In 2023, the Royal Children's Hospital (RCH) Immunisation service piloted an integrated immunisation nursing model in the weekly Immigrant Health Service (IHS) clinic over a 3-month period (October - December 2023),
resulting in 100% uptake of overdue Nationa Immunisation Program (NIP) vaccines.

Targeted nursing immunisation support improved catch-up vaccination and immunisation coverage in refugee and asylum seeker children/adolescents attending the IHS. This model removed access barriers, allowed vaccination during routine clinical care and addressed equity gaps, with benefits to children, families and public health. Despite the success of this integrated nursing model, funding for this work ceased in December 2023.

The GSK Immunisation award would provide the opportunity to continue the integrated immunisation nursing model in the weekly Immigrant health clinic over the next 12 months, and allow evaluation, reporting and
dissemination of findings to inform ongoing practice at RCH and other services. This will support timely delivery and equitable access to NIP vaccines for refugee and asylum seeker childres and adolescents at
RCH and facilitate specialist immunisation assessment for special risk vaccines. The award would support dedicated project time, allowing consolidation of data, robust evaluation, and presentation of quality assurance findings. We will measure catch-up required, catch-up delivered, proportion with special vaccination needs, and completion of additional and seasonal vaccinations. We will report on the service model and barriers and facilitators to immunisation service delivery, examining the impact on clinical and social outcomes.

This work will build on a successful pilot in an established paediatric refugee health service, and develop the evidence base for i) nurse led vaccination in these cohorts, and ii) integrated immunisation for children
requiring hospital ambulatory care. Importantly, this integrated model will reach the most vulnerable children in a vulnerable cohort; those with complex medical needs and/or complex disability. This proposal addresses
both selection criteria 1: improving access, coverage, and timely delivery for NIP vaccines; and 2: improving access for hard to reach populations.

Background and Aim:

Childhood vaccination rates in Australia continue to decline, with one-year coverage dropping from 94.8% in 2020 to 91.5% in 2026. The National Vaccination Insights Project, established in 2024, aimed to assess vaccination barriers faced by parents of up-to-date, partially vaccinated, and unvaccinated children <5 years in 2025 and compare with findings from a separate 2024 sample.

Methods and Analysis:

A cross-sectional online survey of parents of children aged <5 years from all states and territories was conducted (September 1 - October 8, 2025). Participants were recruited via a nationally representative online panel. The Vaccine Barriers Assessment Tool (VBAT) assessed 15 access and acceptance barriers. Barrier prevalence and associations with vaccination status and demographics were analysed, and 2024 and 2025 results compared. Free text captured recent worrying vaccination information parents had heard.

Outcomes:

Parents in 2025 (n=2012; 64.3% female) reported that 93.7% of children were up-to-date with vaccinations, 4.1% partially vaccinated, and 2.2% unvaccinated. Acceptance barriers were substantially more prevalent among parents of partially vaccinated and unvaccinated children compared with up-to-date children. Concerns about vaccine safety showed the largest prevalence differences, reported by 4.7% of parents of up-to-date children compared with 54.9% of partially vaccinated (PD 50.2%, 95% CI: 38.5–61.9) and 88.3% of unvaccinated children (PD 83.6%, 95% CI: 73.8–93.3). Access barriers among partially vaccinated children remained relatively unchanged, with financial stress and single parenthood associated with multiple access challenges. Parents reported recent exposure to concerning vaccine safety messages in the media, particularly originating from the US.

Conclusion and Future Actions:

National surveillance indicates a substantial rise in acceptance barriers to childhood vaccination in 2025 compared with 2024, while access barriers remained stable. Findings may reflect early international spillover effects from US government vaccine announcements and highlight the need for targeted strategies to strengthen vaccine uptake.

Background and aim: Immunisation coverage is low in WA for children 1, 2 and 5-years of age. Public Health Units routinely follow-up children who are overdue for immunisation, create catch-up plans and support consumers and providers. Boorloo (Perth) Public Health Unit supports 80% of children under 5 in WA (around 130,000). Supporting this number of families requires innovative methods and targeted follow-up. Evidence shows that reminders with additional support improve timely vaccination. The Safe Start program aims to offer tiered support to families of overdue children throughout Perth.
Methods and analysis: Carers of children overdue at 8 months and 4.5 years of age are sent an interactive SMS which advises that the child is overdue and promotes vaccination; the message was developed with consumer input. Carers can reply to indicate they believe the records are incorrect or to request nurse follow-up. Public health nurses follow-up to amend records, support carers and provide catch-up plans.
Outcomes: Between October 2025 and January 2026, 13% of carers replied to the SMS, of which 38% requested nurse follow up; 30% were provided with advice on vaccines/clinics and 24% had an issue on the AIR record which led to the child appearing overdue (mostly dose number errors). A minority of carers (9%) opted out of SMS communication. Thirty percent of those who replied and 18% of those who did not reply to the SMS (i.e. reminder only) had at least one vaccine recorded within 30 days. Thirteen percent became completely up to date within 30 days.
Conclusion and future actions: Interactive SMS allows public health to contact large numbers of carers of overdue children. Tiered support enables families to receive intensive support if required (nurse follow-up) or less intensive support (record correction and reminders). In future this approach will be expanded to other age groups.

