Tailoring Strategies to Improve Child Immunisation in Areas of Low Coverage in Local Health Districts in NSW through Partnerships and Community Engagement

Status: Project complete

What is the problem?

Immunisation is a safe and effective way to prevent serious childhood disease. Deaths from vaccine-preventable diseases have dropped by 99% in Australia since vaccination was introduced in 1932.

Internationally, it is estimated that vaccination prevents upwards of 3 million deaths each year.

While most children in Australia are fully immunised, areas of low coverage persist.

In Tamworth, Kempsey and Lismore there is a high proportion of Aboriginal children who are not fully immunised.

Low vaccination rates are not necessarily due to anti-vaccination ideology, but can occur for a range of reasons often closely linked to socioeconomic adversity and logistical barriers. These barriers are more common in rural communities.

About the research translation program

Four studies exploring the barriers to childhood immunisation in areas of low coverage in NSW were conducted in Umina, Tamworth, Kempsey and Lismore.

The research was co-led by university researchers and LHD service providers from public health units and community health staff.

Aboriginal Immunisation Health Workers were involved in all aspects of the studies, and strategies to improve coverage were identified.

What were the findings?

Researchers found a number of similarities across the studies, including;

    • Parents are not opposed to immunisation and want their children to be fully vaccinated;
    • Parents experience socio-economic hardship that often means immunisation isn’t a priority;
    • A number of service access barriers make it difficult for parents to ensure children are immunised in a timely manner;
    • Lack of cultural safety in government health services and general practice mean some Aboriginal families feel unsafe and unwelcome using them;
    • Immunisation data is not well utilised or shared with relevant health services, meaning many were unaware of the pockets of low coverage in their district.

Effective strategies that were recommended by study participants included;

    • Ensuring parents have a range of flexible services in convenient locations that are free of charge including drop in clinics, outreach, and home visiting;
    • Ensuring services are culturally welcoming and acceptable for Aboriginal people, including having Aboriginal Health Workers who understand the cultural factors and practical obstacles faced by many families;
    • Better use of reminders by SMS, mail or phone so parents can organise appointments in advance;
    • Better use of immunisation data to keep service planners and providers informed of trends.

Information about the project has been published on the National Centre for Immunisation Research and Surveillance website at www.ncirs.org.au


Thomas S, Paden V, Lloyd C, Tudball J, Corben P. Tailoring Immunization Programmes in Lismore, NSW; the thing we want our children to do is be healthy and grow well and immunisation really helps that. The Australian Journal of Rural and Remote Health (under review). 2021. doi: 10.22605/RRH6803

Thomas S, Islam F, Higgins H, Cashman P, Durrheim D. Improved childhood immunization coverage using the World Health Organization’s Tailoring Immunization Programmes guide (TIP) in a regional centre in Australia, (under review). Vaccine. 2021. doi: 10.1016/j.vaccine.2021.11.067

Thomas S, Allan N, Taylor P, McGrady P, Bolsewicz K, Islam F, et al. Achieving full childhood immunisation coverage in Tamworth, Australia: learning from First Nations people. International Indigenous Policy Journal (in press). 2021;12(2).

Bolsewicz K, Thomas S, Moore D, Gately C, Dixon A, Cook P, et al. Using the Tailoring Immunization Programmes guide to improve child immunisation in Umina, New South Wales: we could still do better. Australian Journal of Primary Health. 2020;26(3). doi: 10.1071/PY19247

Bolsewicz K, Thomas J, Corben P, Thomas S, Tudball J, Fernando M. “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 NSW, Australia. Australian Journal of Rural Health (under review). 2021. doi: 10.1111/ajr.12771

Thomas S, Bolsewicz K, Leask J, Clark K, Ennis S, Durrheim D. Structural and social inequities contribute to pockets of low childhood immunisation in New South Wales, Australia. International Journal for Equity in Health, submitted. 2021. doi: 10.21203/rs.3.rs-497026/v1


For more information, contact NSW Regional Health Partners – contact@nswregionalhealthpartners.org.au