Vaccine Uptake
Improving vaccine uptake across the lifespan and around the world.
Billions of dollars are spent developing new, safe and effective vaccines – and yet, millions of people don’t receive recommended vaccines each year. Our group focuses on understanding and addressing the reasons for low vaccine uptake.
Our aims are to:
- Understand the individual, social and practical factors that affect vaccine uptake.
- Increase vaccine equity for poorly-reached populations.
- Improve vaccine communication and delivery.
- Develop and evaluate interventions to increase vaccine uptake in Australia 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 across the lifespan for special populations such as adolescents with a disability, pregnant women, migrants and refugees, high-risk populations and people in low resource settings.
- Building capacity in vaccine communication and promotion within Australia and the IndoPacific region.
- Establishing an ongoing surveillance program using validated tools to measure vaccine acceptance and barriers to accessing vaccination.
- Building vaccine confidence by addressing key questions about the safety, immunity and developmental impacts of maternal vaccination.
- Evaluating vaccine mandates to inform immunisation policy.
We have a strong interest in communication and community engagement, vaccine confidence, vaccine service delivery innovations and health program resiliency. Our work applies principles from social and behavioural science and uses both qualitative and quantitative research methods.
Our projects
Behavioural Insights and Communication projects
Our current projects include vaccine sentiment surveillance, policy evaluation, communication and community engagement.
Vaccine Barriers Assessment Tool (VBAT)
This NHMRC-funded project designed and validated a survey tool to diagnose the causes of under-vaccination of children in Australia. 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 and transport).
The VBAT has a short six-question form and a longer 15-question form. It is the first validated tool to measure both access and acceptance. In 2023, we are collaborating with the National Centre for Immunisation Research and Surveillance to apply the VBAT for national and state-wide sentiment surveillance. This information will guide the selection and implementation of cost-effective interventions to increase vaccine uptake.
The VBAT is being adapted and validated in New Zealand for Māori populations, with planning underway to adapt the VBAT for Aboriginal and Torres Strait Islander families.
Key publications:
MandEval
MandEval is a large collaborative study currently under consideration for MRFF funding. It is led by Associate Professor Katie Attwell from the University of Western Australia.
MandEval aims to investigate the impact of COVID-19 vaccine mandates on uptake and attitudes at a population level, including drilling into specific sub-populations, exploring policymakers’ experiences and analysing legal contestation.
Understanding the successes and failures of COVID-19 vaccine mandates in Australia and comparing them to similar policies in France and Italy is crucial to the continued management of COVID-19, for designing strategies for future pandemics, as well as for maintaining public confidence in routine vaccines.
Global Vaccine Champions program
This co-designed program trains community leaders to become Vaccine Champions and advocate for routine vaccination, COVID-19 vaccines and new vaccines.
Vaccine Champions are trained to have one-on-one conversations with hesitant people and host vaccine information sessions for their community. Trainees could be healthcare workers or other members of the community such as faith leaders, sports coaches, NGO workers and teachers. People are more likely to accept and act on vaccination recommendations from people they know and trust.
The training is co-designed by community stakeholders including the Ministry of Health, to ensure country priorities are included and training is adapted to suit the local context. In Fiji in 2022, we trained 35 Vaccine Champions who delivered over 50 vaccine information sessions to more than 1000 community members. In Vietnam, we used a train-the-trainers approach to train over 100 Provincial Trainers, who went on to deliver their own Vaccine Champions training sessions to community leaders in their provinces.
Key publications and resources:
Sharing Knowledge About Immunisation (SKAI) across the lifespan
From 2018 to 2021, we developed and pilot-tested a multicomponent intervention package called MumBubVax, which targets expectant parents and antenatal care providers to improve the uptake of vaccines in pregnancy and childhood vaccines. Access the P3-MumBubVax resources.
In 2023 we are expanding and integrating the MumBubVax website 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) which is funded by the Commonwealth Government. This new hub will feature resources about vaccines for children and pregnant women, as well as new resources about COVID-19 vaccines for other population groups such as adolescents.
The P3-MumBubVax intervention is also being adapted and pilot tested in Canada, funded by the Canadian Institutes of Health Research and Canadian Immunization Research Network.