Background and Aim

Australian coverage rates for childhood vaccinations have declined steadily since the COVID-19 pandemic. The issue is multifactorial, contributed to by perceived and structural access barriers, and growing parental concerns about vaccinations. We aimed to explore the characteristics, experiences, and perspectives of parents using nurse-led Child and Family Health Immunisation (CFHI) clinics on the Central Coast of NSW, and examine the role of these services within the broader vaccination provider landscape.

Methods and Analysis

This was an exploratory, qualitative study with parent-users of CFHI clinics, conducted as part of a larger service evaluation. Participants were recruited from clinic waiting areas and interviewed with consent in person. Purposive recruitment occurred across all six clinic locations and key demographic groups. Semi-structured interviews explored drivers of vaccination across community settings, including access/practical, social interactions and information sharing. Interviews were audio-recorded, transcribed verbatim, and thematically analysed using inductive and deductive approaches. Data saturation was reached at 14 interviews; four additional interviews were conducted to ensure representation across demographic groups.

Outcomes

Eighteen interviews were completed with parents of children aged under five years. Five participants identified as culturally and racially marginalised (CARM), and three as Aboriginal. Three key themes were identified: (1) CFHI clinics address service inaccessibility by offering flexible scheduling, multiple locations, and holistic care; (2) CFHI clinics fill gaps in service acceptability through providing specialist vaccination services, positive interactions and comprehensive vaccine information; and (3) trust built by the CFHI service is key in engaging marginalised families in childhood vaccination.

Conclusion and Future Actions

CFHI clinics fill an important gap in vaccination services and are particularly valued for patient-centred care, family-friendly format, and specialised immunisation advice. To address declining vaccination rates, health services should expand nurse-led immunisation models, invest in culturally responsive services, and develop evaluation frameworks to assess patient-centred vaccination delivery approaches. Further research should examine long-term outcomes and cost-effectiveness of these service models.

Title: Strategies to strengthen childhood vaccination uptake: First Nations families’ perspectives.

Background and aim:
Vaccination is a highly cost‑effective public health strategy, yet childhood immunisation rates have declined nationally since the COVID‑19 pandemic, including among Aboriginal and Torres Strait Islander children. Existing tools used to understand vaccine drivers were not developed with Aboriginal and Torres Strait Islander families and may not reflect their lived experiences or priorities. This study aimed to understand factors shaping vaccine access and acceptance from an Aboriginal and Torres Strait Islander family perspective and to inform the development of a culturally relevant tool to assess drivers of childhood vaccination.

Methods and analysis:
Fourteen family focus groups were conducted with Aboriginal and Torres Strait Islander parents, carers and guardians of children < 5 years old, across Hunter New England Local Health District, New South Wales, and the Northern Territory. Indigenous research methods were used to explore families’ experiences of childhood vaccination. Data were analysed using inductive content analysis, with Aboriginal researchers leading coding and interpretation to ensure cultural integrity and uphold Indigenous data governance principles.

Outcomes:
Families strongly supported routine childhood immunisation, stating a desire to keep children safe and well. Participants stressed the need for clear, culturally relevant information about vaccines, including in local languages. Trust in health care providers was strengthened through cultural connection, continuity of care and respectful two‑way communication. Systemic barriers, such as inflexible service delivery and transport challenges, limited access to vaccination. Practical solutions included appointment reminders, flexible services, transport support, and a strong role for Aboriginal health staff in providing culturally safe care and engagement.

Conclusion and future actions:
Improving vaccination coverage for Aboriginal and Torres Strait Islander children requires culturally grounded approaches that build trust, strengthen relationships between families and healthcare providers, and address persistent structural access barriers. Findings from this study will support the development of tools to evaluate drivers of vaccination and strategies to ensure immunisation equity for Aboriginal and Torres Strait Islander children.

Background and Aim
Boorloo (Perth) Public Health Unit (PHU) supports immunisation providers by preparing immunisation catch-up plans upon request. Rising demand for this support has created a substantial workload. To improve efficiency, a computer algorithm to support catch up plan generation was introduced in January 2025. This project aimed to evaluate the impact of this automation tool on the efficiency and effectiveness of Boorloo PHU’s immunisation catch-up plan process and identify opportunities for further quality improvement.

