Policy & Politics Journal Blog

Katie Attwell & Mark Navin

What should governments do to people who don’t want to vaccinate? This question is especially pressing in the age of COVID-19, as policymakers face challenging questions about whether to exclude committed vaccine refusers from their jobs or public spaces. But this issue, like so many others during the pandemic, is highly contingent and uncertain: policymakers are implementing responses to vaccine refusal without being confident about the consequences of their policies.

Our new article looks at vaccine refusal in a more settled and stable context: routine childhood vaccination. Over the last decade, governments globally have been making it harder for parents to opt-out of vaccinating their kids. In particular, we explore new “No Jab, No Play” policies in Australian states, which prevent unvaccinated children from enrolling in childcare and early education.

The Australian policymakers we interviewed didn’t think No Jab, No Play policies would change the minds of committed vaccine refusers. They hoped these policies would motivate parents who were willing to vaccinate but hadn’t done it yet. But in practice most No Jab, No Play policies exclude unvaccinated children from care and early education, though policymakers also created ways to enrol some unvaccinated children whose parents would have been willing to vaccinate them.

Childhood vaccination promotes many important social benefits, including the protection of children and other vulnerable people, and the protection of societal and economic functioning. But early education is also important to the current and future well-being of children, and especially to disadvantaged children. The authors of Australia’s new vaccine mandates acknowledged the greater need that disadvantaged children have for care and early education, and they have created exemptions based on social disadvantage.

We asked policymakers in four Australian states to share with us their ethical considerations in designing these mandates and their exemptions. Centre-right political actors designed or supported introducing mandates with fewer exemptions, while the centre-left used exemptions to protect vulnerable children’s access to care and education.

We were interested in whether their arguments directly invoked morality or instead relied upon ethical arguments about the downstream consequences of their policies. We were also interested in whether introducing more coercive mandates crowded out non-coercive measures for increasing vaccine uptake.

We found that policymakers used a range of moral frames to discuss childhood vaccine mandates and exemptions. As we expected, they frequently drew on high moral certainty that vaccination was good, but also that early childhood education was important, especially to the vulnerable. They insisted that immunization policies needed to try and serve both these goals.

We look forward to future work that asks moral and ethical questions of those who design and implement COVID-19 vaccine mandates. With less certainty about the effects of these policies in both preventing disease and straining the social fabric of societies, we expect to see more pragmatic arguments than moral ones.

You can read the original research in Policy & Politics: 

Katie Attwell and Mark Navin. (2022) How policymakers employ ethical frames to design and introduce new policies: the case of childhood vaccine mandates in Australia Policy and Politics DOI: https://doi.org/10.1332/030557321X16476002878591

If you enjoyed this blog post, you may also be interested to read:

Analysing boundaries of health and social care in policy and media reform narratives

Drivers of health policy adoption: a political economy of HIV treatment policy

Evaluating the role of bricolage in US Health Care policy reform

The views and opinions expressed on this blog site are solely those of the original blog post authors and other contributors. These views and opinions do not necessarily represent those of Policy & Politics, the Policy Press and/or any/all contributors to this site.