Why are more Australian parents taking childhood influenza vaccination off the priority list?

New findings from the National Vaccination Insights project show a shift in parental willingness to prioritise childhood influenza vaccination, with more families deprioritising protecting against influenza despite heightened risks of severe illness and hospitalisation in young children. 

A nationally representative 2025 survey of more than 2,000 parents of children under 5 years of age examined common access and acceptance barriers to influenza vaccination and compared responses with those reported in 2024. 

In 2025, vaccine acceptance barriers overtook access barriers as the main drivers of parental decisions not to vaccinate their child against influenza, increasing across multiple measures.

The largest increases included:

• not prioritising influenza vaccination (15.7% → 32.3%) 
• not anticipating feeling guilty if an unvaccinated child became ill (15.5% → 30.6%) 
• not intending to vaccinate their child in the next influenza season (12.2% → 26.0%) 
• not believing the vaccine is effective (9.7% → 22.2%). 

‘Not prioritising childhood influenza vaccination is about perceptions of low disease risk, low relevance and poor vaccine effectiveness, as well as access issues such as costs and ease of getting appointments,’ said lead study author Dr Maryke Steffens, Research Fellow at NCIRS. 

While access barriers, such as cost and appointment availability, were reported less frequently overall, they remained more common among families experiencing financial stress, living outside major cities or speaking a language other than English at home. 

‘Even when vaccines are funded, families may still face appointment costs and indirect costs such as travel, time off work, language barriers and difficulty securing appointments. These pressures can influence decisions – especially when influenza vaccination is not seen as a priority,’ said co-author Dr Jess Kaufman, Principal Research Fellow in the Vaccine Uptake Group at MCRI.

Senior author Professor Margie Danchin said the findings reinforce the need to refocus communication and service delivery approaches. 

‘Parents continually report that they believe influenza is not serious for healthy children or that vaccination is not effective, which we know isn’t true. We need to communicate more clearly that influenza can cause severe illness in young children, and in rare cases death, and that vaccination is the most effective way to reduce the risk.

‘We also need to support providers to integrate influenza vaccination into routine care, so it becomes something they recommend and offer opportunistically – just as they already do with age-based vaccines.’

The introduction of a needle‑free nasal spray vaccine from 2026 was welcomed by many parents, with 72.2% of those with unvaccinated children indicating they would be more likely to vaccinate their child if this option were available. However, researchers caution that needle‑free options alone will not address declining acceptance. 

‘The nasal spray vaccine is likely to reduce distress and improve parents’ access if offered in places and at times that are convenient for parents. However, it won’t fully address why influenza vaccination is being deprioritised – we need to address the underlying attitudes and beliefs directly.’ 

Professor Danchin agreed. ‘We need to reposition influenza vaccination as integral. It is free for all children 6 months to 5 years and recommended for all children from 6 months of age. When families understand how serious influenza can be, and we make vaccines easy and convenient to access, influenza vaccination moves back up the priority list.’
 

Access the key findings summary