This page is for immunisation providers (e.g. GPs, nurses, pharmacists) providing influenza vaccination to Aboriginal and Torres Strait Islander families.

Its purpose is to provide you with information and resources that will help you have supportive, culturally appropriate vaccination conversations with Aboriginal and Torres Strait Islander families. 

While the focus here is on influenza vaccination, the relevant principles can be applied to other vaccinations. 

These materials have been designed by Aboriginal and Torres Strait Islander researchers and health providers, in collaboration with the NCIRS Social Science Team, and are informed by research undertaken with immunisation providers working with Aboriginal and Torres Strait Islander families.1 

These resources have been produced as part of Sharing Knowledge About Immunisation (SKAI) and have been presented at provider and community workshops and trainings led and delivered by the Hunter New England Public Health Aboriginal Team. The ‘Example of a supportive flu vaccine yarn’ resource has been adapted by that team to support the needs of health service providers and communities and enable better conversations around vaccination. 

We hope these resources will be shared, adapted and used widely.
 

  • Why is it important to talk with Aboriginal and Torres Strait Islander families about vaccinating against influenza?

    Aboriginal and Torres Strait Islander people are more likely to experience severe influenza disease2 that could be prevented with vaccination. In Australia, seasonal influenza is the most common vaccine preventable disease contributing to hospitalisation, aside from COVID-19.

    Between 2016 and 2018:

    Text: Aboriginal and Torres Strait Islander people were hospitalised for influenza 1. 4 times more often than non-Indigenous people.


    Influenza vaccine has been funded under the National Immunisation Program for all Aboriginal and Torres Strait Islander people over 6 months of age since 2019 – but Aboriginal and Torres Strait Islander families are under-vaccinated.3,4 

    View the most up-to-date influenza vaccination coverage data for Aboriginal and Torres Strait Islander people here
    Immunisation providers have an important role in strongly recommending and opportunistically offering influenza vaccination to all Aboriginal and Torres Strait Islander people over 6 months of age.

    Aboriginal and Torres Strait Islander people value receiving a clear message and strong recommendation to vaccinate from their health provider.

    However, recent studies indicate some providers may not be aware of the risk of influenza complications for Aboriginal and Torres Strait Islander people of all ages and the importance of strongly recommending vaccination. As a result, some may not be opportunistically offering and strongly recommending influenza vaccination to Aboriginal and Torres Strait Islander people.1,5,6
     

  • As an immunisation provider, how can you have better conversations with Aboriginal and Torres Strait Islander families about influenza vaccination?

    Access the SKAI conversation guide 'Talking about vaccination with Aboriginal and Torres Strait Islander families’ 

    • You can use this guide to help you create a culturally safe space to build rapport to then enable better vaccination conversations with Aboriginal and Torres Strait Islander people and families of all ages. It’s designed to support providers to feel comfortable to have these conversations and strongly recommend vaccination.
    • The guide contains a list of topics with accompanying short explanations. Examples include: 
      • why and how to ask patients about Aboriginal and Torres Strait Islander status
      • how to build rapport with families and make your service more welcoming
      • how to offer vaccination opportunistically
      • how to make it easier for families to access the service and vaccination.
    • We recommend that you share this guide with the whole service, not just clinical staff members – for example, the receptionist who is the first point of contact with patients who may be Aboriginal and Torres Strait Islander.

     

    Access the SKAI resource 'Example of a supportive flu vaccine yarn’ 

    • Once you have built rapport with families, you can use this example of an actual flu vaccination conversation with an Aboriginal and Torres Strait Islander person when talking with families about vaccination.
    • You can use this example for ideas about what to say and how to say it – in particular, when talking with individuals and families who have questions or are unsure about vaccinating.
    • This resource is not meant to be prescriptive; feel free to adapt it.

       

    Access the SKAI resource ‘Flu vaccine information sheet for Aboriginal and Torres Strait Islander people’

    • This resource helps answer key questions Aboriginal and Torres Strait Islander families may have about influenza vaccination.
    • You can print this resource and give it to Aboriginal and Torres Strait Islander families when you start your influenza vaccination conversation.
    • Aboriginal and Torres Strait Islander people value having a conversation with their health provider, so use this resource as a conversation starter (rather than leaving it in the waiting room or handing it to the patient without having a conversation).

     

    If you are looking for further resources, access and read the ‘Summary of flu and COVID-19 vaccination communication resources’ 

    • This resource summarises influenza and COVID-19 vaccination information tools and communication resources featured on key Australian health websites designed (with or without input from Aboriginal and Torres Strait Islander people) either for Aboriginal and Torres Strait Islander communities or for immunisation providers working with them.
    • Scan the summary to find relevant resources to support you and/or your Aboriginal and Torres Strait Islander patients. The ACI ‘Yearning to make health decisions together’ shared decision-making tool (see the second row of the summary table) and the NACCHO and NCIRS’ ‘Information about COVID-19 vaccines for Aboriginal and Torres Strait Islander people’ resource (see the third row of the table) may be particularly useful for immunisation providers. 
       
