The Refugee Health Clinic at Bendigo Community Health Services delivers a culturally responsive immunisation model that addresses critical public health gaps among newly arrived refugees in regional Victoria. Established in June 2023, the clinic responds to the pressing need for catch-up immunisation among individuals who arrive in Australia with incomplete or undocumented vaccination histories due to prolonged displacement, conflict, and limited healthcare access in refugee camps.

Bendigo is home to growing refugee communities, including over 4,000 Karen people and increasing numbers of Afghan and South Sudanese residents. Newly arrived refugees face multiple barriers to immunisation, including unfamiliarity with the Australian health system, limited health literacy, language challenges, and inadequate access to interpreters and translated materials. The clinic overcomes these barriers by embedding immunisation into a trusted, community-based setting, supported by a Refugee Health Nurse, GP, bicultural workers, and professional interpreters.

The clinic’s structured approach ensures all immunisation records are translated and uploaded to the Australian Immunisation Register, avoiding duplicate dosing and enabling personalised catch-up schedules. Education on vaccine-preventable diseases is provided using in-language materials, interpreter-supported consultations, and tailored communication strategies. Additional vaccines, including influenza and COVID-19, are offered to support broader community protection.

Key outcomes to date include:
• 100% catch-up immunisation rate within six months of first clinic visit for all newly settled clients
• 150–200 refugees supported annually, with growing numbers expected
• Strong integration with local settlement services and wraparound health programs
• Recognition as a best-practice model by other local health providers

Bendigo Community Health Services is prepared to launch "R U up 2 Date?"—a community awareness campaign targeting established refugee populations with culturally appropriate in-language video and print materials in Karen and Dari. The campaign aims to improve immunisation uptake among longer-settled community members and address broader immunisation needs across the lifespan. Additionally, it provides a pathway for the broader refugee community to access free vaccinations in a trusted setting with all services being bulk billed to ensure equity and access.
The GSK Immunisation Award will directly support the expansion of this work—enabling resource development, deeper community engagement, and the potential replication of this model in other regions.

The Refugee Health Clinic at Bendigo Community Health Services is closing the immunisation gap for some of Australia’s most vulnerable populations while creating a replicable model of compassionate, inclusive, and effective care that ensures every individual’s right to health and protection against preventable diseases.

Background
In Australia, influenza notifications are highest among children, with influenza responsible for high hospitalisation rates and more child deaths than any other vaccine-preventable disease. Despite this, influenza vaccination coverage remains low. In 2026 the intranasally-administered live attenuated influenza vaccine (LAIV) will be available in Australia for children aged 2-17 years by private prescription and funded by several states, offering an alternative to intramuscularly-injected inactivated influenza vaccines (IIVs). Here we review LAIV characteristics and discuss its potential for improving childhood influenza vaccination coverage.
Methods
We applied GRADE to assess LAIV efficacy, effectiveness and safety in children aged 2-17. We limited assessment to randomised clinical trials (RCTs), including systematic reviews where available, comparing LAIV to placebo and/or IIV. Assessed outcomes included efficacy against lab-confirmed influenza (LCI) infection and adverse events following immunisation. Certainty of evidence was assessed for all studies.
Findings
We identified 1 systematic review encompassing data from 8 RCTs suggesting that LAIV has similar efficacy to IIV (Odds Ratio=0.81, 95% Confidence Interval: 0.49-1.34). Additionally, we identified 4 RCTs demonstrating LAIV is efficacious in preventing LCI relative to placebo, with estimates ranging from 36% to 86%, varying by age, year, characteristics of influenza season and strain match. LAIV has a similar safety profile to IIVs, with the exception of more nasal reactions due to intranasal administration. Serious adverse events are rare after LAIV, occurring at a similar frequency to IIVs. Studies conducted among children with mild to severe asthma have demonstrated that LAIV does not exacerbate asthma/wheeze, and LAIV has not been shown to cause asthma/wheeze in healthy children aged 2-17 years.
Conclusion
LAIV is safe and effective and offers a complementary alternative to IIVs. Needle-free administration of LAIV will likely increase acceptability and enable administration by a range of healthcare providers, offering opportunities to improve coverage among children.

