Provider Preference, Logistical Challenges, or Vaccine Hesitancy? Analyzing Parental Decision-Making in School Vaccination Programs: A Qualitative Study in Sydney, Australia

<b>Background:</b> School-based immunization programs are crucial for equitable vaccine coverage, yet their success depends on parental consent processes. This study investigates patterns of vaccine decision-making within Australia’s school-based immunization program, specifically focusi...

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Main Authors: Leigh McIndoe, Alexandra Young, Cristyn Davies, Cassandra Vujovich-Dunn, Stephanie Kean, Michelle Dives, Vicky Sheppeard
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Vaccines
Subjects:
Online Access:https://www.mdpi.com/2076-393X/13/1/83
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author Leigh McIndoe
Alexandra Young
Cristyn Davies
Cassandra Vujovich-Dunn
Stephanie Kean
Michelle Dives
Vicky Sheppeard
author_facet Leigh McIndoe
Alexandra Young
Cristyn Davies
Cassandra Vujovich-Dunn
Stephanie Kean
Michelle Dives
Vicky Sheppeard
author_sort Leigh McIndoe
collection DOAJ
description <b>Background:</b> School-based immunization programs are crucial for equitable vaccine coverage, yet their success depends on parental consent processes. This study investigates patterns of vaccine decision-making within Australia’s school-based immunization program, specifically focusing on human papillomavirus (HPV) and diphtheria-tetanus-pertussis (dTpa) vaccines offered free to adolescents aged 12–13. <b>Methods:</b> This qualitative study was conducted in the South Eastern Sydney Local Health District (2022–2023). Semi-structured interviews were held with school staff (<i>n</i> = 11) across government, Catholic, and independent schools, parents whose children were not vaccinated at school (<i>n</i> = 11) and a focus group with public health unit staff (<i>n</i> = 5). Data were analyzed to identify key barriers and patterns in vaccine decision-making. <b>Results:</b> Analysis revealed three distinct groups of parents whose children were not vaccinated through the school program: (1) those favoring general practitioners for vaccination, driven by trust in medical providers and a preference for personalized care; (2) those intending to consent but facing logistical barriers, including communication breakdowns and online consent challenges; and (3) vaccine-hesitant parents, particularly regarding HPV vaccination, influenced by safety concerns and misinformation. These findings demonstrate that non-participation in school vaccination programs should not be automatically equated with vaccine hesitancy. <b>Conclusions:</b> Tailored interventions are necessary for addressing vaccine non-participation. Recommendations include strengthening collaboration with general practitioners, streamlining consent processes and providing targeted education to counter misinformation. This study provides valuable insights into social determinants of vaccine acceptance and offers actionable strategies for improving vaccine uptake in school-based programs.
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publisher MDPI AG
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spelling doaj-art-76a81fd69d47430a9d7667823208ecd12025-01-24T13:51:53ZengMDPI AGVaccines2076-393X2025-01-011318310.3390/vaccines13010083Provider Preference, Logistical Challenges, or Vaccine Hesitancy? Analyzing Parental Decision-Making in School Vaccination Programs: A Qualitative Study in Sydney, AustraliaLeigh McIndoe0Alexandra Young1Cristyn Davies2Cassandra Vujovich-Dunn3Stephanie Kean4Michelle Dives5Vicky Sheppeard6South Eastern Sydney Public Health Unit, Sydney, NSW 2031, AustraliaKirby Institute, University of New South Wales Sydney, Sydney, NSW 2052, AustraliaSpecialty of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, AustraliaSchool of Public Health, University of Queensland, Brisbane, QLD 4006, AustraliaSouth Eastern Sydney Public Health Unit, Sydney, NSW 2031, AustraliaSouth Eastern Sydney Public Health Unit, Sydney, NSW 2031, AustraliaSouth Eastern Sydney Public Health Unit, Sydney, NSW 2031, Australia<b>Background:</b> School-based immunization programs are crucial for equitable vaccine coverage, yet their success depends on parental consent processes. This study investigates patterns of vaccine decision-making within Australia’s school-based immunization program, specifically focusing on human papillomavirus (HPV) and diphtheria-tetanus-pertussis (dTpa) vaccines offered free to adolescents aged 12–13. <b>Methods:</b> This qualitative study was conducted in the South Eastern Sydney Local Health District (2022–2023). Semi-structured interviews were held with school staff (<i>n</i> = 11) across government, Catholic, and independent schools, parents whose children were not vaccinated at school (<i>n</i> = 11) and a focus group with public health unit staff (<i>n</i> = 5). Data were analyzed to identify key barriers and patterns in vaccine decision-making. <b>Results:</b> Analysis revealed three distinct groups of parents whose children were not vaccinated through the school program: (1) those favoring general practitioners for vaccination, driven by trust in medical providers and a preference for personalized care; (2) those intending to consent but facing logistical barriers, including communication breakdowns and online consent challenges; and (3) vaccine-hesitant parents, particularly regarding HPV vaccination, influenced by safety concerns and misinformation. These findings demonstrate that non-participation in school vaccination programs should not be automatically equated with vaccine hesitancy. <b>Conclusions:</b> Tailored interventions are necessary for addressing vaccine non-participation. Recommendations include strengthening collaboration with general practitioners, streamlining consent processes and providing targeted education to counter misinformation. This study provides valuable insights into social determinants of vaccine acceptance and offers actionable strategies for improving vaccine uptake in school-based programs.https://www.mdpi.com/2076-393X/13/1/83parentsattitudesbeliefsadolescent vaccinationschool-based immunizationvaccine hesitancy
spellingShingle Leigh McIndoe
Alexandra Young
Cristyn Davies
Cassandra Vujovich-Dunn
Stephanie Kean
Michelle Dives
Vicky Sheppeard
Provider Preference, Logistical Challenges, or Vaccine Hesitancy? Analyzing Parental Decision-Making in School Vaccination Programs: A Qualitative Study in Sydney, Australia
Vaccines
parents
attitudes
beliefs
adolescent vaccination
school-based immunization
vaccine hesitancy
title Provider Preference, Logistical Challenges, or Vaccine Hesitancy? Analyzing Parental Decision-Making in School Vaccination Programs: A Qualitative Study in Sydney, Australia
title_full Provider Preference, Logistical Challenges, or Vaccine Hesitancy? Analyzing Parental Decision-Making in School Vaccination Programs: A Qualitative Study in Sydney, Australia
title_fullStr Provider Preference, Logistical Challenges, or Vaccine Hesitancy? Analyzing Parental Decision-Making in School Vaccination Programs: A Qualitative Study in Sydney, Australia
title_full_unstemmed Provider Preference, Logistical Challenges, or Vaccine Hesitancy? Analyzing Parental Decision-Making in School Vaccination Programs: A Qualitative Study in Sydney, Australia
title_short Provider Preference, Logistical Challenges, or Vaccine Hesitancy? Analyzing Parental Decision-Making in School Vaccination Programs: A Qualitative Study in Sydney, Australia
title_sort provider preference logistical challenges or vaccine hesitancy analyzing parental decision making in school vaccination programs a qualitative study in sydney australia
topic parents
attitudes
beliefs
adolescent vaccination
school-based immunization
vaccine hesitancy
url https://www.mdpi.com/2076-393X/13/1/83
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