25 Nov, 2020

Israel will be tying its child benefit allowances to vaccinations, according to the coalition agreement signed to form the new government, The Times of Israel reported. This decision has caused an uproar amongst rights groups in the country.

Israel has a fairly high rate of vaccination, between 90 and 97 percent, but that rate is dropping, the paper reported. In 2014, State Comptroller Yosef Shapira warned of a “great danger” of outbreak among undervaccinated populations in the country.

“Although [90-97 percent] is a relatively high rate, this fact shows that tens of thousands of children in Israel either have not received some or all vaccinations,” he wrote. “There are populations, for example residents of [ultra-Orthodox] neighborhoods in Jerusalem and the Bedouin in the Negev, where the vaccination rates are lower than the national average, and there is a great danger of outbreak of disease (some of which could be contagious) among them,” Shapira wrote.

In fact, a 2012 report showed that as much as 18 percent of children in the primarily ultra-Orthodox city of Bnei Brak remained unvaccinated.

The populations most likely to skip vaccines are the ultra-Orthodox, the Bedouins and the upper-to-middle class, each for its own reasons. While the wealthier segments who opt out of vaccines are unlikely to be significantly impacted by the decision, the impoverished ultra-Orthodox and Bedouin communities may suffer greatly.

The issue first raised its head six years ago, in an earlier coalition agreement signed in 2009. Then, the child payments were slated to be cut for families that did not vaccinate their children. At the time, the move was challenged in court, with rights activists claiming Bedouin communities have limited access to preventive health care and are therefore being penalized for something beyond their control.

The court sided with the government, saying the government’s position was “moderate” and “not an expression of trampling on rights but rather of the government’s commitment to the welfare of children in Israel, a commitment whose importance cannot be emphasized enough.”

Despite the court ruling, former health minister Yael German put the matter to bed in 2013, canceling the linkage outright because she deemed it “not just.”

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The current coalition agreement, which saw United Torah Judaism join Prime Minister Benjamin Netanyahu’s government and positioned party member Yaakov Litzman as deputy health minister, states more forcefully, “the National Insurance law will be amended, such that child allowances will not be given in cases where a parent refuses to vaccinate their child.”

“This is a serious act, even worse than the previous attempt in 2010 to harm the allowances. Then, a reduction of the allowance was being discussed…now this refers to canceling the entire allowance,” Yitzchak Kadman, director of the Israel National Council for the Child, wrote in an email.

Kadman called the move  “draconian, unprecedented and dangerous,” saying it targeted children for the decisions of their parents, since while the allowances are paid out to parents, they are intended for the benefit of the children. He noted, too, that there is no legal requirement in Israel to vaccinate.

“The State of Israel never set a requirement to vaccinate, but it doesn’t hesitate to hit the pocketbooks of families with children who didn’t fulfill an obligation that was never set.”

The Israel National Council for the Child is joined by two other rights groups, Adalah and the Association for Information on Vaccines, in its fight against the amendment. Sawsun Zohar is an attorney representing Adalah, the legal center for Arab minority rights in Israel.

This map shows the outbreak of various preventable diseases around the world. Click here to explore an interactive map explaining vaccine-preventable outbreaks.

This map shows the outbreak of various preventable diseases around the world. Click here to explore an interactive map explaining vaccine-preventable outbreaks.

“If the amendment is implemented, this would be another punitive measure against children in the unrecognized Bedouin villages who, on the one hand, the government refuses to make preventative healthcare accessible, and on the other hand, punishes them by taking away their allowances if they aren’t vaccinated,” Zohar wrote in a statement.

Mor Sagmon, of the Association for Information on Vaccines similarly expressed concerns that the changes could be the beginning of a slippery slope. “Perhaps tomorrow they will reduce it for those who don’t fly a flag on Independence Day or those who smoke?”

Sagmon feels “most” parents who refrain from vaccinating their children make an “informed decision” on the risks and “they are not going to change their decision because of child allowances.”

Kadmon, however, is less certain. He sees a difference between the impoverished ultra-Orthodox and Bedouin communities and those known popularly as “anti-vaxxers,” who choose not to vaccinate their children on religious grounds or because they believe vaccines present unnecessary health risks for minimal benefits.

Although anti-vaxxers are less vocal in Israel than in North America, they represent a growing community in the Jewish state, especially among the middle and upper classes.

“The reduction of child allowances would needlessly harm the poor families and weak populations that are occasionally excluded from health services,” he said. “In contrast, with regard to the groups abstaining from vaccinations on ideological grounds (a relatively small number), the fine will have no benefit since they will not forsake their beliefs for the cut to the child allowances, which is peanuts.”