Background and aim
The COVID-19 pandemic highlighted inequities in vaccine access in New Zealand, particularly for Māori and Pacific communities. Rapidly increasing vaccination capacity was essential. Health New Zealand introduced national policy to allow trained, unregulated health workers to safely administer COVID-19 vaccines under the supervision of regulated health professional vaccinators (CVWUS). The aim was to build a trusted, community-based workforce that could expand vaccination access while supporting culturally safe delivery.

Methods and analysis
Following the success of the CVWUS programme, a staged workforce model was developed and implemented with education steps. This became known as the Vaccinating Healthcare Worker (VHW) programme. Stage 1 vaccinators complete education to deliver influenza, COVID-19, HPV, and Tdap vaccines to people aged 11–12 years and older. Stage 2 vaccinators, after additional training and demonstrated competence, deliver vaccines to children aged five years and above, including MMR. The programme emphasises safety and training standards to ensure quality and trust.

Outcomes
The staged VHW model increased vaccination capacity, enhanced equity of access, and strengthened workforce flexibility. Embedding vaccinators within communities enabled trusted, local vaccine delivery, while structured training ensured safety and consistency. For example, pharmacies empowered pharmacy technicians to upskill to administer vaccines - enabling pharmacists to focus on screening and consent. Alongside extended opening hours, pharmacies have greatly improved equitable access for priority populations.

Conclusion and future actions
The success of the Vaccinating Health Worker programme demonstrates the impact that equity-focused and community-based vaccination workforces can have on increasing immunisation coverage and enabling communities to be equitably protected from vaccine-preventable diseases.
Future priorities include integrating the VHW model into routine immunisation delivery, expanding training opportunities, and applying lessons to reduce ongoing access inequities in underserved populations.

Background and Aim

Australia’s National Immunisation Program funds immunisations for school students from grade 7 and adults aged 50 years and over. To increase immunisation rates among adolescents and adults overdue for scheduled immunisations, the Torres and Cape Public Health Unit in Queensland initiated an onscreen notification project within the local electronic Medical Record (eMR), Best Practice Software. This study investigated the effectiveness of onscreen notifications on immunisation delivery in the Torres and Cape Hospital and Health Service region.

Methods and Analysis

Consultations during 2023-2024 with patients overdue and eligible for funded diphtheria-tetanus-pertussis (dTpa), human papillomavirus (HPV), meningococcal ACWY (MenACWY), and pneumococcal immunisations were included in the study. Onscreen immunisation notifications were added to the records of 3093 patients at 22 remote primary healthcare centres. These consultations were defined as the intervention group. The control group were consultations without an overdue immunisation notification on a patient record. Rate ratios were calculated to compare the immunisation rate in the intervention group with the control group.

Outcomes

The study included 680 overdue immunisations delivered across 38,666 consultations. Patients with an onscreen notification on their record were 13.4 times (95%CI 11.3, 16.1) as likely to receive an overdue immunisation during a consultation as those without a notification. Adolescents with a notification were 6.0 (95%CI 3.8, 10.8), 11.4 (95%CI 7.7, 19.2) and 10.0 times (95%CI 2.4, 41.7) as likely to receive an overdue dTpa, HPV and MenACWY immunisation respectively during a consultation as those without a notification. Older adults with a notification were 14.0 times (95%CI 11.5, 17.6) as likely to receive an overdue pneumococcal immunisation during a consultation as those without a notification.

Conclusion and Future Actions

Onscreen notifications on patient records increase the delivery of overdue immunisations among adolescents and older adults. Automating the display of overdue immunisation notifications within Australian eMR systems should be pursued under the National Immunisation Strategy.

