SCHN information here
results
Discover
Communities in SCHN
Select a community to browse its collections.
Recent Submissions
Childhood influenza vaccination is not a priority for parents: a national, cross-sectional survey of barriers to childhood influenza vaccination in Australia
(2025) Steffens, Maryke S.; Kaufman, Jessica; Bolsewicz, Katarzyna T.; Vidmar, Suzanna; Christou-Ergos, Maria; Sabahelzain, Majdi M.; Leask, Julie; Boxall, Justin; Beard, Frank; Danchin, Margie
Influenza vaccines are recommended and free in Australia for children aged <5 years, but uptake remains low at 25.8% compared to the targets of 40% and 50%. National data on barriers hindering paediatric influenza vaccination can inform strategies to improve uptake.The aim of this study was to measure barriers to influenza vaccination in Australian children aged <5 years. Methods:
A national, crosssectional survey of parents of children aged <5 years was conducted in March/April 2024. Parents were recruited using an online panel and asked about their intention to get an influenza vaccine for their youngest child in the upcoming influenza season. An adapted version of the validated Vaccine Barriers Assessment Tool measured 14 influenza vaccination barriers. Analysis assessed the prevalence of barriers and differences between parents intending to and those unsure or not intending to vaccinate by calculating the prevalence difference and 95% confidence interval.
Results: A total of 2000 parents were recruited nationally.
The most common barrier was parents feeling distressed when thinking about vaccinating their child against influenza (66.1% of intending parents, 65.6% of unsure/not intending parents). The barrier with the largest difference between intending and not intending/unsure parents was not prioritising their child’s influenza vaccination (47.2% vs. 6.1%, PD = 41.1 ppts, 95% CI: 35.9%, 46.3%). Other barriers with large differences were parents not feeling guilty if their unvaccinated child got influenza (41.5% vs. 7.5%, PD = 34.0 ppts, 95% CI: 28.8%, 39.1%) and parents not believing that influenza vaccines are effective (31.3% vs. 3.0%, PD = 28.2 ppts, 95% CI: 23.6%, 32.9%).
Conclusions: Parents should be encouraged and supported to prioritise influenza vaccination alongside routine childhood vaccines in campaigns that emphasise disease risk and the importance, safety and effectiveness of influenza vaccination, and by optimising access to influenza vaccination. We recommend conducting similar surveys regularly to monitor trends in parental barriers to childhood influenza vaccination.
A national, crosssectional survey of parents of children aged <5 years was conducted in March/April 2024. Parents were recruited using an online panel and asked about their intention to get an influenza vaccine for their youngest child in the upcoming influenza season. An adapted version of the validated Vaccine Barriers Assessment Tool measured 14 influenza vaccination barriers. Analysis assessed the prevalence of barriers and differences between parents intending to and those unsure or not intending to vaccinate by calculating the prevalence difference and 95% confidence interval.
Results: A total of 2000 parents were recruited nationally.
The most common barrier was parents feeling distressed when thinking about vaccinating their child against influenza (66.1% of intending parents, 65.6% of unsure/not intending parents). The barrier with the largest difference between intending and not intending/unsure parents was not prioritising their child’s influenza vaccination (47.2% vs. 6.1%, PD = 41.1 ppts, 95% CI: 35.9%, 46.3%). Other barriers with large differences were parents not feeling guilty if their unvaccinated child got influenza (41.5% vs. 7.5%, PD = 34.0 ppts, 95% CI: 28.8%, 39.1%) and parents not believing that influenza vaccines are effective (31.3% vs. 3.0%, PD = 28.2 ppts, 95% CI: 23.6%, 32.9%).
Conclusions: Parents should be encouraged and supported to prioritise influenza vaccination alongside routine childhood vaccines in campaigns that emphasise disease risk and the importance, safety and effectiveness of influenza vaccination, and by optimising access to influenza vaccination. We recommend conducting similar surveys regularly to monitor trends in parental barriers to childhood influenza vaccination.
