Social science in immunisation

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Social science research is a core component of NCIRS’s work. The aims of social science research at NCIRS are to: 

  • seek insights on the behavioural, social, cultural and structural drivers of vaccine uptake 
  • investigate evidence-based approaches to improve vaccine uptake
  • inform immunisation policy and programs.

The NCIRS Social Science Unit conducts original research to achieve these aims using a range of methods, including qualitative interviews and focus groups, surveys and online intervention testing.

NCIRS also incorporates social science research and insights across a broad range of organisational activities, including communications, policy development, program evaluation, Aboriginal and Torres Strait Islander immunisation, vaccine safety and immunisation in the Asia-Pacific regions.

The NCIRS Social Science Unit also collaborates and consults on a range of social science immunisation projects with local and international collaborators and consortiums (see ‘Other activities’).

Key projects 

  • SKAI across the lifespan

    The Social Science Unit undertook a project to evaluate and expand the Sharing Knowledge About Immunisation (SKAI) package. The aim was to build a national hub of vaccination communication resources and training materials to support a range of populations.  

    Components of the project included:

    • evaluation of existing SKAI resources for patients and providers [completed]
    • amalgamation of the SKAI package and sister site MumBubVax into a single platform [completed]
    • expansion to support communication about a range of vaccines and to meet the needs of specific communities, such as Aboriginal and Torres Strait Islander people [ongoing] 
    • enhanced dissemination and promotion activities. [ongoing]
  • Vaccination Insights

    This major study – a collaborative, Commonwealth-funded initiative – is investigating and diagnosing the drivers of under-vaccination in Australian children aged under 5 years, with specific reference to National Immunisation Program-funded and influenza vaccines.
    Its aims are: 

    • to deliver the comprehensive, high-quality data that are needed to develop targeted and data-driven strategies to increase the uptake of routine vaccines in this age group
    • to provide in-depth understanding of the factors that are driving under-vaccination in Australian children 
    • to bring to light the reasons behind suboptimal uptake of certain vaccines in this age group – which has been exacerbated, in some cases, by the COVID-19 pandemic.

     

    In this demonstration project, data are being gathered via a large-scale national survey of parents and carers of children under 5 years of age, as well as through in-depth qualitative interviews with members of a priority population group with low vaccine uptake.

    This work could readily expand into other key NIP target groups such as adolescents, adults, pregnant women, culturally and linguistically diverse communities, Aboriginal and Torres Strait Islander peoples and others. 

    The Social Science Unit is coordinating this project, which is being conducted in close collaboration with the Murdoch Children’s Research Institute and the University of Sydney’s Social and Behavioural Insights in Immunisation research group.

  • COVID-19 vaccination messaging

    In this project, the Social Science Unit aims to support acceptance of COVID-19 vaccines and positive vaccine intentions in key groups.

    Study objectives include exploring community perspectives on COVID-19 vaccines, conducting a systematic review of COVID-19 vaccination messaging, developing and testing evidence-based public health messages to support COVID-19 vaccination programs and exploring the communication needs of immunisation providers in relation to COVID-19 vaccines. 

    Study outputs include reports summarising findings and recommendations for health authorities and other stakeholders, peer-reviewed publications and several public-facing resources. 

    One such resource is a guide for organisations promoting COVID-19 vaccines.  The guide, informed by a review of global literature, highlights factors that may influence acceptance of COVID-19 vaccines, and offers recommendations for developing COVID-19 communication materials. Access the guide here.

    A second resource, developed in collaboration with colleagues at the University of New South Wales, summarises unvaccinated adults’ perspectives on COVID-19 vaccines and provides recommendations to help improve communication between health authorities, providers, unvaccinated individuals and their friends and families. Access the resource here.
     

  • COVID-19 myth debunking

    The aim of this project is to reduce COVID-19 vaccine misperceptions.

