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Vaccine Uptake

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. The Vaccine Uptake group, led by A/Prof Margie Danchin, focuses on understanding and addressing the reasons for low vaccine uptake.

Our aims are:

  • To understand and diagnose the reasons for under-vaccination
  • To target and support vaccine uptake in vulnerable populations
  • To develop and evaluate interventions to increase vaccine uptake in Australia, the Western Pacific region, and globally

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. 

Group Leaders: 
Group Members: 
Group Members: 
Dr Katie Bagot
Role: 
Research Officer
Meaghan Hawley
Role: 
Research Assistant
Carol Jos
Role: 
Research Assistant
Fran Justice
Role: 
Project Manager
Myles Loughnan
Role: 
Research Assistant
Dr Jenny O'Neill
Role: 
Research Officer
Belle Overmars
Role: 
Masters Student
Lily Richard
Role: 
Honours Student
Darren Suryawijaya
Role: 
Research Assistant
Tria Williams
Role: 
Senior Project Coordinator
Dr Jane Oliver
Role: 
Research Officer

COVID Vaccine Preparedness Study

Clear and reliable information is important to answer people’s questions and build trust. The COVID Vaccine Preparedness study aims to understand the questions, concerns, information needs, and decision-making factors of people prioritised to receive and deliver COVID-19 vaccines. This includes 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 will use a co-design approach to inform the development of communication messages and strategies for the COVID vaccine rollout by the Victorian Department of Health (DH). This will help DH give clear and accurate information to Victorians to help them make decisions regarding COVID-19 vaccination.
For more information about participating, see COVID Vaccine Preparedness Study.

COVID Schools Study (Enhanced public health investigation of SARS-CoV-2 cases in Victorian schools and early childhood education and care).

The Murdoch Children’s Research Institute (MCRI), together with the Victorian Department of Health (DH) and the Victorian Department of Education and Training (DET), is conducting a study to increase understanding of coronavirus (COVID-19) transmission in schools and Early Childhood Education and Care (ECEC) services. It is anticipated that the findings from this research will inform the public health response to outbreaks in schools and ECEC services. Schools and ECEC services are an essential part of society and children’s lives. They provide safe and supportive learning environments for children and students, employ teachers and other staff, and enable parents and guardians to work. Ultimately, we need more evidence to understand how coronavirus (COVID-19) is spread in schools and ECEC, inform the best way to respond to outbreaks, and ensure that children, students and staff are supported and can continue to learn and thrive in 2021. The research aims to increase knowledge about key aspects of coronavirus (COVID-19) transmission and the public health response, such as: the role of young children and students in coronavirus (COVID-19) transmission, the direction of coronavirus (COVID-19) transmission in schools and ECEC services, the impact of coronavirus (COVID-19) on school and ECEC communities.

Eligible schools and ECEC services will be invited by MCRI to participate in the research. Participation is voluntary. The standard public health response will continue to apply in schools and ECEC services that experience a coronavirus (COVID-19) outbreak. This research follows on from a study undertaken by the Murdoch Children’s Research Institute in 2020: An analysis of COVID-19 in ECEC and schools and evidence-based recommendations for opening ECEC and schools & keeping them open. Download the report.
Any questions about the research should be directed to: Associate Professor Margie Danchin, email: covidschools@mcri.edu.au.
For more information, see COVID Schools Study.

Vaccine Barriers Assessment Tool (VBAT) 
This is a 4-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.

P3-MumBubVax intervention 
Pregnancy is an important time to inform expectant parents about vaccines for themselves and their infants. This project aims to improve uptake of influenza and pertussis vaccines in pregnancy, as well as childhood vaccines. We developed and pilot-tested a multicomponent intervention package, called P3-MumBubVax, that targets expectant parents and midwives in the Australian public antenatal setting. It is called “P3” because it includes components at the Practice, Provider, and Parent level. Testing the effectiveness of this intervention in a trial is the next phase of this project.

