Background and Aim
Active vaccine safety surveillance may provide reassurance to the public and vaccine providers, helping to address Australia’s declining immunisation coverage rates. In Australia, AusVaxSafety conducts active vaccine safety surveillance through online surveys three days after vaccination and reports aggregated results on its website. Survey participation varies and understanding motivations for survey completion may assist in enhancing participation rates. Additionally, public awareness of AusVaxSafety and its website are unclear. This study aims to describe motivations for survey participation, survey acceptability, and awareness of AusVaxSafety and its website.
Methods and Analysis
An online questionnaire was sent via REDCap to individuals who had completed an AusVaxSafety vaccine safety survey and consented to follow-up. The questionnaire assessed motivations for participation, based on Schwartz’s theory of basic values and the Citizen Science Scale, as well as survey satisfaction and awareness of AusVaxSafety. Descriptive analyses were conducted using R version 4.4.1.
Outcomes
In total, 15,670 questionnaires were sent with 7,825 completions (49.9%). Contribution to society (benevolence), helping to raise public awareness of vaccine safety (universalism) and interest in vaccine safety (self-direction) were the top three motivators. Most respondents (89.5%) found the vaccine safety survey extremely easy to complete and of acceptable length (92.7%). Just over a quarter of participants (28.2%) were aware of AusVaxSafety and 16.5% were aware of the website.
Conclusion and Future actions
The findings highlight opportunities to strengthen active vaccine safety surveillance participation through targeted communication strategies incorporating key motivations. Despite interest in vaccine safety, few participants were aware of AusVaxSafety and most had not visited the website. As public confidence in vaccines is associated with seeking information from Government health websites, enhancing the visibility and accessibility of AusVaxSafety and its vaccine safety data may support efforts to address declining immunisation coverage and reinforce public trust in national immunisation programs.

Background and Aim
Vaccine safety monitoring is a collective responsibility that extends beyond surveillance systems and datasets, with early signals often coming from individuals raising concerns about their health experiences. During the COVID-19 immunisation program, a consumer reported an adverse event following immunisation of giant cell arteritis (GCA) (a painful inflammation of blood vessels in the head) in NSW which was received by the TGA with GCA placed on conditions under ongoing surveillance. The consumer subsequent directly contacted SAEFVIC to ask if further investigations were possible in other datasets. Alongside regulatory attention and a small number of spontaneous reports, and in conjunction with collaborative clinical evaluation in NSW and discussions with the TGA, this triggered a formal signal assessment.

Methods and Analysis
The consumer-initiated signal was assessed using a staged approach. The six spontaneous reports received by SAEFVIC post COVID-19 vaccination were reviewed, and no disproportionality was detected when compared to other vaccines. Further investigation used two Australian healthcare datasets covering general practice and linked hospital presentations (January 2021–September 2024). A self-controlled case series design assessed associations between COVID-19 vaccination and incident GCA. No increased risk of GCA was identified within 42 days of COVID-19 vaccination (GP RI (relative incidence): 0.96, 95% CI: 0.76–1.21; hospital RI: 0.79, 95% CI: 0.68–0.91), with consistent findings across data sources and by vaccine type, age, and sex.

Outcomes
Findings informed surveillance and decision-making and were communicated with stakeholders, including the consumer affected.

Conclusion and Future Actions
Consumer reporting is critical for vaccine safety pharmacovigilance. Taking concerns seriously, investigating when evidence suggests plausible grounds, and communicating outcomes clearly are essential for maintaining trust. Future public health surveillance systems should continue to embed consumer voice, strengthen pathways for consumer-reported signals, and prioritise transparent communication to support collective confidence in public health decision-making.

Background: Antenatal vaccination is a key component of the National Immunisation Program with expanding recommendations creating complexity in clinical practice, including the risk of vaccine administration errors (VAE). While vaccines recommended during pregnancy have a strong safety profile, VAE remains an important and preventable immunisation safety issue, with impacts on vaccine confidence. Surveillance of these errors is essential to identify systemic gaps and inform continuous quality improvement. In Victoria, VAE are reported to SAEFVIC (Surveillance of Adverse Events Following Vaccination in the Community); an immunisation safety service combining enhanced passive surveillance with integrated clinical services.

Aim: To describe antenatal VAE reported to SAEFVIC and identify opportunities to improve immunisation practice and error prevention in antenatal care settings.

Methods and Analysis: Antenatal VAE reports were extracted from the SAEFVIC database between 2007-2025. Fields reviewed included demographics, immunisation provider, vaccine and error type, plus reported outcomes. Recurring themes and contributing factors were identified.

Outcomes: 153 reports were identified involving 158 vaccines including DTPa vaccines (n=58) influenza vaccines (n=40) and RSV products (n=29). The most common provider setting was GP practice (69%) followed by hospitals (19%). Error types included incorrect vaccine, gestational timing or dose/formulation, and extra doses. There were 22 live vaccines administered of which 16 (73%) were inadvertently in early pregnancy. Most reported errors did not result in further AEFI.