Background and AIM: Influenza vaccination coverage has declined in recent years. Coverage for First Nations peoples in Perth was lower in 2024 than in the two preceding years for all age groups. Barriers for First Nations peoples in accessing healthcare include logistic factors and availability of culturally safe services. Our aim was to increase influenza vaccination coverage for First Nations peoples of all ages through accessible, culturally safe clinics and home visiting services.

Method and Analysis: Through extensive consultation with community and outreach organisations, influenza pop-up clinics were organised at family-focused community events including First Nations peoples health, cultural and sporting events from April to September 2025. In addition, ‘flu days’ were organised in the community with home visits conducted to offer vaccination to extended family members. Clinics and home visits were staffed by an Aboriginal Health Liaison Officer and a clinical nurse. Feedback was sought from community organisations following the programs.

Outcomes: A total of 13 pop-up clinics were held at community and health outreach events. Home visits for childhood vaccination were conducted 3 days a week, with a total of 26 extra days, for extended family influenza vaccinations; over 500 vaccines were administered. Influenza vaccine coverage in 2025 increased among all First Nations peoples under 65 years of age in Perth; over 60% of clients vaccinated did not have an influenza vaccine in 2024. The clinics were well received, with positive feedback on the walk-in nature of the clinics. Several organisations requested clinics for 2026.

Conclusion and Future Actions: Offering pop-up clinics and home visits provided the opportunity for staff to engage, educate and provide access to the First Nations peoples community who may not otherwise be vaccinated for influenza.

Aboriginal governance structures: This program was initiated by the Boorloo PHU Aboriginal Health Team following several years of engagement and provision of education at community events. The project was led by the Boorloo PHU Aboriginal Health Team with support and funding from the WA Department of Health, including the support of the Aboriginal Principal Project Officer (WA Department of Health). Aboriginal Controlled Community Organisations were consulted in the choice of events, promotion to the community and set-up of clinics. Findings will be shared with these organisations.

Indigenous data sovereignty: The Boorloo PHU Aboriginal Health Team and Aboriginal Principal Project Officer (WA Department of Health) supported the analysis and interpretation of the evaluation. Feedback was sought from community organisations as part of the evaluation. Data presented was aggregated. The evaluation will be used to improve influenza vaccination programs in future years and provide direct community benefit. The Boorloo PHU Aboriginal Health Team and the Aboriginal Principal Project Officer (WA Department of Health) support presentation of the outcomes for the benefit of similar public health-led community programs.

Background
The South Eastern Sydney Local Health District Public Health Unit received four years of funding to strengthen clinical services’ capacity to provide opportunistic vaccination to priority populations attending NSW Health facilities who may experience barriers accessing vaccination through primary care.
In response, we developed VaxConnect, a district-wide program aimed at delivering opportunistic vaccination to adult patients within key services and supporting clinical teams to embed vaccination into routine care.

Methods
We developed governance frameworks, patient and clinician resources, and data collection systems linked to activity-based funding to support program implementation. Two authorised nurse immunisers (ANIs) were recruited to deliver vaccination.
Clinical services were recruited through expressions of interest and targeted outreach, and assessed for either VaxConnect ANI-led delivery or capacity-building support.
ANI-led vaccination was delivered primarily in hospital outpatient settings. ANIs approached patients in waiting rooms, reviewed immunisation histories, and offered influenza, COVID-19, pneumococcal and shingles vaccines per national and state program eligibility. Patients declining vaccination received education on recommended vaccines.
Capacity-building support included teaching sessions, clinical shadowing, logistical and cold-chain guidance, resources, and assistance monitoring vaccination coverage.

Outcomes
Since January 2025, VaxConnect ANI-led clinics have been rolled-out across five hospitals. In the first 12 months, 2,063 vaccines were delivered across 1,302 encounters (303 influenza, 513 COVID-19, 641 pneumococcal, 606 shingles), alongside 1,007 education encounters. 1,972 unique patients engaged with VaxConnect.
Over 15 clinical services have been supported to establish or enhance their own vaccination models, including gastroenterology, respiratory, aged care, mental health, and drug and alcohol services.
Preliminary analysis suggests the program is at least cost-neutral from a health service perspective.

