Immunisation opportunities overlooked for high-risk Australians

Katie McFadden undertook research to answer this question while completing her Master of Public Health/Master of Health Management at UNSW School of Population Health in 2020 under the supervision of Associate Professor Holly Seale, an infectious disease social scientist at UNSW School of Population Health. Katie’s research has recently been published in the journal Vaccine.

Despite the availability of fully funded vaccines for many higher-risk groups, coverage remains sub-optimal. In Australia, annual influenza vaccination has been funded nationally since 1999 for those aged above 65 years and, since 2010, for those aged less than 65 years who are more susceptible to infection, such as people with circulatory and respiratory conditions and pregnant women. Since 2005, pneumococcal vaccination has also been funded for all adults aged above 70 years and Aboriginal and Torres Strait Islander people over 50. 

“The goal of this project was to examine existing missed opportunities and potential for vaccination in hospitals. One option to increase uptake is to vaccinate outside of the traditional primary care setting by capitalising on opportunities in other health contexts, such as hospitals,” said Katie. 

The first step in the research was to conduct a review focused on interventions delivered in critical care settings to increase opportunistic influenza vaccination for high-risk adults. The next step was to examine the perceptions of Australian adults towards hospital-based immunisation programs and their previous exposures to receiving vaccines via tertiary care.

The study found that although 72% of adults indicated a willingness to be immunised, only 13/1292 vaccinations were reported as received in hospital. Further, 57.2% and 28.3% of respondents were not immunised for pneumococcal and influenza, respectively.

The importance of a healthcare professional’s recommendation aligns with findings across different at-risk groups and vaccines in the literature and highlights the importance of expert recommendations to improve coverage for adults.

“Our findings support international work that shows very low rates of opportunistic vaccination in hospitals despite national recommendations to vaccinate prior to discharge. Considering the need for high levels of uptake of the COVID-19 vaccine, especially for those at medically heightened risk, hospitals may need to be considered to opportunistically capture those not accessing the vaccine in other settings,” said Katie.

According to Associate Professor Holly Seale, who is also Director of the Bachelor of International Public Health at the School, given the urgent need to support COVID-19 vaccine uptake amongst the Australian community, it is important to look at a broad range of opportunities so all members of the population can access the vaccine. 

"While some people will be happy to receive a vaccine via a mass clinic, others may seek the support of hospital specialists to support their decision making and this is where hospital-based programs can be useful. This new research helps support the value of including hospitals,” said Associate Professor Seale.

The publication, with several authors from the School (Katie McFadden, Associate Professor Holly Seale and Associate Professor Anita Heywood), can be found here: Minimising missed opportunities to promote and deliver immunization services to middle and older age adults: Can hospital-based programs be a solution?

The systematic review by Katie McFadden and Holly Seale can be found here: A review of hospital-based interventions to improve inpatient influenza vaccination uptake for high-risk adults.

This photo is from Flickr under a Creative Commons license. Attribution 2.0 Generic (CC BY 2.0). Original photo.

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