parents of young children, but parents that depend on the financial benefits or utilize child care services may be disproportionately affected by the policy. Childhood vaccination coverage in Australia could best be improved by increasing access to vaccination services and by imposing significant administrative barriers to obtaining non-medical exemptions.