Antibody responses against influenza A decline with successive years of annual influenza vaccination
(2025) Sullivan, Sheena G; Khvorov, Arseniy; Carolan, Louise; Dowson, Leslie; Hadiprodjo, A Jessica; Sánchez-Ovando, Stephany; Liu, Yi; Leung, Vivian K Y; Hodgson, David; Blyth, Christopher C; Macnish, Marion; Cheng, Allen C; Haugenauer, Michelle; Clark, Julia; Dougherty, Sonia; Macartney, Kristine; Koirala, Archana; Khatami, Ameneh; Jadhav, Ajay; Marshall, Helen; Riley, Kathryn E; Wark, Peter A B; Delahunty, Catherine; Subbarao, Kanta; Kucharski, Adam J; Fox, Annette
Influenza vaccine effectiveness and immunogenicity can be compromised with repeated vaccination. We assessed immunological markers in a cohort of healthcare workers (HCW) from six public hospitals around Australia during 2020-2021. Sera were collected pre-vaccination and ~14 and ~180 days post-vaccination and assessed in haemagglutination inhibition assay against egg-grown vaccine and equivalent cell-grown viruses. Responses to vaccination were compared by the number of prior vaccinations. Baseline sera were available for 595 HCW in 2020 and 1031 in 2021. 5% had not been vaccinated during five years prior to enrolment and 55% had been vaccinated every year.Post-vaccination titres for all vaccine antigens were lowest among HCW vaccinated in all 5-prior years and highest among HCW with 0 or 1 prior vaccinations, even after adjustment. This was observed for both influenza A subtypes and was dependent on pre-vaccination titre. Expanded cohorts are needed to better understand how this translates to vaccine effectiveness.
Immunisation health workforce capacity building in Southeast Asia: reflections from training programme implementation in Cambodia and Lao PDR
(2025) Saravanos, Gemma; Teo, Alvin Kuo Jing; Chanlivong, Niramonh; Leask, Julie; Sheel, Meru; Saravanos, Gemma; Teo, Alvin Kuo Jing; Chanlivong, Niramonh; Leask, Julie; Jenkins, Kylie; Sheel, Meru; Teo, Alvin Kuo Jing; Yam, Esabelle Lo Yan; Yi, Siyan; Yam, Esabelle Lo Yan; Chou, Sok Chamreun; Chanthorn, Phorng; Thy, Chhit; Yi, Siyan; Sayavong, Souphon; Jenkins, Kylie; Kirk, Martyn; Gray, Darren; Sheel, Meru; Danchin, Margie; Morgan, Chris; Macartney, Kristine; Coghlan, Ben; Apostol, Michelle; Arora, Dinesh; Smart, Tracy
The Immunization Agenda 2030 emphasises the need for a motivated, skilled and knowledgeable workforce equipped to plan, manage, implement and monitor immunisation programmes at all levels. The rapid introduction of COVID-19 vaccines during the pandemic highlighted the adaptability of the health workforce but also exposed gaps in professional development and learning.This practice paper describes the implementation of an immunisation training programme in the Kingdom of Cambodia and the Lao People’s Democratic Republic. The programme was developed and delivered by the project team in partnership with local stakeholders and technical experts. A country-centric approach ensured that training programmes met each country’s needs, while input from technical experts ensured an evidence-based programme that aligned with international standards. There were 445 training participants from professional groups across various levels and sectors of the health system. Training curricula included a range of differentiated training modules which aimed to build knowledge and skills to drive increased vaccine demand, improve service delivery and optimise monitoring and evaluation of programmes.
The Gavi Learning and Performance Management framework supported a structured reflection of programme strengths, limitations and opportunities. Strengths were the country-centric and learner-centric approach and the high technical quality of the programme. The pandemic context necessitated agility and adaptation to meet changing country needs and priorities, however, this introduced some limitations. Future training programmes should undertake an enhanced assessment of training needs, workforce and digital capabilities and learning and performance management systems, alongside the development of country-driven immunisation workforce training roadmaps to ensure optimal impact and sustainability.
The Gavi Learning and Performance Management framework supported a structured reflection of programme strengths, limitations and opportunities. Strengths were the country-centric and learner-centric approach and the high technical quality of the programme. The pandemic context necessitated agility and adaptation to meet changing country needs and priorities, however, this introduced some limitations. Future training programmes should undertake an enhanced assessment of training needs, workforce and digital capabilities and learning and performance management systems, alongside the development of country-driven immunisation workforce training roadmaps to ensure optimal impact and sustainability.
Australian parents' experiences with adolescent age-based vaccinations during the COVID-19 pandemic
(2025) Steffens, Maryke S.; Bolsewicz, Katarzyna T.; King, Catherine; Bullivant, Bianca; Abdi, Ikram; Beard, Frank
PurposeIn Australia, adolescents are scheduled to receive vaccinations against diphtheria, tetanus, pertussis, human papillomavirus, and meningococcal disease, delivered via school vaccination programs and general practitioners (GPs).
Public health measures implemented in response to the COVID-19 pandemic impacted uptake of some adolescent age-based vaccinations. Limited information is available on parents' approaches to vaccinating their adolescent children during the pandemic.
We aimed to explore parents' experiences of adolescent age-based vaccinations during the pandemic, and factors they perceived as hindering or facilitating vaccination.