    Objectives include:

    • measuring the prevalence of misperceptions about COVID-19 vaccines, including about the safety and impact of COVID-19 vaccines on fertility, pregnancy and breastfeeding
    • developing and testing tailored communication interventions designed to debunk misinformation.
       
  • Aboriginal influenza vaccination study

    In Australia, seasonal influenza is the most common vaccine preventable disease, aside from COVID-19, contributing to hospitalisation. Hospitalisation rates are 2.4 times higher among Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) people across all age groups than non-Aboriginal people. Since 2019 influenza vaccination has been funded for all Aboriginal people aged 6 months and older, but coverage remains suboptimal.

    The Aboriginal Influenza Vaccination Study aimed to understand the communication needs of Aboriginal families and their healthcare providers relating to influenza vaccination. The Social Science Unit purposively approached immunisation stakeholders and Aboriginal communities in geographically diverse areas of New South Wales, using qualitative methods to gather and explore a range of perspectives.

    The team conducted this study with cultural guidance from and in collaboration with the NCIRS National Indigenous Immunisation Coordinator (NIIC), NCIRS Aboriginal Population Health Trainee and the NCIRS Cultural Governance Group (CGG).

    Key findings
    • There are opportunities to further support Aboriginal Medical Services (AMSs), which are trusted and welcoming service providers for Aboriginal families.
    • There are opportunities to improve the accessibility and appropriateness of mainstream services for Aboriginal families.
    • Supporting healthcare providers to more accurately understand influenza risk in Aboriginal families and strengthen their recommendations could encourage more Aboriginal families to vaccinate.
    • Influenza vaccination resources designed by communities may support Aboriginal families with influenza vaccination decisions.

     

    Key recommendations

    To achieve optimal influenza vaccination coverage among Aboriginal people:

    • all health services must take responsibility for providing culturally responsive clinical care to Aboriginal families
    • where possible, mainstream services must incorporate elements of the family-centred and broader model of health used by AMSs, including:

             - creating a welcoming environment,

             - appropriately identifying and getting to know Aboriginal patients o taking a preventative approach

             - opportunistically offering and strongly encouraging influenza vaccination to the individual and their family.

     

    Access a summary of key findings and recommendations here

    Access publication here
     

    This study is now complete. The Social Science Unit continues to respond to the vaccination communication needs of Aboriginal and Torres Strait Islander communities through the SKAI Across the Lifespan project, including building on the findings and recommendations from the Aboriginal Influenza Vaccination Study.

  • WHO COVID-19 vaccine safety communication

    The Social Science Unit worked with the WHO Global Advisory Committee on Vaccine Safety to produce guidelines on communicating about COVID-19 vaccine safety. Risk communication principles informed these guidelines, developed for health authorities and other vaccine safety stakeholders. NCIRS Professorial Fellow Julie Leask led this project. This project is now complete.

  • SKAI influenza update

    The Social Science Unit developed influenza vaccination resources for parents to enhance the Sharing Knowledge About Immunisation (SKAI) package. The team designed these resources to support parents’ influenza vaccination information needs and guide them in their decision to vaccinate. This project is now complete.

Other activities 

  • Peer-to-Peer communication about vaccines training toolkit

    The aim of this project is to enhance and improve peer-to-peer (P2P) communication about vaccines in Somali communities in the US and Kenya. Working closely with project partners, phase 1 of this project involved developing and assessing a P2P education toolkit with a Somali American diaspora community in Minneapolis, Minnesota.

    The team is using findings from Phase I to inform the adaptation of the tool to the needs of Somali diaspora communities in Kenya. A field test is currently underway in Nairobi, Kenya to understand the acceptability, feasibility and usability of this tool to inform implementation.

    The project team consists of the Taskforce for Global Health, the US Centers for Disease Control and Prevention, US-based non-governmental organisation Voices for Vaccines, the University of Sydney, Université de Sherbrooke, Kenyan-based partner the African Institute for Health and Development, and NCIRS. 