Key publications and resources:
Interpersonal communication training and community engagement to create demand and increase childhood vaccine uptake in Indonesia
In partnership with UNICEF and the University of Gadjah Mada, this project aims to generate vaccine demand in 10 hard-to-reach provinces in Indonesia through building interpersonal communication (IPC) capacity amongst key advocacy groups, including health workers, religious and youth groups, to improve vaccine confidence and support Indonesia’s immunisation agenda to reduce zero-dose children and increase routine and new vaccine coverage. This involves research to understand barriers to childhood vaccine uptake, co-designing IPC train-the-trainer (ToT) training and developing IPC modules for the three stakeholder groups. Following this initial program of work, we will commence capacity building for the three stakeholder groups and conduct the training and rollout of the ToT program across the 10 provinces with comprehensive monitoring, evaluation, and ongoing surveillance of barriers to vaccination.
Factors affecting COVID-19 vaccine booster and childhood vaccine uptake in selected regions in the Philippines
In collaboration with the University of the Philippines, this project aims to determine and address the barriers influencing COVID-19 booster and childhood vaccine uptake in areas with low vaccine coverage in the Philippines, by using surveys and focus groups. We will also review the existing Department of Health, Health Promotion Bureau’s IEC materials (Information Education and Communication) for COVID-19 booster and paediatric vaccination. Other suggested strategies to address both access and acceptance barriers in these priority areas will be discussed at a stakeholder forum with the Department of Health’s National Vaccination Operations Center.
Vaccine Delivery and Practice in Special Populations projects
Our current projects target adolescents, migrant families, pregnant women as well as children and adolescents with high-risk medical conditions or disabilities.
Gen V
The world-first, large-scale study of 20,000 mothers and their babies will deliver rapid results and provide data on the longer-term health and developmental outcomes following maternal vaccination for women, antenatal care providers and policymakers.
Enhancing Protection against Influenza and COVID-19 for pregnant women and medically at-risk children (EPIC Study)
The EPIC Study aims to evaluate the impact of multi-component nudge interventions on the uptake of influenza and COVID-19 vaccines among pregnant women and medically at-risk children. These cohorts are at an increased risk of hospitalisation and death from both COVID-19 and influenza.
The EPIC Study will conduct four randomised control trials investigating the impacts of nudge interventions on vaccine uptake. The EPIC Study was informed by the FluText4U intervention study, which trialled a parent nudge to increase influenza vaccine uptake for children with special risk medical conditions.
FluText4U resources:
DIS-COVER (New strategies to improve protection for adolescents with DISability and optimise vaccine COVERage)
Immunisation programs are significantly less likely to reach and vaccinate young people with disability. This includes human papillomavirus (HPV) vaccination which provides a crucial safety net against HPV-related cancers.
The DIS-COVER stream of work comprises several studies that aim to address barriers to access and improve the vaccination experience for young people with disabilities. The main aim of DIS-COVER is to develop the best model of service delivery nursing care with key stakeholders to optimise the delivery of vaccines in specialist schools.
Studies include:
DOVES (HPV) Study
The Developing Optimised Vaccination Engagement in Specialist Schools for HPV (DOVES HPV) study is a partnership with Cancer Council Victoria and the Victorian Department of Health and aims to identify the barriers and facilitators for HPV vaccination in special schools among adolescents with a disability and ways to optimise these services.
It is anticipated that these findings will then inform the development of disability-inclusive services to improve the immunisation experience and uptake of HPV vaccinations among young people with disability.
Guideline for Immunisation Practices in Schools for Students with Disabilities (GIHPS) study
This project established best practice holding and milestones for the vaccination journey.
Key publications:
Vax4Youth
The primary objective of the Vax4Youth study is to explore the extent of young people aged 12-17 years seeking COVID-19 vaccination without parental consent, as encountered in primary health care. In the first phase of this work, we are surveying primary health care practitioners practising in Victoria, Australia, about their experience of young people seeking COVID-19 vaccination without parental consent.
Key publications and resources:
Virtual Reality for Immunisation
This pilot study investigates whether virtual reality (VR) is a feasible and acceptable method for managing needle phobia for immunisation in neurotypical children and children with developmental disabilities, aged 4-14 years.
Migrant Immunisation Access (MIA) Project
The MIA project is a mixed-methods study that is focused on exploring under-immunisation among children of migrant parents by identifying gaps in health service delivery, exploring migrant experiences and awareness of immunisation services in the City of Melbourne, Victoria.
