News that some parents are planning their own "vax-free" childcare centres, following the federal government's announcements of plans to restrict child care rebates to families of vaccinated children, should be a warning sign for population health policy advisers.
It's just another twist in the ongoing and highly divisive debate among parents of young children regarding vaccination choices and a potential sign that simply penalising parents for being frightened might not do anything to solve the problem.
As a researcher, I know and understand that the government's "no jab, no pay policy" is informed by overwhelming science that vaccines work and are safe. But as a parent of a toddler, when I come across the latest emotive story about the risks or side effects of vaccinations, my natural inclination, like any parent, is to worry.
"What if this happened to my child?" is a question any parent would naturally ask, regardless of their scientific background.
Many well-educated parents like me who carry such concerns feel that while there's a wealth of uninformed information out there about why not to vaccinate, the information that can reassure parents like us doesn't seem to be hitting the target.
The problem is that the current healthy policy approaches blame fearful parents who do not vaccinate their children when some of the blame might rest on public health campaigns which fail at arguably the most important first step.
It sounds surprising, but it's been a long time since anyone actually asked Australian parents what they are worried about when it comes to vaccinating their children. And if we want to convince parents about the need to vaccinate, first we need to know what the majority of parents' concerns and beliefs are and where those attitudes might be coming from.
My husband and I had serious reservations about giving our newborn baby the government-recommended Hepatitis B vaccination. Even with our scientific backgrounds, we were scared at the thought of potentially overwhelming our tiny son's body with a vaccine within hours of his birth.
We are fortunate enough to have an excellent GP who took the time to listen to our concerns and have a respectful conversation with us about the risks, benefits and possible courses of action. In the end, we went ahead with the vaccination, but we both kept a watchful eye over him, and have done so for all of his subsequent vaccinations.
In Australia it is believed that the vast majority of parents actually sit on the fence when it comes to vaccinations while it's at the margins that the most vehemently opposed or for actually sit.
The term 'vaccine hesitancy' has now emerged as a way of moving away from the false dichotomy of 'pro-' versus 'anti-' vaccination attitudes to reflect a more realistic position that many parents actually fall somewhere in between being either extremely opposed or extremely in favour of vaccinating their children.
These are the parents who might express their hesitancy by delaying vaccines, refusing some vaccines but accepting others, or by vaccinating their child but still feeling concerned or uncertain about the fact that they have done so.
Arguably, this is the group of parents that we should be concentrating our efforts on. Research suggests they are more likely to be persuaded by public health efforts to improve adherence to and acceptance of childhood vaccines.
The few studies that have directly asked Australian parents what they really think about vaccines were conducted in the early 2000s or earlier.
Obviously a lot has changed since then: The sheer volume of information now available online and the ubiquitous world of social media where personal opinions and experiences, typically lacking scientific validation, are relentlessly shared are two key, and very influential, changes.
As my own mother put it, in her day, "there wasn't a decision to be made. You just did it". Today, parents' decisions about their child's vaccinations these days are based on increasingly complex beliefs, attitudes and concerns. They are more likely to question the value of vaccines, seek alternative or delayed schedules, or refuse vaccines altogether.
If we know what Australian parents' beliefs about vaccinations are and how they form those opinions, we can then start to look at ways to have respectful and open discussions with parents about vaccine safety and effectiveness, if that is what is required.
This is the gap our research is seeking to fill with a national online anonymous survey of Australian parents with children aged five years and under.
We believe such research will hold the key to helping support parents to feel that they are making the right decision for their children. If we are going to give health care professionals the tools and knowledge they need to talk to parents, we first need to know what is really worrying parents about vaccinations in the first place.
Parents who would like to participate in the survey and have their voice heard can click here.
* Dr Cassandra Dittman is a Research Fellow at The University of Queensland Parenting and Family Support Centre.