Conclusions and Future actions: SAEFVIC surveillance provides valuable insights into antenatal VAE and plays a key role in identifying and reporting emerging trends. Although most errors do not result in significant clinical harm, they can generate maternal anxiety, necessitate additional clinical follow-up, and potentially undermine public confidence in vaccination programs. Improving awareness and providing targeted education for immunisation providers may help to reduce the incidence of vaccination errors.
Longer term follow-up of antenatal vaccination error is needed to further understand implications.

Background and Aim

Maternal vaccination protects both pregnant individuals and their infants; however, the expansion of recommended maternal vaccines, including the recent introduction of respiratory syncytial virus (RSV) vaccination in Australia, has increased the complexity of vaccine decision-making. Understanding how pregnant individuals make decisions about maternal vaccines is critical to inform effective implementation strategies. The MyVax Study aimed to evaluate vaccine prioritisation, co-administration preferences, and key factors influencing maternal vaccine decision-making.

Methods and Analysis

A cross-sectional, anonymous survey was conducted between April 2024 and July 2025 among pregnant individuals attending public and private antenatal services in metropolitan Melbourne. The 29-item questionnaire assessed demographics, decision-making factors, prioritisation of recommended maternal vaccines (influenza, pertussis [Tdap], COVID-19, RSV), and preferences for co-administration. Descriptive analyses summarised participant responses.

Outcomes

402 people completed the survey. Most participants preferred co-administration, with 203/310 (65.5%) choosing to receive at least two vaccines on the same day, while 81/310 (26.1%) preferred separate administration. When considering newly recommended maternal vaccines, 221/321 (68.8%) indicated they would accept vaccination if recommended by a healthcare provider. Infant safety was the most important factor influencing vaccination decisions (252/374, 67.4%), followed by healthcare provider recommendation (80/329, 24.3%). Among respondents, Tdap was prioritised as the single most important maternal vaccine (249/374, 66.5%).

Conclusion and Future Actions

Co-administration of maternal vaccines is preferred by most pregnant individuals, supporting same-day delivery as schedules expand. However, vaccine acceptance is primarily driven by perceived infant safety. To achieve high uptake of newly introduced vaccines such as RSV, policymakers must ensure that clear safety communication remains central to rollout strategies.

Background and Aim: Certain population groups are at an increased risk of severe outcomes from respiratory syncytial virus (RSV) including children with complex medical conditions (e.g. chromosomal abnormalities, congenital heart and lung conditions and those born very preterm). In 2025, a hybrid RSV immunisation program was introduced across Australia offering a maternal vaccine with States/Territories offering a monoclonal antibody. Understanding awareness of RSV and attitudes towards immunisation among high-risk groups, including those from culturally and linguistically diverse (CALD) backgrounds, is essential to inform effective communication strategies to support immunisation uptake. Our aim was to understand the knowledge and attitudes of RSV disease and immunisation among two groups: caregivers from CALD backgrounds and caregivers of children <2 years with complex medical conditions.
Methods and Analysis: In-depth interviews and focus groups were conducted with caregivers to explore knowledge of RSV, attitudes and preferences towards immunisation, and information needs to support immunisation uptake. Data were analysed thematically in NVivo.
Outcomes: At present, interviews and focus groups have been conducted with 24 caregivers. Those from CALD backgrounds were less knowledgeable about RSV disease and immunisation, than caregivers of medically at-risk children. There was concern among a minority of CALD caregivers about the link between all childhood immunisations and autism. However, all caregivers were supportive of RSV immunisation with a preference for maternal vaccination over infant immunisation, to spare their child unnecessary needle pain. Caregivers trusted information coming from their child’s health worker, and wanted further information about RSV including details of the effectiveness of each immunisation option.
Conclusion and Future Actions: Findings will inform the development of targeted health education materials to improve RSV awareness and immunisation confidence. This will support ongoing implementation of RSV immunisation programs, enhance uptake, and strengthen community understanding of RSV as a significant cause of infection in Australian children.

Background and Aim
Fear of needles in children is a well-recognised barrier to timely and complete immunisation, contributing to distressing vaccination encounters, delayed schedules, and missed vaccinations. While children’s experiences of needle fear have been explored in the literature, less is known about how healthcare providers manage these encounters in practice and the support available to them. The aim of this study was to explore i) healthcare workers’ experience of vaccinating children with a fear of needles; ii) current and potential strategies to support these children through the vaccination process; and iii) requirements for healthcare worker support.

