A critical analysis of the Australian public consultation on childhood vaccine mandate introduction

Several countries have revised their policies to make vaccine refusal more difficult. The role of the public in this process has seldom been examined. We analysed the public consultation process for the Australian government’s 2016 ‘No Jab No Pay’ mandatory childhood vaccination policy to better understand who participated, their arguments, and how their contributions were incorporated into the legislative process. Publicly available submissions and hearing transcripts were categorised by submitter type, stance on the legislation, and writing style. We undertook a qualitative reflexive thematic analysis of the submissions’ structure and content and compared our findings with the Inquiry Report. Most public submissions (95%) opposed the legislation. Vaccine-rejecting submitters focused on safety arguments to argue the legislation was unjustified, unethical or ineffective. Vaccine-supportive submitters focused on the importance of vaccination but supported or opposed the legislation based on positions that weighed collective goods against individual rights. The findings of this analysis differed somewhat from the Inquiry Report that analysed the same evidence. The Report identified similar key legislation-specific concerns, but the committee’s explicit position on the importance of vaccines meant that vaccination concerns were not considered relevant. The Report drew heavily on supportive arguments from academics, medical organisations, and government, while minimising critical arguments. Our findings suggest a process that epistemically privileged expert opinion in favour of mandates and discounted testimony driven by experiences, emotion, and beliefs of opponents. Future consultations on vaccination policy might consider approaches which are designed to connect high quality evidence with the plural values of citizens. • Australians consulted on removing non-medical exemptions for childhood vaccination • Submissions highlighted ethics, effectiveness, negative impacts, policy alternatives • Government report selectively emphasized supportive arguments, minimised criticism • Inclusive and deliberative democratic methods could improve public trust • This is important for legitimacy in contested policy areas like vaccination mandates