Background: Australia’s National Immunisation Program provides three vaccines (dTap, meningococcal ACWY, HPV) to adolescents at no cost through school immunisation programs. Whilst communication resources supporting school provider vaccination conversations are available, we know little about how these resources are used. Currently, the Sharing Knowledge About Immunisation (SKAI) website addresses routine vaccination in pregnancy and early childhood. To inform the expansion of SKAI to include routine adolescent vaccination, this study aimed to understand what questions about routine adolescent vaccination school providers answer, what communication resources they use and what resources they want.

Methods: We purposefully recruited a sample of 17 school immunisation providers and co-ordinators for qualitative interviews. We aimed for participant diversity by state/territory, professional role and years of school immunisation delivery experience. We thematically analysed qualitative data using an inductive team approach.

Results: Participants shared that their vaccination conversations routinely provided information about diseases and vaccines, provided reassurance about the importance of vaccines and clarified vaccine misunderstandings. Participants reported a lack of resources to support conversations with Aboriginal and Torres Strait Islander and culturally diverse communities. Some providers shared that they have tailored their communication strategies to help address these gaps. Providers suggested that new resources should be in plain language and shareable on social media.

Discussion: Interviews informed the SKAI expansion to adolescent vaccination. Findings supported maintaining the current SKAI topic areas but identified that information is needed about booster vaccines, HPV vaccination and how spiritual and religious observances can be respected during vaccination. We also identified that information address adolescent needle anxiety and routine vaccination for those with certain medical risk conditions is needed. To develop resources for priority populations, future SKAI research should be conducted in consultation with community members from Aboriginal and Torres Strait Islander communities and culturally diverse populations.

Provider recommendation is considered a major driver of a parent’s decision to vaccinate their child. Every clinical presentation to a healthcare provider should be an opportunity for clinicians to discuss immunisation with families and offer or provide vaccination as a routine part of care. If healthcare staff are not confident to have these conversations, the opportunity is missed, to the detriment of the health and wellbeing of the families we care for.

Failure to provide safe, appropriate and timely vaccination for our paediatric cohort impacts consumer acceptance of vaccination and herd immunity, with an increased risk of vaccine preventable disease in the communities our patients live. Addressing these challenges to the provision of vaccination is ongoing and complex.

Yellow fever (YF) is a viral disease transmitted by mosquito bites that is endemic in parts of South America and Africa. Despite the availability of an vaccine, YF still affects >100,000 persons annually,1 and poses a significant risk to unvaccinated travellers (170/100,000 YF cases per month of travel, with 40% case-fatality rate).

YF vaccines are effective; however, as live vaccines there are precautions and contraindications for their use in some individuals. Severe adverse events following immunisation (AEFI) with catastrophic consequences (including deaths) have been reported , particularly among those aged >65 years, those with a history of thymectomy and immunocompromised individuals.3 YF vaccination is required for travellers to certain countries. While YF vaccine requirements are applied at a country level,4 the risk of YF can vary substantially within a country. For example, YF is endemic in the Amazon region of Peru, but there is no transmission at altitudes above 2,300m or in most coastal areas. If a health professional advises against vaccination for medical reasons, a medical exemption letter may be issued.
A YF vaccine risk-benefit analysis tool would greatly assist clinicians and travellers to weigh the risks (severe AEFI) and the benefits (reduction in risk of YF) of vaccination, and help with decisions about getting vaccinated versus obtaining a medical exception certificate. This is particularly relevant for older and immunocompromised travellers to regions with variable risk of YF infection within a country.

Current social bot detection methods primarily rely on heuristics or rule-based approaches. These methods analyse factors like account activity, metadata, content characteristics, and network connections. However, the landscape has shifted dramatically with the emergence of powerful generative AI (GenAI) powered by Large Language Models (LLMs) with billions of parameters.

These GenAI-powered bots pose a significant challenge to tracking social bot influence in online discussions, particularly those related to vaccines. They can mimic human conversation remarkably well, not only generating posts, comments, and replies but also weaving conversation threads. This ability to simulate human-like interaction significantly hinders traditional detection methods. These challenges include sophisticated AI-generated content and adversarial attacks by malicious actors.

