Vaccine Uptake
Improving vaccine confidence and uptake across the lifespan in Australia and globally.
Billions of dollars have been spent developing new, effective, and safe vaccines–and yet, nearly 20 million children don’t receive basic vaccines each year. Our group focuses on understanding and addressing the reasons for low vaccine uptake.
Our aims are to:
- understand and diagnose the reasons for under-vaccination
- target and support vaccine uptake in vulnerable populations
- develop and evaluate interventions to increase vaccine uptake in Australia, the Western Pacific Region, and globally
- inform effective, equitable and evidence-based vaccine policy in Australia.
We have a range of projects that include:
- Developing and testing interventions to improve vaccine uptake for pregnant women, children, high-risk populations and in low resource settings.
- Designing and validating tools to measure vaccine acceptance and barriers to accessing vaccination.
- Informing and evaluating policy, particularly the evaluation of vaccine mandates or studies to further inform immunisation policy.
- Training and building capacity to implement and evaluate vaccine promotion strategies within Australia and the Western Pacific Region.
We have a strong interest in vaccine confidence, trust, health program resiliency and communication. Our work applies principles from social and behavioural science and uses both qualitative and quantitative research methods.
Our research
COVID-19 Vaccine Preparedness Study Summary
To support the COVID-19 vaccine program, the Victorian Government funded this research to find out if Victorians were planning to get the vaccine, what concerns people had, and what information they needed to make this decision.
Vaccine Uptake Symposium 2021
The Vaccine Uptake Group at the Murdoch Children’s Research Institute focuses on building vaccine confidence and understanding and addressing the reasons for low vaccine uptake across the lifespan, for different vaccines, populations and settings.
Given the global focus on COVID-19 vaccine uptake this year, the symposium showcased some of our world-leading social science research on vaccine confidence and uptake of COVID-19 vaccines, and other vaccines, including three sessions on:
- Understanding drivers and barriers to COVID-19 vaccine uptake in high-risk groups
- Improving routine NIP vaccination in key priority groups
- Global vaccination strategies to diagnose the causes of under-vaccination in different settings and tailor strategies to improve vaccine coverage

Our projects
COVID Wellbeing Study
This mixed-methods longitudinal cohort study investigates the immediate and longer-term health and wellbeing impacts of COVID-19 on children and families. With a combination of surveys and interviews, we explore the clinical, psychosocial, educational, and economic impacts of COVID-19 on their families. This study will help us answer questions such as, how can our health services provide the best care and ongoing support for families affected by COVID-19? And how we can improve communication, support and care for children tested and/or diagnosed with COVID-19 in the future?
COVID Schools Study
Together with the Victorian Department of Health (DH) and the Victorian Department of Education and Training (DET), we are conducting an enhanced public health investigation of COVID-19 cases in Victorian schools and early childhood education and care (ECEC). The research aims to increase knowledge about key aspects of COVID-19 transmission and the public health response, including the role of young children and students in COVID-19 transmission and the impact of coronavirus (COVID-19) on school and ECEC communities.
Vaccine Barriers Assessment Tool (VBAT)
This is a four-year NHMRC-funded project to design and validate a survey tool to diagnose the causes of under-vaccination in Australia and New Zealand. Vaccine uptake requires both acceptance (confidence in vaccine safety and effectiveness, trust in healthcare systems and providers) and access (adequate supply of vaccines, affordability, availability, transport). The VBAT will be the first tool to help us understand the reasons for low uptake in specific populations. This information will guide the selection and implementation of cost-effective interventions to increase vaccine uptake. Planning is underway to adapt the VBAT for Aboriginal and Torres Strait Islander families and adult vaccination.
P3-MumBubVax Intervention
We developed and pilot-tested a multicomponent intervention package, called P3-MumBubVax, which targets expectant parents and antenatal care providers to improve uptake of vaccines in pregnancy and childhood vaccines. It is called “P3” because it includes components at the Practice, Provider, and Parent level. You can find most of the P3-MumBubVax resources at mumbubvax.org.au
The P3-MumBubVax intervention is currently being adapted and pilot tested in Canada, funded by the Canadian Institutes of Health Research and Canadian Immunization Research Network.
It is also being expanded and integrated into the national Sharing Knowledge About Immunisation (SKAI) Across the Lifespan online hub, in partnership with the National Centre for Immunisation Research and Surveillance (NCIRS) and funded by the Commonwealth Government.
COVID-19 vaccination message testing study
Acceptance of COVID-19 vaccines is essential to achieve high uptake and prevent severe disease. Information interventions are one strategy to support acceptance of COVID-19 vaccines, but evidence on what messages work best to promote uptake is limited. The aim of this online survey study is to test the impact of different messages about COVID-19 vaccines (1) in adults vaccinated against COVID-19 on intention to receive a COVID-19 vaccine booster dose, and (2) in parents of children aged 5-11 years on intention to take their child for a COVID-19 vaccine. This study is being conducted in partnership with colleagues from the National Centre for Immunisation Research and Surveillance.
