Medical Exemptions to Mandatory Vaccinations: The State of Play in Australia and a Pressure Point to Watch

Australia s mandatory vaccination policies have historically allowed for non-medical exemptions, but this changed in 2016 when the Federal Government discontinued non-medical exemptions for childhood vaccination requirements. Australian states introduced further mandatory vaccination policies during the COVID-19 pandemic for a range of occupations including healthcare workers. There is global evidence to suggest that medical exemptions increase following the discontinuation of non-medical exemptions; the new swathe of COVID-19 mandatory vaccination policies likely also placed further pressure on medical exemption systems in many jurisdictions. This paper examines the state of play of mandatory vaccination and medical exemption policies in Australia by outlining the structure and operation of these policies for childhood vaccines, then for COVID-19, with a case study of healthcare worker mandates. Next, the paper explores healthcare workers experiences in providing vaccine exemptions to patients (and medical exemptions in particular). Finally, the paper synthesizes existing literature and reflects on the challenges of medical exemptions as a pressure point for people who do not want to vaccinate and for the clinicians who care for them, proposing areas for future research and action.