Methods
In July 2022 we recruited 21 Australian parents of adolescent children eligible for age-based vaccinations in 2021. We recruited from metropolitan and regional settings, and from states where uptake was most and least affected by pandemic disruptions. We conducted 30-min virtual or phone interviews and analysed the data thematically.
Results
Parents described how experiences before and during the COVID-19 pandemic influenced their perspectives on and experiences with adolescent age-based vaccinations. Motivation to vaccinate their children was informed by personal beliefs and experiences with the healthcare system. Parents described practical issues, including ease of access to the school vaccination program or a GP, and knowledge about vaccination schedules and services.
Parents suggested enhancing promotion of adolescent vaccination benefits and information sharing, and recommended improving access to vaccination services outside the school program.
Discussion
Findings have potential to improve delivery of adolescent age-based vaccinations, including during future pandemics. While this study was conducted in the Australian context, findings and recommendations have relevance to overseas adolescent age-based vaccination programs.
Public health measures implemented in response to the COVID-19 pandemic impacted uptake of some adolescent age-based vaccinations. Limited information is available on parents' approaches to vaccinating their adolescent children during the pandemic.
We aimed to explore parents' experiences of adolescent age-based vaccinations during the pandemic, and factors they perceived as hindering or facilitating vaccination.
Methods
In July 2022 we recruited 21 Australian parents of adolescent children eligible for age-based vaccinations in 2021. We recruited from metropolitan and regional settings, and from states where uptake was most and least affected by pandemic disruptions. We conducted 30-min virtual or phone interviews and analysed the data thematically.
Results
Parents described how experiences before and during the COVID-19 pandemic influenced their perspectives on and experiences with adolescent age-based vaccinations. Motivation to vaccinate their children was informed by personal beliefs and experiences with the healthcare system. Parents described practical issues, including ease of access to the school vaccination program or a GP, and knowledge about vaccination schedules and services.
Parents suggested enhancing promotion of adolescent vaccination benefits and information sharing, and recommended improving access to vaccination services outside the school program.
Discussion
Findings have potential to improve delivery of adolescent age-based vaccinations, including during future pandemics. While this study was conducted in the Australian context, findings and recommendations have relevance to overseas adolescent age-based vaccination programs.
The association between routine immunisation and COVID-19 vaccination in small Island developing states
(2025) Patel, Cyra; Bilgin, Gizem; Hayen, Andrew; Kirk, Martyn; Ali, Akeem; Dey, Aditi; Sargent, Ginny; Sheel, Meru; Harapan, Harapan
ObjectivesUnderstanding the link between routine immunisation (RI) performance and vaccination during an epidemic can provide insights on health systems resilience and investments to strengthen health systems. We examined the relationship between RI performance and COVID-19 vaccination coverage in small island developing states (SIDS).
Methods
We analysed immunisation and health system performance data in 55 SIDS. Our primary outcome was COVID-19 vaccination coverage at four timepoints (June 2021, December 2021, June 2022 and December 2022). We examined associations with coverage of six childhood immunisations (5-year mean annual coverage for 2015-2019), pandemic-related disruptions to RI, new vaccine introductions, health system performance measures, and economic and demographic characteristics. We calculated Spearman correlation coefficients (r) with p-values (p FindingsCOVID-19 vaccination coverage was higher in countries that sustained pre-pandemic RI coverage during the pandemic, and where HPV, influenza and measles-containing (second dose) vaccines had been introduced.
There were weak correlations (
r
Conclusions
Countries that achieved high COVID-19 vaccination coverage also sustained RI coverage during the pandemic, demonstrating health system resilience. Our findings highlight the importance of having sufficient skilled health professionals and experience in introducing new vaccines targeting different age groups into national programs, particularly in small island settings.
Methods
We analysed immunisation and health system performance data in 55 SIDS. Our primary outcome was COVID-19 vaccination coverage at four timepoints (June 2021, December 2021, June 2022 and December 2022). We examined associations with coverage of six childhood immunisations (5-year mean annual coverage for 2015-2019), pandemic-related disruptions to RI, new vaccine introductions, health system performance measures, and economic and demographic characteristics. We calculated Spearman correlation coefficients (r) with p-values (p FindingsCOVID-19 vaccination coverage was higher in countries that sustained pre-pandemic RI coverage during the pandemic, and where HPV, influenza and measles-containing (second dose) vaccines had been introduced.
There were weak correlations (
r
Conclusions
Countries that achieved high COVID-19 vaccination coverage also sustained RI coverage during the pandemic, demonstrating health system resilience. Our findings highlight the importance of having sufficient skilled health professionals and experience in introducing new vaccines targeting different age groups into national programs, particularly in small island settings.