Parental Immunisation Needs and Attitudes Survey in paediatric hospital clinics and community maternal and child health centres in Melbourne, Australia.

AIM: Despite Australia's high vaccination rates, an estimated 3.3% of children are under-vaccinated due to vaccine refusal and the proportion of parents with concerns is unclear. Amongst Australian parents, we aimed to determine the prevalence of vaccine concerns, resources and health-care providers (HCPs) accessed and satisfaction with these resources in two different settings. We also aimed to identify relationships between the level of vaccine concern, socio-economic status and vaccine uptake. METHODS: Parents of children under 5 years attending general paediatric clinics in a tertiary paediatric hospital (n = 301/398, 76%) and children under 19 months attending community maternal child health centres (n = 311/391, 81%) completed the survey. Vaccination status was obtained from the Australian Childhood Immunisation Register. RESULTS: Despite high support for vaccination (98%, confidence interval (CI) 97-99), 43% of parents reported vaccine concerns (CI 40-47) including the number of vaccines given in the first 2 years (25%, CI 22 to 29), vaccine ingredients (22%, CI 19-25), allergies (18%, CI 15-21), weakening of the immune system (17%, CI 14-20) and autism (11%, CI 8-13). HCPs were the most commonly accessed and trusted information source. In all, 23% of parents reported insufficient knowledge to make good vaccination decisions (CI 20-26). There was little evidence of an association between parental vaccine acceptance or socio-economic status and vaccination status. CONCLUSIONS: Despite high support for vaccines, nearly half of Australian parents have some concerns and a quarter lack vaccine decision-making confidence regarding childhood vaccines. Parents frequently access and report high trust in HCPs, who are best placed to address parental vaccine concerns through provision of clear information, using effective communication strategies. Further research in more highly hesitant populations is required to determine the relationship between the level and nature of vaccination concerns and vaccine uptake.

Vaccine discussions with parents: The experience of Australian paediatricians.

AIM: Health-care providers are crucial in maintaining parental confidence in vaccination. Health-care providers are the most commonly accessed resource by parents for vaccine-related information and are highly trusted. We investigated paediatricians' (i) frequency of vaccine discussions; (ii) specific vaccine-related topics discussed; (iii) perceived role in childhood vaccination; (iv) challenges faced when having discussions; (v) confidence in vaccine-related knowledge and communication skills; and (vi) interest in online education and training. METHODS: We invited members of the Australian Paediatric Research Network to complete an online Research Electronic Data Capture survey in 2015-2016. RESULTS: Of 383 active Australian Paediatric Research Network members, 165 (43%) completed the online survey. A total of 61% reported 'frequently' or 'almost always' having vaccine-related discussions, with 15% 'rarely' having them. 'Lack of time' was the most commonly reported barrier to having vaccine discussions (54%). Vaccine necessity was most commonly discussed (33%), followed by vaccine safety (24%), general vaccine concerns (23%) and catch-up schedules (23%). While only 25% of paediatricians lacked confidence in their vaccine-related knowledge and 11% in their communication skills, most expressed interest in online training to address vaccine knowledge (62%) and communication skills (53%). CONCLUSION: Paediatricians play a key role in maintaining public confidence in vaccination. However, opportunities to address concerns are not being maximised by Australian paediatricians. There is a need and desire for training and resources to increase vaccine knowledge and communication skills for paediatricians, to optimise the frequency and effectiveness of vaccine discussions with parents and to ensure ongoing high immunisation coverage rates in Australia.