Methods and Analysis
All immunisation catch-up plan requests from 1 July 2023 to 24 September 2025 were reviewed to determine the timeliness of the PHU response. To assess adherence to recommended catch-up plans, receipt of the recommended vaccines was reviewed for a sample of 1,000 plans.
A total of 3359 plans were reviewed. Catch-up requests nearly doubled between 2023 and 2025. The median turnaround time for a catch-up plan fell from 9 days (IQR 2-16) to 3 days (IQR 1-6) (p<0.00001) following implementation of the automation tool. There was no significant change in the proportion of plans that were fully followed after implementation (21.1% v 22.9%; p 0.5594).

Outcomes
The semi-automated system substantially improved the efficiency of preparing catch up plans; however, this did not lead to improved adherence to the recommended plans. In response, the catch-up program model was reviewed, and further opportunities for quality improvement were identified. Patient centred communication and providing general practitioners with clear return timeframes were identified as potential strategies to improve adherence to catch up plans.

Conclusion and Future actions
Boorloo PHU will begin notifying patients directly when their catch-up plan is available and give clear response timeframes to providers. These changes aim to improve patient follow up for recommended immunisations. The program will be re-evaluated after implementation of these changes and updated findings will be presented at the conference.

Background and Aim

Declining trust in institutions and increasing complexity in immunisation decision-making have exposed the limits of information-based approaches to vaccine acceptance. While public health strategies often prioritise messaging and access, less attention has been given to how trust is built, sustained, and translated into policy and practice when institutional authority alone is insufficient. This presentation aims to examine consumer involvement as a core mechanism for building trust in immunisation systems, rather than as a supplementary engagement activity.

Methods and Analysis

This presentation draws on reflective analysis of a decade of community-led immunisation work in Australia, integrating lived experience, real-world practice, and consumer–researcher partnerships. Insights are informed by initiatives that emerged following the death of a newborn, Riley Hughes, from pertussis in 2015, and the subsequent development of structured pathways for consumer involvement in advocacy, research collaboration, and policy engagement. Analysis focuses on how trust is operationalised across community environments, research processes, and system interfaces.

Outcomes

Consumer involvement reshaped immunisation practice in three key ways. First, community-based environments such as parenting expos revealed how families assess trust, credibility, and safety outside traditional healthcare encounters. Second, early and meaningful consumer involvement in research improved relevance, legitimacy, and translation of findings, illustrated through national RSV immunisation advocacy. Third, consumer organisations functioned as intermediaries, translating lived experience into policy-ready insights while managing ethical risks related to vulnerability, authenticity, and public scrutiny.

Conclusion and Future actions

Consumer voices should not be treated solely as persuasive narratives but as a form of system infrastructure that supports immunisation acceptance when public trust is under strain. Public health programs, researchers, and policymakers should embed consumer involvement deliberately across immunisation design, research, and delivery to strengthen legitimacy, improve uptake, and sustain trust in an increasingly contested public health environment.

Background
Vaccine infodemics and misinformation pose a critical threat, often causing the community to fear immunisations more than the preventable diseases themselves. Amplified by social media, these concerns hinder vaccine uptake, costing lives and straining economies. Governments struggle to organise effective responses due to limited regulation and complex social dynamics. Australia, as a multicultural nation, reflects many of these challenges, with varied and imported beliefs complicating public health programmes.
Australia risks losing its measles elimination status as on-time MMR coverage dropped from 76.8% in early 2020 to 65.4% by late 2024. With even sharper declines among Aboriginal and Torres Strait Islander children.

Aim: To identify vaccination-related misinformation on various online platforms

Method and Analysis
The Vaccine Infodemic Risk Assessment Lifecycle (VIRAL), VaxPulse’s core component, uses a multi-agent framework to extract and fact-check online misinformation against authenticated sources. Fine-tuned models ensure high extraction accuracy, with continuous optimisation via expert human feedback to enhance public health outcomes.

Outcome
Using the VIRAL tool, VaxPulse analysed 128,564 social media posts regarding measles, mumps, and rubella (MMR) vaccination from X, Reddit, YouTube, and Bluesky between October 2024 and January 2026. This process identified 24,437 instances of misinformation. General classification revealed that 65.42% was misleading, followed by opinion (22.40%), factual errors (11.48%), and satire or sarcasm (0.70%). Thematic analysis showed that misinformation related to adverse effects and safety dominated discourse at 60.70%. Other prominent clusters included effectiveness (18.12%), baseline disease risk (9.18%), and pharmaceutical and government-related misinformation (8.56%).
Potential public health risks are assessed using toxicity scores (0–1) to identify misinformation about vaccine safety. In the analysed data, 555 instances reached high toxicity threshold (≥ 0.80).

Conclusion
Effective and timely identification and mitigation of misinformation are critical for ongoing campaigns to rebuild trust in public health programmes and restore immunisation rates.