Conclusions
ANI-led opportunistic vaccination was feasible and demonstrates the potential to embed vaccination into routine care by hospital-based services.
Ongoing roll-out and capacity-building, model-of-care refinement, and further evaluation (including acceptability, economic analysis, and vaccination coverage) will inform sustainability and broader implementation.

Background and Aim
Across Australia, jurisdictions are grappling with how to deliver equitable, responsive immunisation programs amid hesitancy and declining vaccination rates and increasingly complex service environments. National strategies and research identify access, affordability and trust as key barriers to vaccination.

Victoria’s local government model delivers immunisation through a fully integrated universal service platform, embedded within maternal and child health, early years, public/environmental health, and health and wellbeing planning. Immunisation is delivered as part of an ongoing relationship with communities rather than a one-off transaction. This integration strengthens access, confidence and equity, and enables agile local responses to evolving public health demands.

This paper examines the features and value of Victoria’s integrated, council-led immunisation model, and the risks and opportunities shaping its long-term sustainability.

Methods and Analysis
In 2024, 77 of Victoria’s 79 councils responded to a Municipal Association of Victoria survey examining immunisation service delivery, funding pressures and future opportunities. The survey captured quantitative data on service volumes and qualitative insights into outreach activity, workforce capacity and system challenges.

Outcomes
Findings show Victorian councils delivered more than 7,000 community immunisation sessions and 1,400 school-based clinics. Around 90 percent deliver overseas catch-up programs, often as the sole provider in a municipality, averaging more than 500 vaccinations per month statewide. Sixty-nine percent provide customised services to vulnerable cohorts. Outdated federal and state funding models leave councils covering, on average, 80 percent of program costs, creating unsustainable pressure that places access, equity and targeted services at risk at a time when they are needed most.

Conclusion and Future Actions
Victorian councils are essential partners in achieving the National Immunisation Program, leveraging local knowledge, trusted relationships and public health expertise. Securing sustainable funding for council-led immunisation is critical to protecting equitable access, supporting vulnerable communities and maintaining a resilient, responsive public health system.

Background and Aim
Declines in routine childhood immunisation coverage in Australia highlight the need for multi-pronged responses addressing structural, service-delivery, acceptance-related, and access barriers. Central Coast Local Health District operates a long-standing, nurse–led community immunisation clinic model unique within NSW. We aimed to evaluate its contribution to equitable childhood vaccination uptake, to inform local service improvement and support potential replication and scale-up in other settings.

Methods and Analysis
A mixed-methods evaluation was undertaken, comprising retrospective analysis of administrative data (2015-2025), a parent survey (n=139) and semi-structured interviews with parents (n=18) and staff (n=8) to explore experiences of using and delivering the service. Quantitative data were analysed descriptively and qualitative data thematically.

Outcomes
Parent expressed strong satisfaction with the clinics role in addressing access barriers through a free ‘drop-in’ model across multiple locations. Parents also valued unhurried, supportive vaccine conversations and information sharing. A central theme was trust, which parents identified as critical for engaging marginalised families and staff described as foundational to their practice.
Quantitative findings supported these themes. Since 2020, overall clinic use increased by 44%, with attendance at northern clinics serving more disadvantaged areas rising by over 230%. The proportion of clinic users identifying as Aboriginal and/or Torres Strait Islander increased three-fold, and children born overseas four-fold. The clinics now reach over 40% of children under one year at least once in their first year of life, with 56% returning for repeat visits. Parent survey responses also indicated substantially greater difficulty accessing GP appointments and affording vaccination costs compared with national data, reflecting local access challenges.

Conclusion and Future Actions
Nurse-led, community-based drop-in immunisation services can play a critical role in improving equitable childhood vaccination uptake by addressing access barriers, increasing engagement in vaccination and building trust with marginalised families. These findings support adaptation and scale-up of flexible, relationship-based, community immunisation models in settings facing similar challenges.