  • COVID-19 vaccine intentions, preferences and decision-making 

    The 45 and Up Study is Australia’s largest longitudinal study of health and ageing, with >250,000 participants and 15 years of survey and linked data. Starting in 2020, COVID-19 specific surveys delivered rapid insights to inform decision-making during the pandemic.

    The team is collaborating with the Sax Institute to conduct a qualitative content analysis of the free-text responses captured by the survey. The aim of this study is to identify themes relating to vaccine intentions, preferences and factors influencing COVID-19 vaccination decision-making.

    Qualitative content analysis is currently ongoing.

     

  • Summary of strategies to increase childhood vaccination rates
    Tree of community informed strategies to increase childhood vaccination rates

    The resource presents practical strategies for health services to improve childhood vaccination rates in communities that may generally support vaccination, but experience socio-economic disadvantage and access barriers to immunisation services.

    The Tree may also be used by communities to start a conversation about what makes it difficult or easy to get children vaccinated on time in their community, and advocate for changes. 

    The resource is a visual summary of findings from studies conducted in five regional locations across New South Wales by researchers from the University of Newcastle and NCIRS, in collaboration with the University of Sydney, the World Health Organization, NSW Ministry of Health and local public health units. It incorporates suggestions from immunisation stakeholders such as parents/carers, public health units and health services. 

    The research followed the World Health Organization Tailoring Immunization Programmes (TIP) approach and, in addition to summarising practical strategies to improve childhood vaccination rates, shows the complex relationship between broad determinants of childhood vaccination.

    Access this resource here

    Access print-ready version here

     

  • COSSI Steering Committee

    The Collaboration on Social Science and Immunisation (COSSI) is a collective of people from Australia and around the world who work collaboratively to improve vaccine acceptance and uptake by understanding barriers and enablers of immunisation. COSSI is an initiative of NCIRS and the University of Sydney, established in 2016. Members of the NCIRS Social Science Unit are on the COSSI Committee.

  • AusVaxSafety evaluation

    NCIRS and partners established AusVaxSafety in 2014 to monitor adverse events following influenza immunisation in children. Social science research informs work that evaluates the surveillance system among immunisation providers.

  • Participation in the Australian Regional Immunisation Alliance (ARIA)

    NCIRS established ARIA in 2019 in collaboration with experts and partners from multiple Australian universities and research institutes. Social science research is informing efforts to support immunisation activities in the Asia-Pacific regions. 

  • Australian Technical Advisory Group on Immunisation (ATAGI)

    NCIRS provides scientific research support to the ATAGI and the Immunisation and Communicable Diseases Branch of the Australian Government Department of Health. Social science research supports the development and implementation of national immunisation policies.

  • NCIRS-USYD Masters of Public Health elective course

    The Social Science Unit developed a social science of immunisation component of the NCIRS-University of Sydney Masters of Public Health program’s elective course “Vaccines and Public Health”.

    This component involves a series of online lectures, real social science of immunisation case studies and interactive group activities under the theme “Enabling high vaccine coverage”.  

    Students gain knowledge about and learn how to apply in practice:

    • theoretical framework useful in understanding determinants of vaccine uptake
    • types of determinants of vaccine uptake
    • types and specific examples of evidence-based strategies to address determinants of vaccine uptake
    • social sciences and qualitative approaches for mapping determinants of vaccination uptake and tailoring them to given context. 
       
  • Qualitative research capacity building

    The Social Science Unit collaborates within NCIRS and health partners nationally to build capacity in qualitative methodologies, with a focus on building capacity within Aboriginal and Torres Strait Islander health partners and/or projects that address health needs of the Aboriginal communities.

  • Student projects: past and present

    The NCIRS social science unit has supported a number of postgraduate higher degree by research (HDR) scholars over the years.

    If students are interested in being supervised by NCIRS social science staff, please send an email to: SCHN-NCIRS@health.nsw.gov.au