In the early phases of the MIA project, we examined migrant children’s immunisation service use, access and vaccination status and immunisation provider workload through surveys and in-depth interviews. In our most recent phase of this project, we co-designed an intervention to optimise childhood catch-up immunisations for migrant children.
The project is a collaboration with the City of Melbourne Immunisation Team, as well as key stakeholders including migrant parents and General Practitioners.
Key publications:
COVID Schools Study
The COVID Schools Study is an enhanced public health investigation of SARS-CoV-2 cases in Victorian schools and early childhood education and care. This study aims to increase understanding of coronavirus (COVID-19) transmission in schools and Early Childhood Education and Care (ECEC) services.
Completed projects
- COVID Vaccine Preparedness
- COVID Wellbeing Study - Challenges experienced by families with a child diagnosed with COVID-19
- COVID-19 vaccines for children: supporting parent and child decision-making - Decision support: Helping parents make decisions about vaccinating their children aged 5 to 11 against COVID-19.
- Cohealth Health Concierge Evaluation Study
- Exploring the lived experience of families with a COVID-19 positive child: The journey from a critical grounded theory approach - Kaufman 2023
- Measuring Immunisation in NeuroDiverse Populations (MIND) - Loschiavo et al 2022
- Schools Study
- Vaccine Uptake Symposium 2021 - Vaccine Uptake Symposium 2021 - YouTube
- Women’s Vaccine Decisions and COVID-19 Study - Oliver et al 2022
Current funders
- Australian Department of Foreign Affairs and Trade
- Australian Department of Health
- Australian Regional Immunisation Alliance (ARIA)
- Australia-Indonesia Centre (AIC)
- Gold Coast Primary Health Network
- Marian and E.H. Flack Trust
- MCRI Infection & Immunity Theme
- Medical Research Future Fund (MRFF)
- National Health and Medical Research Council (NHMRC)
- NSW Health
- The Royal Children’s Hospital Foundation
- University of Sydney
- Victorian Department of Health
Collaborations
Australian collaborators
- Australian College of Midwives
- Australian Regional Immunisation Alliance (ARIA)
- Burnet Institute
- Cancer Council Victoria
- Collaboration on Social Science and Immunisation (COSSI)
- Commonwealth, Victorian, NSW and WA Departments of Health
- Kirby Institute
- National Centre for Immunisation Research and Surveillance (NCIRS)
- Telethon Kids Institute
- The Peter Doherty Institute for Infection and Immunity
- University of Adelaide
- 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
- Fiji National University
- The Sydney Vietnam Institute (previously known as the Woolcock Medical Research Institute)
- Johns Hopkins Bloomberg School of Public Health, USA
- United Nations Children’s Fund (UNICEF)
- United States Centers for Disease Control and Prevention (US CDC)
- University of the Philippines
- World Health Organization (WHO)
- WHO Regional Office for Europe
- Yale University, USA
Featured publications
- Exploring the lived experience of families with a COVID-19 positive child: the journey from a critical grounded theory approach. Kaufman et al. 2023.
- Effect of persuasive messaging about COVID-19 vaccines for 5-11 year-old children on parent intention to vaccinate. Kaufman et al. 2023.
- Short Message Service Reminder Nudge for Parents and Influenza Vaccination Uptake in Children and Adolescents with Special Risk Medical Conditions: The Flutext-4U Randomized Clinical Trial. Tuckerman et al. 2023.
- Examining catch‐up immunisation service use for migrant children in the City of Melbourne, Victoria: A quantitative study Journal of Paediatrics and Child Health. Tuckerman et al. 2023.
- Vaccine Champions Training Program: Empowering Community Leaders to Advocate for COVID-19 Vaccines. Kaufman et al. 2022.
- Vaccination of young people from 12 years of age for COVID-19 against parents' wishes. Massie et al. 2022.
- Parent-level barriers to uptake of childhood vaccination: a global overview of systematic reviews. Kaufman et al. 2021
- How to use qualitative methods for health and health services research. Jane Tuckerman et al. 2020.
Media and resources
- Preparing your child with disability for the HPV vaccine - including the 'Supporting your child with disability with vaccination fact sheet' and 'Preparing for school vaccinations social story downloadable'.