MIND (Measuring Immunisation in Neurodiverse populations)
This study is examining 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 necessarily 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 due to practical barriers like behavioural challenges or anxiety. With this small mixed methods study, supported by a 2019 Infection and Immunity Theme grant, we’re exploring this issue. We are comparing uptake and hesitancy across three groups of children and their siblings: those with Austism Spectrum Disorder, Down Syndrome, and the general population.

Acute RCH Wellbeing Cohort: Clinical, psychosocial and economic impacts of COVID-19 on a paediatric hospital cohort of children and families
For all tested children through the outpatient Respiratory Infection Clinic (RIC) or wards (Short Stay Unit and general medical inpatients), we are seeking to understand the level of psychological trauma experienced in an acute hospital cohort of children related to testing and hospitalisation and management by staff in full PPE. We will also ascertain what factors predict risk and resilience, parents’ knowledge of COVID-19, trust in government and interpretation of and adherence to public health prevention measures. We are undertaking a mixed methods study, including an economic analysis from health system and household perspective. The study will be linked to the Campus Mental Health Strategy and expanded to include national data collection in six tertiary hospital sites through the Paediatric Active Enhanced Disease Surveillance (PAEDS) study. This project will help us answer questions like, 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 in the future?

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
It has noted that due to the closure of Maternal and Child Health Services (MCHN) in Victoria at various times during the pandemic that there has been a huge increase in the number of infants presenting with feeding difficulties, poor weight gain, irritability, as well as a large impact on maternal mental health and requirement for parental support. We are conducting an audit in infants < 12 weeks admitted to RCH between March-June 2020 to try and understand the impact of the pandemic infants and their mothers from withdrawal of this service. Differences in nature and severity of presentations will be compared for the same time periods in 2020 and 2019. The study is also being expanded statewide through the Melbourne Academic Centre for Health (MACH) Health Services Research Group.

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 will also explore the impact of COVID-19 on access to routine immunisation services and interpretation of public health messaging. The project is a collaboration between the Vaccine Uptake Group and the City of Melbourne’s Immunisation Section, as well as key stakeholders including General Practitioners (GPs) and migrant parents.

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 9 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), I am 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. Other implementation partners include Rotary International & Asian Development Bank. These data will provide behavioural and social science data to inform new vaccine introduction in 9 PICs through ARIA.

GIPHS Project

The issue of 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, due to 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 the Vaccine Uptake 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. 

 Other projects:

  • Understanding the association between vaccine hesitancy and moral values in parents’ decision-making
  • Monitoring exposure to news and social media to understand vaccine hesitancy and inform vaccine communication interventions
  • Impact of Australian mandatory “No Jab, No Pay” and “No Jab, No Play” immunisation policies on immunisation services, parental attitudes to vaccination and vaccine uptake
  • Optimising Rotavirus Vaccine in Aboriginal Children
  • Barriers to flu vaccine uptake in medically at-risk children. 
  • The School-based Immunisation Program for young people with disabilities in specialist school in Victoria
  • 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
  • Federal Department of Health
  • Glaxo Smith Kline (GSK) 
  • Gold Coast PHN
  • MCRI Infection and Immunity Theme
  • National Health and Medical Research Council
  • RCH Foundation
  • University of Sydney
  • Victorian Department of Health and Human Services
  • Wesfarmers Centre for Vaccine Research, WA
  • World Health Organization
Collaborations: 

Australian Collaborators:

  • Australian College of Midwives
  • Collaboration on Social Science and Immunisation (COSSI)
  • National Centre for Immunisation Research and Surveillance (NCIRS)
  • Telethon Kids Institute
  • University of Melbourne, Department of Paediatrics 
  • University of Melbourne, Department of General Practice
  • University of Sydney
  • University of Western Australia
  • Victorian, NSW and WA Departments of Health
  • Commonwealth Department of Health
  • Doherty Institute 
  • Burnet Institute

International Collaborators: 

  • WHO Europe
  • World Health Organization
  • Yale University
  • UNICEY, New York
  • CDC, Atlanta, USA
  • Johns Hopkins Bloomberg School of Public Health, Baltimore, USA 

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