Childhood vaccination barriers in Australia – key findings summary

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Findings from a nationally representative survey on the barriers to uptake of childhood vaccines in Australia
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This page summarises key findings from the National Vaccination Insights project survey of a nationally representative cohort of 2,000 parents. The aim of the study was to understand the barriers to uptake of National Immunisation Program vaccines among children under 5 years of age.


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Vaccine Barriers Assessment Tool (VBAT)

VBAT barriers include acceptance and access barriers. These can be further grouped according to the following domains:

  • thinking and feeling 
  • social processes 
  • practical issues.

These categories are informed by the World Health Organization Behavioural and Social Drivers of Vaccination (BeSD) framework.
 
 

Acceptance and access barriers to childhood vaccination, as measured by the VBAT*

* For more information on the development and validation of the VBAT, see Kaufman J, Tuckerman J, Bonner C et al. Development and validation of the Vaccine Barriers Assessment Tool for identifying drivers of under-vaccination in children under five years in Australia. Human Vaccines & Immunotherapeutics 2024;20:2359623

Most common vaccination barriers  

The most common barriers reported by all parents (n=2000) were as follows:

  • Six in 10 (60.2%) parents reported the acceptance barrier of feeling distressed when thinking about vaccinating their child (see the ‘Acceptance barriers: thinking-feeling’ graph below). 
     
  • More than 1 in 10 (11.0%) parents reported the access barrier that they cannot afford costs associated with vaccinating their child (see the ‘Access barriers: practical’ graph below).
     
  • Almost 1 in 10 (9.3%) parents reported the access barrier that it is not easy to get a vaccination appointment when their child’s vaccination is due (see the ‘Access barriers: practical’ graph below).
     
     

Percentage of parents reporting vaccination barriers – overall and by childhood vaccination status

Acceptance barriers: thinking-feeling
Acceptance barriers: social influence
Access barriers: practical

Vaccination barriers associated with partial vaccination

The barriers significantly associated with parents of partially vaccinated children* were found to be a mix of access and acceptance barriers. 
These barriers** were:

  • not prioritising their child’s vaccination appointments over other things: 
    • 23.9% of parents of partially vaccinated children vs 6.9% of parents of up-to-date children reported this barrier, a 17.1 percentage-point difference (95% confidence interval [CI]: 7.2%, 26.9%) 
       
  • not finding it easy to get an appointment when their child’s vaccination is due: 
    • 24.8% of parents of partially vaccinated children vs 8.5% of parents of up-to-date children reported this barrier, a 16.3 percentage-point difference (95% CI: 6.3%, 26.3%)
       
  • not believing vaccines are safe for their child:
    • 17.7% of parents of partially vaccinated children vs 4.8% of parents of up-to-date children reported this barrier, a 12.9 percentage-point difference (95% CI: 4.3%, 21.4%) 
       
  • not trusting the information they receive about vaccines from their child’s doctor or nurse:
    • 16.8% of parents of partially vaccinated children vs 5.4% of parents of up-to-date children reported this barrier, a 11.4 percentage-point difference (95% CI: 2.9%, 19.9%)
       
  • not believing vaccinating their child helps protect others in the community:
    • 14.0% of parents of partially vaccinated children vs 3.9% of parents of up-to-date children reported this barrier, a 10.1 percentage-point difference (95% CI: 2.2%, 18.0%) 
       
  • not being able to afford costs associated with vaccinating their child:
    • 20.5% of parents of partially vaccinated children vs 10.4% of parents of up-to-date children reported this barrier, a 10.0 percentage-point difference (95% CI: 0.7%, 19.3%) 
       
  • not believing vaccines are effective for preventing diseases:
    • 14.3% of parents of partially vaccinated children vs 4.4% of parents of up-to-date children reported this barrier, a 9.9 percentage-point difference (95% CI: 2.2%, 17.7%) 
       
  • not feeling guilty if their unvaccinated child got a vaccine preventable disease:
    • 16.0% of parents of partially vaccinated children vs 7.1% of parents of up-to-date children reported this barrier, an 8.9 percentage-point difference (95% CI: 0.2%, 17.6%. 
       

Although feeling distressed when thinking about vaccinating their child was the most common vaccination barrier parents reported (55.4% of parents of partially vaccinated children vs 60.3% of parents of up-to-date children reported this barrier, a 4.9 percentage-point difference; 95% CI: −16.4%, 6.5%), this acceptance barrier was not found to be associated with parents of partially vaccinated children. 
 

* Of the parents surveyed, 4.9% (n=97/2000) had partially vaccinated children and 93.5% (n=1870/2000) up-to-date children. ‘Partially vaccinated’ was defined as children who had received some but not all vaccines recommended for their age. ‘Up-to-date’ was defined as children who had received all vaccines recommended for their age.

