Peer-reviewed article
Examining catch‐up immunisation service use for migrant children in the City of Melbourne, Victoria: A quantitative study
Jane Tuckerman, Philippa Holland, Jessica Kaufman, Isabella Overmars, Margie H Danchin ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined immunisation service use among migrant children in Melbourne, Australia, finding that most families accessed catch-up vaccination services through informal channels like word-of-mouth rather than formal health providers. While vaccine hesitancy was low (99% of parents reported minimal concerns), significant barriers existed in accessing services and understanding Australia's immunisation requirements. About 9% of children were lost to follow-up after initial contact, and many parents lacked clear information about how to access vaccinations in Australia. The research highlights resource-intensive demands on immunisation services to support migrant families in meeting vaccination requirements.
Key points
- 75.7% of 1,403 migrant children who presented for catch-up immunisation had vaccines due; 23.4% needed vaccination history evaluation and AIR registration
- 59% of families were referred through informal sources (word-of-mouth, Google, social media) rather than formal health services
- Only 35% of surveyed parents (92 respondents) were informed about catch-up vaccination needs by a healthcare provider; 47% learned from informal sources
- 99% of parents reported no or minor vaccine hesitancy, but 50% were primarily motivated by educational facility requirements or benefits rather than health concerns
- 9% of children who presented for catch-up immunisation did not receive all required vaccines or were lost to follow-up
Limitations
The study focuses only on migrant children who already accessed the Melbourne immunisation service, so it cannot tell us about migrant families who never made contact with services or faced different barriers. Response rate for the parent survey was 63%, which may introduce selection bias regarding parental perspectives.
Abstract
Globally, migrants experience a higher burden of vaccine-preventable disease and lower immunisation rates than non-migrants.1, 2 Frequently, migrant families require catch-up vaccinations to comply with Australian immunisation requirements. For migrant parents, access barriers are more prominent than lack of acceptance3 and anomalies with immunisation records may reflect under-vaccination or inadequate reporting to the Australian Immunisation Register (AIR).4 Recent immunisation coverage data for migrant children is limited, including information about how these families can access vaccinations. Australian coverage data focuses on refugee children, or reports on Australian-born children with mothers born overseas.5-8 This two-phase study aimed to explore under-immunisation among children of migrant parents in Melbourne, Victoria by identifying gaps in service delivery and awareness of immunisation services. Phase I was an audit of catch-up immunisation encounters with the City of Melbourne immunisation service. Children were eligible if they were migrants, aged <18 years, resided in the City of Melbourne and attended at least one appointment during the study period (2016–2020). Phase II was a survey (available in English, Hindi or Mandarin) with migrant parents who had attended the service between January 2019 and August 2021. Participants reported demographics, patterns of health-care service use, access, motivation to get vaccinations and sources of information. Surveys were completed between 31 May and 18 August 2021. Data for both phases were analysed descriptively. Approval was obtained from the Royal Children's Hospital Human Research Ethics Committee (72165). For phase I, 1403 records were eligible for analysis (Table 1). Most (85.3%) presentations were for children <5 years. Presentations decreased throughout each calendar year. Overall, 1,062 children (75.7%) had vaccines due, 328 (23.4%) did not require any vaccines but still required their vaccination history to be evaluated and uploaded to the AIR, a further 13 (1%) had AIR issues that required resolving (e.g. incorrect vaccine or date). Nine percent of children who presented for catch-up did not receive all required vaccines or were lost to follow-up. Some 59% of families were referred to the City of Melbourne immunisation service through informal sources (i.e. word of mouth, Google, social media and Melbourne magazine). In phase II, 92 of 147 eligible parents completed the survey: response rate 63%. The median age of parents was 36 years (Table 1). Almost half obtained information on the need for catch-up vaccines from informal (43/91; 47% family, friends, work or online) rather than formal sources (48/91; 53%, General Practitioner, Maternal and Child Health nurse, hospital, educational facility (school, day-care, kindergarten)); only 35% (32/91) were informed by a health-care provider. Many parents (46/92; 50%) were primarily motivated by wanting their child to attend an educational facility or receive benefits, with the majority reporting either 'no' (76/92; 83%) or 'minor' concerns (15/92; 16%) towards vaccination. Just 55% (50/90) reported being explained the process to access vaccinations in Australia, with many 36% (18/50) acquiring this knowledge informally. Our study identified intensive resource requirements for catch-up vaccination and challenges for migrant parents to access immunisation services. While not all children in phase I required vaccines, the high proportion requiring a review and associated reporting to the AIR, has resource implications. As the AIR is principally used to determine up-to-date status for the purpose of such policies, not having an accurate AIR record can have implications for the child and their family. We found most catch-up presentations were initiated in the first two quarters of the year suggesting that the No Jab immunisation policies impact migrant families, despite the majority (99%; 91/92) reporting low vaccine hesitancy, confirming previous research.9-11 Consistent with international studies,9, 10, 12 our findings indicate that parents' sources of health information are highly variable and informal. Concerningly, numerous parents initiated catch-up vaccination but were lost to follow-up. This study found many migrant parents established contact and engaged with immunisation services through informal channels. Our findings support work to establish the best ways of placing information about immunisation services for migrant parents. The Migrant Immunisation Access (MIA) Project was a recipient of a Public Health Association of Australia 2020 GlaxoSmithKline Immunisation Grant. Open access publishing facilitated by The University of Melbourne, as part of the Wiley - The University of Melbourne agreement via the Council of Australian University Librarians.