Introduction: The amplification of vaccine misinformation has had demonstrable effects on vaccine trust and confidence in Australia. During the COVID-19 pandemic, vaccine misinformation was particularly prevalent among Arabic-speaking communities in Victoria. Psychological inoculation, which teaches people to recognise techniques used to mislead, is one promising intervention to address misinformation. With guidance from an Arabic-speaking community advisory group, this study aimed to co-design an Arabic-language adaptation of an online psychological inoculation game, and to evaluate the game’s effectiveness in improving misinformation discernment, vaccine attitudes and institutional trust.
Methods: We conducted a three-phase mixed-methods study comprising a) online focus groups (n=16), b) co-design workshops to adapt the game (n=65), and c) a randomised controlled trial (ncontrol=98; nintervention=100). Participants were recruited through online and face to face Arabic-language social groups and networks. Translators and bilingual facilitators assisted in the focus groups and workshops. All participant-facing materials were written in Modern Standard Arabic. The psychological inoculation game was Cranky Uncle – Vaccine, originally developed and adapted in several African countries. In this online game, misinformation is shared by a ‘Cranky Uncle’ character, and a healthcare professional refutes him and educates the player. Players complete interactive quizzes before progressing a level.
Findings: Focus group and workshop participants reported that vaccine misinformation was easily recalled, pervasive and more accessibly delivered than official information. Fear and uncertainty of vaccine side-effects were more salient than mistrust of authorities. Game characters and scripts were adapted to reflect the Victorian Arabic-speaking community. The trial showed no statistically significant improvement in discernment, attitudes and trust, but there was support and appreciation for the game among community members.
Conclusion: While the trial did not produce significant findings, our experiences in all phases of this study provided valuable insights to support future implementation and evaluation of psychological inoculations like Cranky Uncle - Vaccine.

Context: South Eastern Sydney Local Health District (SESLHD) Public Health Unit received funding from the Central and Eastern Sydney Primary Health Network to improve vaccination coverage in SESLHD residential aged care homes between June and December 2024. The project targeted four recommended and funded vaccines for residents: COVID-19, influenza, pneumococcal, and shingles.

Aim: To increase vaccination coverage in SESLHD residential aged care residents.

Methods: Barriers to vaccination were identified via surveys and interviews with geriatricians, GPs, care staff, residents and their families, and used to develop tailored action plans for the 90 participating care homes and other resources including staff education sessions. Australian Immunisation Register (AIR) data was downloaded to create a vaccination tracker for each resident in each home. Vaccination coverage was compared pre- and post-intervention. An evaluation survey was distributed to participating facilities.

Results: Barriers included difficulties accessing and tracking resident vaccination histories, finding vaccination providers, lack of simple or translated vaccine information, and complex consent processes. Changes in vaccination coverage pre- and post-intervention varied between facilities, with a median (and range) of 8.2% (-64% to 88%) for COVID-19, 4.4% (-4.7% to 79%) for pneumococcal, and 20.8% (-5.4% to 85%) for shingles. Influenza coverage remained unchanged due to timing of the intervention after the 2024 season.

The evaluation survey had 25 responses, with 84% very satisfied with the project. Notably, 92% found the vaccination tracker useful, and 45% identified incomplete vaccination records in the AIR.

Conclusion: Addressing barriers like access to resident vaccination histories and vaccination providers are crucial for improving vaccination coverage in aged care homes. Longer evaluation periods are needed to assess the sustained impact of this initiative. This project demonstrates the need for continuous support, including education and advocacy, for staff working with vulnerable populations to ensure high vaccination coverage can be achieved.

Introduction
Social media present an opportunity for public health service organisations (PHSOs) to promote vaccination directly to the public. Additionally, social media can facilitate real-time audience engagement, enabling PHSOs to continuously support the audience to make informed choices about vaccination. However, PHSOs’ social media public service announcements (PSAs) promoting vaccination often go unnoticed, thereby missing the objectives set for such PSAs. Through the lens of three humour theories, this study explored PSAs promoting COVID-19 vaccination posted by Australia’s health departments to identify the potential of humorous health messaging to influence audience engagement.

Methods
The accounts of Australia’s nine health departments on Facebook, X, and YouTube were scanned for humorous PSAs promoting COVID-19 vaccination posted between October 2021 and May 2023. Twenty-three unique humorous PSAs posted by six health departments generated high audience engagement and were extracted for our content analysis. The six health departments were ACT Health, Queensland Health, SA Health, TAS Health, VIC Health, and the Australian Government Department of Health and Aged Care.

Results
The health departments used five humour types, namely comic wit, sentimental humour, sentimental comedy, solidarity, and full comedy, to promote COVID vaccination. The PSAs reinforced the benefits of COVID vaccination through gain-framed messages. A quarter of the PSAs promoted vaccination for self-protection, while the remaining prioritised community protection.

Conclusion
PHSOs may adopt a range of health messaging strategies, aiming to obtain optimal audience attention and engender high audience engagement. Humour appeal in PSAs promoting vaccination has the potential to influence audience engagement, creating opportunities for public acceptance of vaccination practices. This study establishes the relevance of a range of humour types for promoting vaccination via social media. PHSOs should consider infusing their social media promotion of vaccination with a variety of humour types, leveraging on the conviviality of the social media environment to achieve audience engagement.