What is ‘No Jab, No Pay’?
In November 2015, the federal parliament passed Social Services Legislation Amendment (No Jab, No Pay) Act 2015.
This amendment imposed a vaccination requirement for the purpose of eligibility to certain benefits provided under A New Tax System (Family Assistance) Act 1999 (Cth) (the Act), by abolishing the right to conscientiously object to vaccination (which was previously available). The right to object to vaccination on religious grounds was also abolished.
The law took effect on 01 January 2016.
- Is my unvaccinated child eligible to be enrolled in childcare or early education services?
- Which benefits are subject to the vaccination requirement?
- Which age groups are subject to the vaccination requirement?
- Which vaccines are included in the vaccination requirement?
- What are the permitted exemptions to the vaccination requirement?
- How the law passed
Is my unvaccinated child eligible to be enrolled in childcare or early education services?
‘No Jab, No Pay’ is a federal law applicable in all states and territories, however, the law does not prohibit enrolment in childcare or other early childhood education services; it affects only eligibility to certain subsidies and benefits.
State laws determine enrolment criteria, so, whether or not you can enrol your unvaccinated child in childcare or early childhood education services (and as such become conditionally eligible for childcare subsidies) will depend on where you live.
Since 2015, five states, Queensland, Victoria, New South Wales, South Australia, and Western Australia have enacted laws which affect the enrolment of unvaccinated children in childcare and early childhood education services to varying degrees. To determine if your child is eligible for enrolment in childcare or early childhood education services under state-based laws, please refer to the guides linked immediately below.
No Jab, No Play (Qld)
No Jab, No Play (Vic)
No Jab, No Play (NSW)
No Jab, No Play (WA)
No Jab, No Play (SA)
Other states and territories
Which benefits are subject to the vaccination requirement?
Childcare Subsidy and a small percentage of Family Tax Benefit A are subject to the vaccination requirement. See table below, which is current from 15 October 2024.
| Benefit/Subsidy | Vaccination Requirement |
|---|---|
| Family Tax Benefit A | No, however, if your child is unvaccinated (or partially vaccinated), or has not undergone a 4 year old health check (or both) your Family Tax Benefit A will be reduced by $34.44 per fortnight per child. You will continue to be eligible for the remainder of your Family Tax Benefit A entitlement even if your child remains unvaccinated. |
| Family Tax Benefit A supplement | No |
| Family Tax Benefit B | No |
| Family Tax Benefit B supplement | No |
| Childcare Subsidy | Yes |
Also see the AVN blog No Jab, No Family Tax Benefits? Not True!.
Which age groups are subject to the vaccination requirement?
All children, from 0 to 19 years of age, are now subject to the vaccination requirement, however, as noted in the following section, only vaccines recommended for children aged 0 to 4 years are included in the vaccination requirement.
Which vaccines are included in the vaccination requirement?
The number and type of vaccines that a non-exempt child is required to receive in order to satisfy the vaccination requirement depends on the year of birth of the child, and in general, includes most, but not all vaccines recommended for children aged 0 to 4 years under the National Immunisation Program.
Importantly, the vaccination requirement does not include such vaccines as HPV and dTpa boosters recommended for older children under the School Vaccination Program.
The required vaccines, based on a child’s year of birth, are listed in the two legislative instruments linked below.
Child Care Subsidy:
Family Assistance (Immunisation and Vaccination) (Education) Determination 2018
Family Tax Benefit A:
Family Assistance (Immunisation Principles and Vaccination Schedules) (DSS) Determination 2018
What are the permitted exemptions to the vaccination requirement?
As ‘No Jab, No Pay’ abolished the right to conscientiously object to vaccination, there are few ways by which a child will be exempted from the vaccination requirement.
| Exemption Category | Reference in the Act |
|---|---|
| Medical contraindication to vaccination | s 6(3)(a) |
| Secretary (of the Commonwealth Department of Human Services) determines in writing that the child meets the immunisation requirement | s 6(6) & 6(7) |
| Natural immunity | s 6(3)(b) |
| Undergoing an approved catch-up schedule | s 3 & 4(1)(b) |
| Participant in vaccine study | s 6(3)(c) |
| Temporary unavailability of vaccine | s 6(4) |
Medical contraindication to vaccination
Section 6 (3) (a) of the Act provides that a child meets the vaccination requirement if:
[A] general practitioner, a paediatrician, a public health physician, an infectious diseases physician or a clinical immunologist has certified in writing that the immunisation of the child would be medically contraindicated under the specifications set out in the Australian Immunisation Handbook.
Which doctors are permitted to certify a medical contraindication to vaccination?
- General Practitioner who is a recognised Fellow of the Royal Australian College of General Practitioners (RACGP)
- General Practitioner who is registered as a general practitioner under the Vocational Register of General Practitioners
- Medical Practitioner who meets Australian College of Rural and Remote Medicine fellowship standards
- Paediatrician
- Public Health Physician
- Infectious Diseases Physician
- Clinical Immunologist
Reference: s 3 and s 6 (3) (a) of the Act
What is the doctor required to certify?
Based on the wording of the legislation, a relevant doctor must certify in writing that “immunisation of the child would be medically contraindicated under the specifications set out in the Australian Immunisation Handbook”.
Reference: s 6 (3) (a) of the Act
Medical contraindication exemption form
The doctor may certify a medical contraindication by way of:
- Australian Immunisation Register Immunisation Medical Exemption form IM011; or
- a doctor’s letter.
Medical contraindication exemption forms or letters should be submitted directly to the Australian Immunisation Register by your GP or specialist.