MIND (Measuring Immunisation in Neurodiverse populations)
This mixed-methods study examines vaccine uptake, hesitancy, and practical barriers to vaccination among families of children with neurodevelopmental disorders. A study in the US showed that children with Autism Spectrum Disorder and their siblings may be less likely to be vaccinated and more likely to be vaccine hesitant, but we don’t know if this is true in Australia. We also don’t know if this is related to a perceived link between vaccines and autism, or if it is because of practical barriers like behavioural challenges or anxiety. We are exploring this issue by comparing uptake and hesitancy across three groups of children and their siblings: those with Autism Spectrum Disorder, Down Syndrome, and the general population.
Migrant Immunisation Access (MIA) Project
The MIA project will determine the extent of and examine the specific reasons behind under-immunisation among children of migrant parents by identifying gaps in health service delivery and exploring migrant experiences and awareness of immunisation services in the City of Melbourne, Victoria. We are exploring the impact of COVID-19 on access to routine immunisation services and interpretation of public health messaging. The project is a collaboration between our group and the City of Melbourne’s Immunisation Section, as well as key stakeholders including General Practitioners (GPs) and migrant parents.
COVID Vaccine Preparedness Study
Clear and reliable information is important for answering people’s questions and building trust. This study aimed to understand the questions, concerns, information needs, and decision-making factors of people prioritised to receive and deliver COVID-19 vaccines. This included health care workers, aged and disability care workers, people aged 70 years-old and older, and adults with an underlying health conditions. With involvement from participants, we used a co-design approach to inform the development of communication messages and strategies for the COVID-19 vaccine rollout by the Victorian Department of Health (DH). This helped DH give clear and accurate information to Victorians to help them decide regarding COVID-19 vaccination.
COVID-19 vaccines for children: supporting parent and child decision-making
Children are a major focus for the 2022 COVID-19 vaccine rollout. We know that parents have questions and require support to make informed decisions about vaccinating their children. In this study, we will develop and pilot test vaccination resources and decision support tools for parents and children. We will also deliver and evaluate training for healthcare providers, educators and community leaders to build confidence in and communicate about COVID-19 vaccines for children. This study will include surveys and focus groups and is supported by the Victorian Department of Health.
Why are the babies not growing? A study of paediatric hospital admissions for infants with poor growth or maternal mental health concerns during the COVID-19 pandemic.
There has been a substantial increase in the number of Victorian infants presenting with feeding difficulties, poor weight gain, irritability, as well as a large impact on maternal mental health and requirement for parental support, because of the closure of Maternal and Child Health Services (MCHN) at various times during the pandemic. We are conducting an audit in infants < 12 weeks admitted to the Royal Children’s Hospital between March-June 2020 to understand the impact of the pandemic infants and their mothers from withdrawal of this service. We have also expanded the study state-wide through the Melbourne Academic Centre for Health (MACH) Health Services Research Group.
Rapid Formative Assessment Prior to New Vaccine Introduction in 9 Pacific-Island Countries
UNICEF Pacific have requested support to develop a Rapid Formative Assessment survey to guide new vaccine introduction in nine Pacific Island Countries (PICs) to inform new vaccine introduction strategies, specifically around risk communication, knowledge, attitudes and practices towards immunisation. Through the Australian Regional Immunisation Alliance (ARIA), we are co-leading this project to develop the survey tool with countries administering the survey and ARIA supporting the data analysis and reporting results back to UNICEF. The implementers will rely on existing UNICEF and in-country capacity to oversee and coordinate engagement with local stakeholders. These data will provide behavioural and social science data to inform new vaccine introduction in nine PICs through ARIA.
Guidelines for Immunisation Holding Practices in Schools (GIHPS) Project
Holding young people with a disability for immunisations given through the School-based Immunisation Program is complex. Many young people with cognitive difficulties will not assent to immunisation, because of issues such as communication, lack of understanding of the benefit of the procedure, fear of needles and anxiety about the process. Whether the student has sufficient capacity to assent, or whether their right to refuse should be prioritised over the benefits of immunisation, raises ethical tensions. To explore this issue, GlaxoSmithKline plc awarded our group a grant to develop a guideline for the holding of young people with disability during immunisation at school. The aim of this project is to design and develop an ethically informed best-practice guideline, to guide the use, appropriateness and method of holding young people with disabilities during immunisations within the School-based Immunisation Program in Victoria.