** Barriers are ordered by strength of association with parents of partially vaccinated children. This is measured as the percentage point difference between the percentage of parents of partially vaccinated children reporting the barrier and the percentage of parents of up-to-date children reporting the barrier.

Vaccination barriers associated with not vaccinating

The barriers significantly associated with not vaccinating* were mostly acceptance barriers. 
These barriers** were:

  • not intending to give their child all recommended vaccines:
    • 48.8% of parents of unvaccinated children vs 4.8% of parents of up-to-date children reported this barrier, a 44.0 percentage-point difference (95% confidence interval [CI]: 23.7%, 64.2%)
       
  • not believing vaccines are safe for their child: 
    • 47.9% of parents of unvaccinated children vs 4.7% of parents of up-to-date children reported this barrier, a 43.0 percentage-point difference (95% CI: 22.9%, 63.2%)
       
  • not prioritising their child's vaccination appointment over other things: 
    • 47.6% of parents of unvaccinated children vs 6.9% of parents of up-to-date children reported this barrier, a 40.7 percentage-point difference (95% CI: 20.4%, 61.1%)
       
  • not feeling guilty if their unvaccinated child got a vaccine-preventable disease: 
    • 46.7% of parents of unvaccinated children vs 7.1% of parents of up-to-date children reported this barrier, a 39.6 percentage-point difference (95% CI: 19.7%, 59.5%) 
        
  • not trusting information they receive about vaccines from their child’s doctor or nurse: 
    • 43.7% of parents of unvaccinated children vs 5.4% of parents of up-to-date children reported this barrier, a 38.3 percentage-point difference (95% CI: 18.8%, 57.7%)
       
  • not believing vaccinating their child helps protect others in the community:
    • 39.7% of parents of unvaccinated children vs 3.9% of parents of up-to-date children reported this barrier, a 35.8 percentage-point difference (95% CI: 17.1%, 54.5%)
       
  • not believing vaccines are effective for preventing diseases:
    • 39.8% of parents of unvaccinated children vs 4.4% of parents of up-to-date children reported this barrier, a 35.4 percentage-point difference (95% CI: 16.2%, 54.7%)
       
  • people close to them not supporting vaccination:
    • 21.8% of parents of unvaccinated children vs 5.5% of parents of up-to-date children reported this barrier, a 16.2 percentage-point difference (95% CI: 0.9%, 31.6%).
       

* Of the parents surveyed, 1.7% (n=33/2000) had unvaccinated children and 93.5% (n=1870/2000) up-to-date children. ‘Unvaccinated’ was defined as children who had not received any vaccines recommended for their age. ‘Up-to-date’ was defined as children who had received all vaccines recommended for their age.

** Barriers are ordered by the strength of association with parents not vaccinating their child. This is measured as the percentage point difference between the percentage of parents of unvaccinated children reporting the barrier and the percentage of parents of up-to-date children reporting the barrier.

Vaccination barriers associated with financial stress

Significantly more parents experiencing financial stress reported the following access and acceptance barriers to childhood vaccination than parents not experiencing financial stress:*

  • not being able to afford costs associated with vaccinating their child:
    • 16.4% of parents experiencing financial stress vs 8.1% of parents not experiencing financial stress reported this barrier, a 8.4 percentage-point difference (95% CI: 0.7%, 19.3%)
       
  • not believing vaccines are safe for their child:
    • 8.0% of parents experiencing financial stress vs 4.9% of parents not experiencing financial stress reported this barrier, a 3.1 percentage-point difference (95% CI: 0.5%, 5.6%).


* Of the parents surveyed, the percentage of parents who did and did not report experiencing financial stress was 36.3% (n=726/2000) and 63.7% (n=1274/2000), respectively. Experiencing financial stress was defined as selecting two or more response options to the following question: ‘Since January 2023, did any of the following happen to you because of a shortage of money?’ Response options were as follows: ‘Could not pay electricity, gas or telephone bills on time’; ‘Could not pay the mortgage or rent on time’; ‘Pawned or sold something’; ‘Went without meals’; ‘Was unable to heat home’; ‘Asked for financial help from friends or family’; and ‘Asked for help from welfare/community organisations’. 

Vaccination barriers associated with where parents live

Significantly more parents living in metropolitan-regional areas* reported cost as a vaccination barrier compared with parents living in rural-remote areas: 11.1% said they experienced the access barrier of not being able to afford the costs associated with vaccinating their child, compared with 6.6% of parents living in rural-remote areas, a 4.5 percentage-point difference (95% confidence interval: 0.8%, 8.1%).


* Of the parents surveyed, the percentage of parents who lived in metropolitan-regional areas and rural-remote areas was 90.3% (n=1806/2000) and 9.7% (n=194/2000), respectively.

A full report that includes comprehensive findings from the survey, as well as proposed policy- and practice-related actions for consideration, will be released in early 2025.
 

Back to report overview

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