Attitudes about and access to influenza vaccination in Australia: experiences of parents of children hospitalised for acute respiratory infection

Abstract

Influenza vaccination is the most effective tool to prevent influenza disease, however, uptake in children in Australia is low. Accordingly, this thesis asked: why is influenza vaccine coverage low, and how can it be increased to prevent children from being hospitalised for influenza? Methods include: 1) a systematic review of the known barriers and facilitators of influenza vaccination of children and pregnant women in Australia between 2004 and 2015, 2) qualitative interviews with parents of children hospitalised in two sites in Australia for influenza in 2017, and 3) a cross-sectional survey with parents of children who were hospitalised for acute respiratory infection (+/– laboratory-confirmed influenza) in five sites across Australia in 2019. To understand the complexities of behaviour, the Capability-Opportunity-Motivation-Behaviour model was used across the multiple studies. This thesis highlights the importance of receiving an influenza vaccination recommendation from a health care provider; the lack of such a recommendation was a strong variable associated with lack of influenza vaccination in children who had been hospitalised for acute respiratory infection. This thesis also highlights the importance of increasing influenza vaccination opportunities; motivation to vaccinate is low if influenza vaccination is difficult to remember, organise and access. By systematically mapping out the barriers to influenza vaccination of children in Australia, we were able to understand exactly where and how to practically target efforts to change behaviour, and thus increase uptake of influenza vaccine.