Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, 15 Hospital Avenue, Nedlands, Perth, 6009, WA, Australia.
School of Social Sciences, The University of Western Australia, Perth, WA, Australia.
BMC Health Serv Res. 2024 Aug 22;24(1):968. doi: 10.1186/s12913-024-11371-8.
In Western Australia (WA), children aged 24 months living regionally or remotely (non-urban) have suboptimal vaccine uptake. As there has not yet been a systematic approach to understanding the facilitators and barriers to childhood vaccination in regional and remote WA, this study aimed to understand the views of key immunisation stakeholders regarding barriers and solutions.
Drawing on the World Health Organization's "Tailoring Immunization Programmes" approach, we undertook a qualitative study with three forms of data collection: (1) semi-structured interviews with immunisation experts within Australia's immunisation system, (2) a semi-structured focus group with immunisation coordinators and health workers working in regional or remote WA, and (3) member checking with senior staff from WA Health. Data from the interviews and focus group was deductively analysed using the Capability-Opportunity-Motivation-Behaviour (COM-B) model on NVivo 20.
There was no clear consensus on the typical under-vaccinated child in country WA. A range of barriers were identified: lack of awareness of the vaccine schedule, difficult access to vaccination services, a shortage in a workforce able to have meaningful conversations with vaccine hesitant parents, ineffective reminder systems, and the rapid spread of misinformation. Participants described previous efforts used to improve vaccine uptake, and felt the following would improve uptake: better access to vaccine clinics, building capacity of Aboriginal Health Workers, and vaccine reminders.
This is the first time the facilitators and barriers to routine childhood vaccine uptake in country WA has been explored. Addressing some of these barriers may see an increase in uptake.
在澳大利亚西澳地区（WA），居住在偏远地区（非城市地区）的 24 个月大的儿童疫苗接种率不理想。由于目前还没有系统的方法来了解西澳偏远地区儿童疫苗接种的促进因素和障碍，因此本研究旨在了解关键免疫利益相关者对障碍和解决方案的看法。
本研究借鉴世界卫生组织的“定制免疫规划”方法，采用三种形式的数据收集方法进行定性研究：（1）对澳大利亚免疫系统内的免疫专家进行半结构化访谈，（2）对在西澳偏远地区工作的免疫协调员和卫生工作者进行半结构化焦点小组讨论，（3）与西澳卫生部门的高级工作人员进行成员核对。使用 NVivo 20 软件对访谈和焦点小组的数据进行演绎分析，使用能力-机会-动机-行为（COM-B）模型。
在西澳偏远地区，没有明确的共识认为哪些儿童是典型的未接种疫苗者。确定了一系列障碍：缺乏对疫苗接种时间表的认识、难以获得疫苗接种服务、缺乏能够与对疫苗犹豫不决的父母进行有意义对话的劳动力、提醒系统效率低下以及错误信息迅速传播。参与者描述了以前为提高疫苗接种率而做出的努力，并认为以下措施将提高疫苗接种率：更好地获得疫苗接种诊所、增强原住民卫生工作者的能力以及疫苗接种提醒。
这是首次探索西澳偏远地区常规儿童疫苗接种的促进因素和障碍。解决其中一些障碍可能会提高接种率。
