Using the Tailoring Immunization Programmes guide to improve child immunisation in Umina, New South Wales: we could still do better

Abstract

In the Central Coast Local Health District of New South Wales, Australia, childhood immunisation (CI) rates are around 95%, but pockets of underimmunisation exist. Using the World Health Organization’s Tailoring Immunization Programmes, we identified areas of potential low vaccine coverage using Australian Immunisation Register (AIR) data (2016–18) and investigated factors that influence CI. Individual and group interviews with carers, community members and service providers (n=52 participants) were conducted. Data were analysed thematically and the themes presented to stakeholders for feedback before finalisation. During 2018, Umina had 218 children at least 1 month overdue for at least one vaccination. Five themes emerged: (1) broader socioeconomic factors may apply pressures that influence CI; (2) parents largely supported immunisation and knew of its benefits to their children and the community; (3) immunisation service providers are committed, experienced and collaborate with community partners; (4) there is potential to increase access to free immunisation services in Umina; and (5) AIR data and reminder systems could be better used to inform service delivery and prompt parents before immunisations are due. This study identified opportunities to improve CI coverage in Umina and new information useful in developing a tailored immunisation strategy. Awareness of the pressures socioeconomic factors may have on families could help plan and deliver supportive primary health care that includes equitable access to immunisation.

“To Protect Myself, My Friends, Family, Workmates and Patients …and to Play My Part”: COVID-19 Vaccination Perceptions among Health and Aged Care Workers in New South Wales, Australia

“…While COVID-19 vaccination in Australia is offered to eligible individuals at no cost, there may be factors other than vaccine cost that hinder access for the public and HACWs, including awareness of services, booking systems, geographical distance and transport to services, service convenience and cultural appropriateness [3,35,36]. Further qualitative research with priority populations from different geographic, social and cultural environments conducted during different stages of COVID-19 vaccine rollout will provide insights into motivational and practical factors that influence vaccine acceptance and uptake over time.…”

Combining First Nations Research Methods with a World Health Organization Guide to Understand Low Childhood Immunisation Coverage in Children in Tamworth, Australia

“…Many service providers were surprised to learn that a relatively large number of First Nations children in Tamworth were not fully immunised for their age. This lack of awareness was found in previous TIP studies in NSW (Bolsewicz et al, 2020;Thomas et al, 2018). In Australia, good quality immunisation data is available from the AIR and from medical software used in ACCHSs and general practice.…”

‘Immunisation, I haven't had a problem, but once again the transport, making an appointment, the time that you waste and all of those things are an issue’—Understanding childhood under‐immunisation in Mid North Coast New South Wales, Australia

“…Recruitment and data collection methods followed the protocols used in previous TIP studies in Australia, described in detail elsewhere. 4 Briefly, health service providers servicing Kempsey (listed in Table 2) were identified by members of the research team. Mothers and grandmothers residing in Kempsey were identified by staff of community organisations and through attendance at First Nations community events, during which researchers established relationships with community participants.…”

“…1 Recent Australian studies found that while most parents are supportive of immunisation, some children either appear to have fallen behind due to errors in immunisation records 2 or have fallen behind due to social, economic and cultural access barriers. [2][3][4] Targeted approaches are required to improve immunisation rates in areas of low coverage. 5,6 The World Health Organization's Tailoring Immunization Programme (TIP) is a guide to exploring and addressing childhood under-immunisation attributed to barriers other than entrenched ideological views.…”

“…7 TIP has been used in several European countries [8][9][10] and across NSW, Australia. 3,4 Routine analysis of Australian Immunisation Register data conducted by the New South Wales (NSW) Mid North Coast (MNC) Public Health Unit identified Kempsey as an area with low coverage for children aged 5 years and under who were at least 30 days overdue for at least one scheduled vaccination. As of 1 September 2018, 101 of 995 children (9.9%) were overdue, with 57% (58) being of Aboriginal and Torres Strait Islander background (hereafter referred to as First Nations peoples).…”