DOVES HPV Study
Despite the profound and measurable health benefits of immunisation programs in Australia, research shows that programs are significantly less likely to reach and vaccinate young people with disability, including HPV vaccination which provides a crucial safety net against HPV related cancers. We developed this study in partnership with Cancer Council Victoria, the Victorian Department of Health and Department of Education and Training and aims to identify the barriers and facilitators for HPV vaccination among adolescents with a disability, and ways to optimise these services. We hope these findings can then inform the development of disability-inclusive services and supports to improve the immunisation experience and uptake of HPV vaccinations among young people with disability.
Women’s Vaccine Decisions and COVID-19 Study
COVID-19 vaccine hesitancy is higher among women of childbearing age, including pregnant and breastfeeding women. This is the first Australian study to clearly reveal the key factors influencing their COVID vaccine uptake decisions. We interviewed women of childbearing age; many were vaccine hesitant, including some who were pregnant or breastfeeding. Predominant concerns were around unknown long-term safety effects, fertility, birth outcomes and child development post-COVID-19 vaccination. Loss of trust in Government and healthcare providers following vaccine mandating was voiced. We need robust safety data and transparent public health communications to ensure confidence in COVID-19 vaccines for women of childbearing age. Vaccine mandates should be used judiciously as these can reduce trust in healthcare providers.
Cohealth Health Concierge Evaluation Study
Good health, including access to health services, is a fundamental human right. Culturally and linguistically diverse people, and people living in public housing, may find it harder to access the health care and support services that are right for them. Cohealth is a health care provider which hired people to work as Health Concierges in public housing communities. Their job is to give residents information about COVID-19 and conduct health promotion activities to help reduce the spread of COVID-19. This project will be co-designed with residents of public housing communities and Health Concierges to evaluate the impact of the Health Concierge program on residents’ engagement with health services and public health activities.
Vaccine Champions and Vaccine Communication (VCVC) training program
At the start of the pandemic in Australia, a team from the Collaboration on Social Science and Immunisation (COSSI) [link: https://www.ncirs.org.au/COSSI] network developed the VCVC training program with support from the Victorian Department of Health. This program empowers healthcare providers, community, faith and industry leaders to become vaccine advocates or “champions”. We have delivered this program to over 70 groups around Australia, and now aim to adapt, deliver and evaluate this program in the Western Pacific Region. Working with local stakeholders in four Western Pacific countries, we will tailor the VCVC program and train and support local vaccine champions to deliver their own community sessions. This project is supported by the Australian Regional Immunisation Alliance (ARIA) and undertaken in partnership with UNICEF.
Other projects
- Optimising rotavirus vaccine in Aboriginal children
- Characterising clinical presentation and outcomes of children presenting with seizures following vaccination and revaccination outcomes of children with seizures
Funding
- Australian Department of Health
- Australia-Indonesia Centre (AIC)
- Bell Charitable Fund
- GlaxoSmithKline (GSK)
- Gold Coast Primary Health Network
- MCRI Infection & Immunity Theme
- National Health and Medical Research Council (NHMRC)
- The Royal Children’s Hospital Foundation
- University of Sydney
- UNICEF
- Victorian Department of Education and Training
- Victorian Department of Health
- Wesfarmers Centre of Vaccines & Infectious Diseases
- World Health Organization (WHO)
Collaborations
Australian collaborators
- Australian College of Midwives
- Burnet Institute
- Cancer Council Victoria
- Collaboration on Social Science and Immunisation (COSSI)
- Commonwealth, Victorian, NSW and WA Departments of Health
- National Centre for Immunisation Research and Surveillance (NCIRS)
- Telethon Kids Institute
- The Peter Doherty Institute for Infection and Immunity
- University of Melbourne Department of Paediatrics
- University of Melbourne Department of General Practice
- University of New South Wales
- University of Sydney
- University of Technology Sydney
- University of Western Australia
- Victorian Department of Education and Training
International collaborators
- Johns Hopkins Bloomberg School of Public Health, USA
- World Health Organization (WHO)
- WHO Regional Office for Europe
- United Nations Children’s Fund (UNICEF)
- United States Centers for Disease Control and Prevention (US CDC)
- Yale University, USA
Featured publications
- Feasibility and acceptability of the multi-component P3-MumBubVax antenatal intervention to promote maternal and childhood vaccination: a pilot study.
Kaufman et al. F. https://doi.org/10.1016/j.vaccine.2020.04.010 - Parent-level barriers to uptake of childhood vaccination: a global overview of systematic reviews.
Kaufman et al. https://gh.bmj.com/lookup/doi/10.1136/bmjgh-2021-006860 - Revision of the Australian Immunisation Register should be considered to meet the needs of migrant children.
Tuckerman et al. https://onlinelibrary.wiley.com/doi/10.1111/jpc.15670 - Qualitative exploration of intentions, concerns and information needs of vaccine-hesitant adults initially prioritised to receive COVID-19 vaccines in Australia.
Kaufman et al. https://doi.org/10.1016/j.vaccine.2020.04.010