Barriers to childhood immunisation: Findings from the Longitudinal Study of Australian Children.

OBJECTIVES

To examine barriers to childhood immunisation experienced by parents in Australia.

DESIGN

Cross-sectional analysis of secondary data.

SETTING

Nationally representative Longitudinal Study of Australian Children (LSAC).

PARTICIPANTS

Five thousand one hundred seven infants aged 3-19 months in 2004.

MAIN OUTCOME MEASURE

Maternal report of immunisation status: incompletely or fully immunised.

RESULTS

Overall, 9.3% (473) of infants were incompletely immunised; of these just 16% had mothers who disagreed with immunisation. Remaining analyses focussed on infants whose mother did not disagree with immunisation (N=4994) (of whom 8% [398] were incompletely immunised). Fifteen variables representing potential immunisation barriers and facilitators were available in LSAC; these were entered into a latent class model to identify distinct clusters (or 'classes') of barriers experienced by families. Five classes were identified: (1) 'minimal barriers', (2) 'lone parent, mobile families with good support', (3) 'low social contact and service information; psychological distress', (4) 'larger families, not using formal childcare', (5) 'child health issues/concerns'. Compared to infants from families experiencing minimal barriers, all other barrier classes had a higher risk of incomplete immunisation. For example, the adjusted risk ratio (RR) for incomplete immunisation was 1.51 (95% confidence interval: 1.08-2.10) among those characterised by 'low social contact and service information; psychological distress', and 2.47 (1.87-3.25) among 'larger families, not using formal childcare'.

CONCLUSIONS

Using the most recent data available for examining these issues in Australia, we found that the majority of incompletely immunised infants (in 2004) did not have a mother who disagreed with immunisation. Barriers to immunisation are heterogeneous, suggesting a need for tailored interventions.