  • Summary table: Influenza and COVID-19 vaccination information tools and communication resources, designed for Aboriginal and Torres Strait Islander communities, or for immunisation providers working with them*

    Document name 

     

    Aboriginal input in designKey pointsIcon Link
    Sharing Knowledge About Immunisation (SKAI)No
    • Can be helpful for immunisation providers in facilitating effective vaccine communication and decision-making with patients who are either accepting, hesitant about or refusing vaccination. Includes website, resources and e-learning for healthcare providers
    • Provides user-friendly resources for parents/carers and pregnant women and their partners to help answer their vaccination questions and concerns 
    • As a provider, you can refer your patients to, or print and share, SKAI resources for parents
    • SKAI focuses on childhood vaccinations (including influenza vaccination); however, the relevant conversation principles can be applied to other vaccinations
    SKAI LogoAccess here
    Yarning to make health decisions together – Agency for Clinical InnovationYes
    • Can be used as a conversation guide to help foster supportive conversations about vaccination with Aboriginal and Torres Strait Islander families
    • Providers can print the guide and give it to the patient
    • Designed with COVID-19 in mind, but could be adapted for any vaccination, and, further towards any health concern
    • Designed by Aboriginal and Torres Strait Islander people and community representatives to target vaccine hesitancy and uncertainty
    • Puts Aboriginal and Torres Strait Islander people ‘in the centre’
    • Culturally appropriate
    • Interactive
    Screenshot of Yarning to make health decisions togetherAccess here
    Information about COVID-19 vaccines for Aboriginal and Torres Strait Islander people – National Aboriginal Controlled Community Organisation (NACCHO) and NCIRSYes
    • Can be helpful for immunisation providers in addressing Aboriginal and Torres Strait Islander people’s questions and facilitating discussions about COVID-19 vaccination
    Screenshot of Information about COVID-19 vaccines for Aboriginal and Torres Strait Islander PeopleAccess here
    COVID-19 vaccines: Information for Aboriginal and Torres Strait Islander people affected by cancer – Cancer Australia (Australian Government)Yes
    • Can be helpful for immunisation providers in addressing Aboriginal and Torres Strait Islander people’s questions and facilitating discussions about COVID-19 vaccines for people affected by cancer
    Screenshot of COVID-19 vaccines: Information for Aboriginal and Torres Strait Islander people affected by cancerAccess here
    Meningococcal B vaccination — a guide for healthcare providers – NCIRSYes
    • Can be helpful for immunisation providers in having supportive conversations with Aboriginal and Torres Strait Islander people about meningococcal B vaccine
    • Designed with input from NCIRS National Indigenous Immunisation Coordinator
    Screenshot of Meningococcal B vaccination - a guide for healthcare providersAccess here
    COVID-19 vaccines: Frequently asked questions (FAQs) – NCIRSNo
    • Can be helpful for immunisation providers in addressing patients’ questions about COVID-19 vaccination
    • May be hard to navigate and understand for community
    • Not Aboriginal and Torres Strait Islander-specific
    Screenshot of Questions about getting vaccinated/Severity of COVID-19 in childrenAccess here
    Decision aid (16+ years): Should I get the COVID-19 vaccine? NCIRSNo
    • Providers can go through this decision aid with patients
    • May be too ‘wordy’ for individuals with low literacy and low health literacy
    • Not Aboriginal and Torres Strait Islander-specific
    Screenshot of Decision aid (16+ years): Should I get the COVID-19 vaccine?Access here
    MMRV decision aid – NCIRSNo
    • Providers could use this decision aid to support and facilitate conversations about the measles-mumps-rubella-varicella (MMRV) vaccine 
    • Not Aboriginal and Torres Strait Islander-specific
    Screenshot of MMR Vaccination decision toolAccess here
    COVID-19 vaccination – Aboriginal and Torres Strait Islander vaccine provider resources – Australian Government Department of Health and Aged CareUnsure
    • Information and resources (e.g. posters, fact sheets, videos, FAQs, social media) on a range of subjects relating to COVID-19 and COVID-19 vaccines for Aboriginal and Torres Strait Islander communities and organisations
    • More useful for immunisation providers than community members
    • Resources not specifically designed for Aboriginal and Torres Strait Islander people
    Screenshot of Communication materials for Aboriginal and Torres Strait Islander peopleAccess here

    *The tools and resources summarised in this table come from the search of key Australian health websites, conducted in April 2022 by Larissa Karpish and Kiya Shipley, NCIRS Aboriginal Population Health Trainees, with input from the NCIRS Social Science Team and the NCIRS National Indigenous Immunisation Coordinator, Katrina Clark. The search included websites of the Australian Government Department of Health and Aged Care, the Agency for Clinical Innovation, NSW Health, NCIRS, the National Indigenous Australians Agency, NACCHO, Australian Indigenous HealthInfoNet and the Aboriginal Health & Medical Research Council of NSW.

 

References  

1  Bolsewicz KT, Steffens MS, Karpish L, et al. ‘Every interaction you have … should be an opportunity to discuss and offer influenza vaccination’. Health service perspectives on influenza vaccination promotion and delivery to Aboriginal families living in New South Wales, Australia. Vaccine 2022;40:5814-20

2 Pathel C, Dey A., Wang H et al. Summary of National Surveillance Data on Vaccine Preventable Disease in Australia, 2016–2018 Final Report. Communicable Diseases Intelligence 2022; 46. doi:10.33321/cdi.2022.46.28

3 Hull B, Hendry A, Dey A, et al. Annual Immunisation Coverage Report 2020. Sydney: National Centre for Immunisation Research and Surveillance; 2021. 

4 National Centre for Immunisation Research and Surveillance. Influenza vaccination coverage data. Available from: https://ncirs.org.au/influenza-vaccination-coverage-data

5 O’Grady KA, Dunbar M, Medlin L, et al. Uptake of influenza vaccination in pregnancy amongst Australian Aboriginal and Torres Strait Islander women: a mixed-methods pilot study. BMC Research Notes 2015;8:169.

6 Menzies R, Aqel J, Abdi I, et al. Why is influenza vaccine uptake so low among Aboriginal adults? Australian and New Zealand Journal of Public Health 2020;44:279-83.