Methods and Analysis
A qualitative study design was undertaken. Semi-structured interviews were conducted with 10 healthcare providers involved in childhood immunisation, including nurses and pharmacists working across primary care and community settings in Aotearoa New Zealand. Interviews explored providers’ experiences, perceived challenges, and strategies used when vaccinating needle-averse children. Data were analysed using a directed qualitative content analysis approach, enabling identification of both anticipated and emergent themes.

Outcomes
Three dominant themes were identified. First, providers described significant emotional and behavioural challenges, including managing high levels of child distress, resistance, and their own emotional burden. Second, providers employed a range of informal strategies to support children, such as distraction techniques, rapport-building, caregiver involvement, and sensory tools. Third, participants consistently highlighted gaps in training, resources, and system-level guidance, noting the absence of structured clinical pathways for managing needle aversion.

Conclusion and Future Actions
Healthcare providers frequently encounter needle-averse children but may be underprepared and under-resourced to manage these situations effectively. Future action should include the development of national guidance, targeted training, and practical resources to support providers and improve vaccination experiences. Addressing needle fear at a system level may enhance equity, access, and confidence in childhood immunisation services.

Background: Immediate hypersensitivity reactions (IHR) following vaccination include urticaria, angioedema and respiratory symptoms which occur within one hour of immunisation. Presentations range from mild and self-limiting to severe reactions such as anaphylaxis, an extremely rare event with an estimated incidence of 1.31 cases per million vaccine doses. SAEFVIC is the reporting service in Victoria for Adverse Events Following Immunisation (AEFI) and is integrated with clinical services. SAEFVIC has developed a collaborative pathway with the Royal Children’s Hospital (RCH) Allergy & Immunology department to support children experiencing IHR.

Aim: To describe how the management of IHR has evolved overtime in response to emerging evidence and clinical experience, particularly regarding revaccination practices and recurrence of AEFI.

Methods: SAEFVIC reports from 2020–2024 were reviewed for individuals aged under 18 years who experienced IHR and referred for specialist consultation at the RCH Allergy clinic.

Analysis: 113 individuals were identified of whom 85 (75%) were revaccinated over 88 vaccine challenges with the same antigen(s) as their index reaction. Of those revaccinated, 50 (57%) underwent split-dose challenge and 12 (14%) received a full dose under observation in the allergy unit; 24 (27%) were immunised at the RCH Immunisation Centre with one hour observation. In 2020, two individuals underwent intradermal or skin prick testing prior to challenge, however protocol changes have since discontinued this practice.

Outcome: Of those revaccinated, 8 (7%) experienced further AEFI, majority being mild such as rash (no treatment) and injection site reactions. One individual, who initially developed angioedema and rash five minutes after receiving 18-month vaccines (ActHib, Infanrix, and ProQuad), experienced anaphylaxis following split-dose protocol (0.05mL followed by 0.45mL, 30 minutes apart) with the Varivax vaccine, managed with adrenaline.

Conclusion: SAEFVIC has facilitated safe revaccination for children with IHR through specialist allergy clinics and will continue evaluating this experience to inform future protocols.

Background and Aim
In NSW, National Immunisation Program vaccines are ordered by providers with a State Vaccine Centre registered vaccine account number (VAN). To minimise vaccine wastage and support best practice, the South Eastern Sydney Local Health District (SESLHD) Public Health Unit (PHU) commenced a cold chain audit project in 2023, initially targeting GP and pharmacist VAN holders, adopting a methodology developed by Perth Metro PHU. In 2025, this work was extended to residential aged care home (RACH) VAN holders.
The audit aimed to strengthen operational procedures and ensure RACH staff adhered to the National Vaccine Storage Guidelines – Strive for 5. The goal was to prevent cold chain breaches (CCBs), reduce vaccine wastage, and enhance vaccine safety and efficacy for residents.

Methods and Analysis
Audits of RACH vaccine cold chain processes were conducted between January and June 2025. An existing REDCap survey tool was adapted to include questions specific to the aged care context.
Within SESLHD, 89 RACHs held VANs, servicing 91 of 97 homes. Audits were completed either onsite or online.

Outcomes
Of the 89 VAN holders, 49 (55%) completed the audit, 37 (42%) VANs were closed due to organisational decisions, and three had a stop placed on their accounts.
Thirteen CCBs were identified, including one major incident requiring re‑vaccination of 59 residents with Shingrix. Common issues included failure to reset minimum/maximum thermometers, inadequate use of data loggers, and insufficient emergency equipment.
Audits were positively received, with many RACHs updating procedures, purchasing new equipment, and implementing recommendations. Some organisations extended audits to homes in other districts, supporting sustainability.

Conclusion and Future Actions
The project increased confidence in cold chain practices across SESLHD RACHs. Annual audits are now embedded, with the 2026 cycle underway. Future work should continue to strengthen and standardise cold chain systems across all RACHs storing vaccines.

