One in 10 Australian parents are struggling to afford the costs of vaccinating their children, according to a nationally representative survey conducted earlier this year.
The national vaccination insights project surveyed 2,000 Australian parents of children under five between March and April, and found the biggest barrier to turning declining vaccination rates around were the practical difficulties parents face.
Dr Katarzyna Bolsewicz, one of the lead investigators of the project which is a collaboration between the National Centre for Immunisation Research and Surveillance (NCIRS), the University of Sydney and the Murdoch Children’s Research Institute, said the project offers the first ever national social and behavioural insights study around vaccination.
Bolsewicz presented the early findings from the survey at a NCIRS webinar on Thursday, and a separate presentation based on data from the Australian Immunisation Register showed the steady decline in childhood immunisation coverage since the pandemic has continued into mid-2024.
Only 90.8% of two year olds were fully vaccinated in 2023, a fall from 92.1% in 2020, while only 93.3% of five years old in 2023 were fully vaccinated compared with 94.8% in 2020, according to associate professor Frank Beard from the NCIRS.
While much of the media attention and popular perception around lagging vaccination rates has focused on vaccine hesitancy and concern, Bolsewicz said “the survey shows those practical barriers are really pronounced”.
Of the respondents, 11% said they could not afford the vaccinations, 9.3% found it was not easy to get to an appointment, 8.2% did not prioritise vaccination appointments, while 6% did not not believe vaccines were safe and 5.3% did not believe vaccines were effective.
“Even though childhood vaccination under the national immunisation program is supposed to be free of charge, there are other costs,” Bolsewicz said. “If you get a consultation at the same time some GPs will charge a co-payment, or costs associated with taking time off work for parents who are single parents, or the costs related to transport, especially for people living in regional and rural areas.”
The survey results, which were weighted for state, regionality and age group, reflected vaccine uptake that was largely representative of current national childhood immunisation rates with 93.5% of respondents saying their children were up to date with their vaccinations, 4.85% partially vaccinated and 1.65% unvaccinated.
“This is pretty spot on nationally,” Prof Margie Dashin, another lead investigator of the project and a paediatrician at the Royal Children’s Hospital in Melbourne, said.
The most common barrier parents reported in the survey was 60% said they felt distressed about vaccinating their child and the needle pain.
Although people cited fear of needles, the barriers that were most associated with partial vaccination rates compared with the fully vaccinated group were practical access barriers – including affording, prioritising and getting to appointments – were most strongly linked.
The barriers were higher amongst parents who also reported financial stress, Dashin said. The project will involve further research interviewing participants to understand more about the reasons why they could not afford costs or struggled to get to an appointment.
Some of the barriers to parents getting to appointments include the inability to take young children under five to a pharmacy for their vaccinations, the lack of pop-up or weekend clinics and besides Victoria, very few free nurse-led immunisation clinics, Dashin said.
Beard, who was not involved in the national vaccination insights project, said “regular monitoring of vaccination coverage is important, but it doesn’t tell us why childhood vaccination rates in Australia are declining. It is therefore critical to identify the barriers to vaccination uptake so that we can implement evidence-based approaches to address them”.