Secretary (of the Commonwealth Department of Human Services) determines in writing that the child meets the immunisation requirement
Section 6 (6) of the Act provides that the Secretary may make a determination that a child meets the vaccination requirement in accordance with the decision-making principles (Principles) made under section 6 (7) of the Act.
The Principles were amended on 09 August 2017, with effect from 10 August 2017, to include an additional category of exemption from the vaccination requirement (section 13), which may assist parents of children with significant developmental or behavioural disorders who react with aggression when faced with a medical procedure, to obtain an exemption from the vaccination requirement.
Section 13 Unacceptable risk of harm to child or another person The requirements of this section are met if: (a) a listed medical practitioner has certified in writing, in a form and manner, if any, required by the Secretary, that, for the reasons set out in the certificate, immunisation of the child would result in an unacceptable risk of physical harm to the child or a person administering a vaccination to the child; and (b) the Commonwealth Chief Medical Officer has certified in writing that he or she agrees with the listed medical practitioner. Example: A child with a disruptive behavioural disorder or developmental disorder who reacts with aggression or defiant behaviour when faced with a medical procedure.
Which classes of doctors are permitted to certify that vaccination of the child would result in an unacceptable risk of physical harm to the child or a person administering a vaccination to the child under section 13 of the Principles?
The Principles define a ‘listed medical practitioner’ as: “a medical practitioner whose name has been given to the Commonwealth Chief Medical Officer by the Chief Health Officer of a State or Territory for the purpose of giving certificates under section 13.”
The Explanatory Statement (ES) for this amendment provides some interpretation guidance about ‘listed medical practitioners’.
The Chief Health Officer in each state and territory must nominate in writing to the Commonwealth Chief Medical Officer the ‘listed medical practitioner/s’ for their state.
Chief Health Officers can also request the removal of a listed medical practitioner/s if they are no longer required to perform the role.
The Department of Health consulted health departments in each State and Territory who agreed to ensure there will only be a small number of highly qualified ‘listed medical practitioners’ able to assess patients and refer their details to the Chief Medical Officer for consideration under this Determination.
Listed medical practitioners are expected to be clinicians with specialist expertise in immunisation, for example those working in specialist immunisation clinics. Jurisdictions have agreed that a very limited and highly qualified group of individuals would be nominated. The Commonwealth Department of Health will keep a list of listed medical practitioners. This practitioner list is now a defined term in Section 4 of the Amendment Principles.
Most states and territories have a Specialist Immunisation Clinic where most ‘listed medical practitioners’ will work. A referral from a GP is likely to be required to see a ‘listed medical practitioner’.
Reference: s4 Principles and p 3 ES
What is the listed medical practitioner required to certify under section 13 of the Principles?
Based on the wording of section 13, a relevant doctor must certify in writing, that, for the reasons set out in the certificate, ”immunisation of the child would result in an unacceptable risk of physical harm to the child or a person administering a vaccination to the child”.
Reference: s13 Principles
By what means is the listed medical practitioner required to make a certification under section 13 of the Principles?
Based on the wording of section 13, a relevant doctor must certify “in a form and manner, if any, required by the Secretary, the reasons set out in the certificate”.
An individualised letter should meet the certification requirements under the Principles. We are not aware of a standardised form for this type of certification.
Reference: s13 Principles
How do I apply for this type of exemption?
Parents who wish to access this type of exemption should make an appointment with a GP as a starting point. A referral to a Specialist Immunisation Clinic is likely to be required.
Also see Medical contraindication to vaccination (under s6 (3) (a) of the Act) to see if your child is eligible for an exemption under that section.
Natural immunity
Section 6 (3) (b) of the Act provides that a child meets the vaccination requirement if:
[A] general practitioner, a paediatrician, a public health physician, an infectious diseases physician or a clinical immunologist has certified in writing that the child does not require immunisation because the child has contracted a disease or diseases and as a result has developed a natural immunity”.
See Medical contraindication to vaccination for a list of the classes of doctors which may certify that a child has natural immunity to a disease/s.
The availability of an exemption for natural immunity is unlikely to assist many though, because a child would need to have so-called natural immunity to all of the diseases listed in the prescribed schedule of vaccines, or to all diseases for which a combination (multivalent) vaccine is alleged to provide immunity.
In addition, the government has chosen to make individual (monovalent) vaccines impossible to access, so that even natural immunity will not enable an exemption from the vaccination requirement unless the child has natural immunity to all of the diseases that a combination (multivalent) vaccine targets. For example, the individual (monovalent) Measles, Mumps and Rubella vaccines are not available in Australia.
Further information about certification of natural immunity is available on pages 2 and 3 of Australian Immunisation Register Immunisation Medical Exemption form IM011.
Undergoing an approved catch-up schedule
A guide to catch-up vaccination is provided in the Australian Immunisation Handbook.
An online catch-up calculator for National Immunisation Program vaccines is available to assist in determining appropriate catch-up schedules for children ≤7 years of age across Australia.
However, please note that the catch-up schedule is aggressive, requiring a large number of doses in a short period of time, and its safety and effectiveness has not been established.
See Medical contraindication to vaccination for a list of the classes of doctors which may certify that a child is undergoing a catch-up schedule.
The doctor may choose to certify that a child is on a catch-up schedule either by way of the Australian Immunisation Register Immunisation History Form IM013, or by individualised letter.
The form or letter should be submitted directly to the Australian Immunisation Register by your GP or specialist.
Disclaimer
All information contained herein was, to the author’s knowledge, correct at the time of writing, but please note, this information is not intended to constitute legal advice about eligibility for government subsidies or benefits. Parents should verify all information with Services Australia.
This page was last reviewed and updated on 15 October 2024.