McIndoe Leigh, Young Alexandra, Davies Cristyn, Vujovich-Dunn Cassandra, Kean Stephanie, Dives Michelle, Sheppeard Vicky
South Eastern Sydney Public Health Unit, Sydney, NSW 2031, Australia.
Kirby Institute, University of New South Wales Sydney, Sydney, NSW 2052, Australia.
Vaccines (Basel). 2025 Jan 17;13(1):83. doi: 10.3390/vaccines13010083.
School-based immunization programs are crucial for equitable vaccine coverage, yet their success depends on parental consent processes. This study investigates patterns of vaccine decision-making within Australia's school-based immunization program, specifically focusing on human papillomavirus (HPV) and diphtheria-tetanus-pertussis (dTpa) vaccines offered free to adolescents aged 12-13. This qualitative study was conducted in the South Eastern Sydney Local Health District (2022-2023). Semi-structured interviews were held with school staff ( = 11) across government, Catholic, and independent schools, parents whose children were not vaccinated at school ( = 11) and a focus group with public health unit staff ( = 5). Data were analyzed to identify key barriers and patterns in vaccine decision-making. Analysis revealed three distinct groups of parents whose children were not vaccinated through the school program: (1) those favoring general practitioners for vaccination, driven by trust in medical providers and a preference for personalized care; (2) those intending to consent but facing logistical barriers, including communication breakdowns and online consent challenges; and (3) vaccine-hesitant parents, particularly regarding HPV vaccination, influenced by safety concerns and misinformation. These findings demonstrate that non-participation in school vaccination programs should not be automatically equated with vaccine hesitancy. Tailored interventions are necessary for addressing vaccine non-participation. Recommendations include strengthening collaboration with general practitioners, streamlining consent processes and providing targeted education to counter misinformation. This study provides valuable insights into social determinants of vaccine acceptance and offers actionable strategies for improving vaccine uptake in school-based programs.
以学校为基础的免疫规划对于实现公平的疫苗接种覆盖率至关重要，但其成功与否取决于家长的同意程序。本研究调查了澳大利亚以学校为基础的免疫规划中的疫苗决策模式，特别关注向12至13岁青少年免费提供的人乳头瘤病毒（HPV）疫苗和白喉-破伤风-百日咳（dTpa）疫苗。这项定性研究于2022年至2023年在悉尼东南部地方卫生区开展。研究人员与政府、天主教和独立学校的学校工作人员（n = 11）、孩子未在学校接种疫苗的家长（n = 11）以及一个由公共卫生部门工作人员组成的焦点小组（n = 5）进行了半结构化访谈。对数据进行分析，以确定疫苗决策中的关键障碍和模式。分析发现，有三组不同的家长，他们的孩子未通过学校计划接种疫苗：（1）那些因信任医疗服务提供者并偏好个性化护理而倾向于让全科医生进行疫苗接种的家长；（2）那些打算同意接种但面临后勤障碍的家长，包括沟通不畅和在线同意方面的挑战；（3）对疫苗持犹豫态度的家长，特别是在HPV疫苗接种方面，他们受到安全担忧和错误信息的影响。这些发现表明，不参与学校疫苗接种计划不应自动等同于疫苗犹豫。需要采取针对性的干预措施来解决疫苗接种不参与的问题。建议包括加强与全科医生的合作、简化同意程序以及提供有针对性的教育以对抗错误信息。本研究为疫苗接受度的社会决定因素提供了有价值的见解，并为提高以学校为基础的计划中的疫苗接种率提供了可采取行动的策略。