Background and Aim: In Australia, childhood vaccination coverage has declined at key milestones, and on-time vaccination rates remain below pre–COVID-19 pandemic levels. These trends have prompted growing interest in alternative immunisation delivery models, including community health nurse-led clinics (CHNLCs). While CHNLCs are increasingly used across preventative and ambulatory care, evidence has largely focused on service models and outcomes, with limited insight into staff perspectives and experiences. Understanding the latter can help inform service continuity and sustainability; however, evidence remains sparse, particularly in relation to multi-role perspectives and regional CHNLCs. Using the long-running, nurse-led Child and Family Health Immunisation (CFHI) clinics on the Central Coast of New South Wales, this study explored how staff conceptualise and deliver community immunisation care and how these practices support service continuity.

Methods and Analysis: This study formed part of a broader CFHI clinic service evaluation. Semi-structured interviews with staff representing clinical, administrative and leadership roles explored service operations, strengths and challenges, and perspectives on care quality, access and sustainability. Data were analysed thematically.

Outcomes: Eight key informants participated. Three interrelated themes were identified: (1) trust-building through relational, parent-centred immunisation care; (2) extending access through flexible specialist nurse-led practice that addressed clinical and social complexity; and (3) sustaining continuity through collective capability, tacit expertise and supportive leadership.

Conclusion and Future Actions: CFHI clinics function as a complementary immunisation service to primary care, supporting equitable access while providing specialist, relationship-centred care. Service continuity was sustained through relational practice, workforce capability and leadership. To address declining childhood vaccination rates, governments should consider expanding CHNLC models. Further research should examine how leadership and workforce practices inform transferability, scalability and sustainability across different organisational contexts.

Background and Aim
Healthcare workers (HCWs) are at increased risk of vaccine-preventable diseases (VPDs), making immunisation a critical component of occupational health. A hospital-based workforce immunisation service can ensure compliance with national guidelines, reduce transmission risk, and improve staff as well as patient safety. In July 2025, Austin Health (AH) enhanced its Workforce Immunisation service with the addition of a Nurse Practitioner, Infectious Diseases consultant and additional administrative time. This presentation describes the implementation, uptake and outcomes of the service.

Methods and Analysis
The enhanced service provided an increase in the number of on-site vaccination clinics, electronic reminders and targeted follow-up for non-compliant staff. Vaccines include Hepatitis B, Measles Mumps and Rubella (MMR), varicella and diphtheria, tetanus and pertussis (dTpa). The team also began “looking-back” over staff vaccination records, starting with higher-risk areas. A retrospective review of immunisation data resulted in significant improvements in the uptake of vaccines. Vaccination rates were compared to previous years, demonstrating dramatic increases.

Outcomes
From 1 July 2025 to 31 December 2025, 737 staff were vaccinated in the clinic, with a total number of 901 vaccines. This is an 87% increase compared to the same period in 2024. Over 2,000 staff vaccination records have been reviewed to determine compliance with vaccination, the high-risk Emergency department (ED) one of the first. 68% of the ED medical staff were vaccinated for pertussis vaccine at onset, and 3 months after a targeted follow-up, 81% are now up to date.

Conclusion and Future actions
A dedicated hospital-based Workforce Immunisation service significantly improved vaccination coverage and addressed gaps in compliance at AH. Strategies such as electronic reminders and tailored follow-up were effective in enhancing staff protection and patient safety. This is a reflection of the hard work of dedicated professionals who continually seek to deliver effective and high quality services.

Background:
Papua New Guinea (PNG) continues to report some of the lowest immunisation coverage globally. In 2023, 41% of children in East New Britain (ENB) did not receive the first dose of the diphtheria-tetanus-pertussis vaccine (‘zero-dose’), while 55% were under-immunised, those who have not received a third dose of DTP vaccine.

Objective:
The project aimed to reduce the number of zero-dose and under-immunised children in ENB by strengthening routine immunisation through community and facility-based interventions informed by formative research.

Methods:
This two-phase approach began with a research phase in partnership with the ENB Provincial Health Authority, including population identification, qualitative and quantitative research with caregivers and healthcare workers and immunity mapping using a novel sero-surveillance tool. This was followed by co-design of interventions with communities, health workers, and leaders, incorporating findings from the research and local priorities.

Findings / Discussion:
Key barriers included low community awareness of immunisation and limited refresher training for health care workers. In response, co-designed strategies were implemented: (1) community sensitisation using tailored educational materials, (2) training 66 community leaders, and (3) healthcare worker training on WHO’s Immunisation in Practice (IIP) and sensitive communications methods. Eight Local Advisory Groups were formed to create linkages between health care workers and communities across 5 LLGs. Early results showed increased community demand for immunisation, improved clinical practice and communications around immunisation from health care worker evaluations.

Conclusion:
Evidence-based interventions from strong research, community-driven, co-designed approaches with collaboration significantly improve immunisation coverage and sustainability.