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The Vaccination Insights project – national surveillance of drivers of under-vaccination in Australian children aged under 5 years

Suboptimal uptake of certain vaccines exists in Australia – and in some cases, this has been exacerbated by the COVID-19 pandemic. 

To understand why, we need to collect data on drivers of under-vaccination. 

Currently, however, Australia has no systematic, routine method of identifying and tracking these data within specific population groups or for specific vaccines. 

While some evidence does exist, it could be made more robust through the routine collection of data on the factors that are influencing under-vaccination.

The project

The Vaccination Insights project – a collaborative, Commonwealth-funded initiative – is establishing the first systematic national surveillance of drivers of under-vaccination in Australia. 

NCIRS’ Social Science Unit is coordinating this project, working closely with the Murdoch Children's Research Institute and the University of Sydney’s Social and Behavioural Insights in Immunisation research group.

Over the next two years, the study is investigating and diagnosing the reasons behind under-vaccination in children aged under 5 years, with specific reference to National Immunisation Program (NIP) funded vaccines and influenza vaccines. It aims 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.

The study is related to another project, led by Vaccination Insights partner the University of Sydney, that is conducting a national survey of drivers of under-vaccination in adults relating to influenza vaccine. 


Data are being gathered via a large-scale national survey on vaccine attitudes and behaviours among parents and carers of children under 5 years of age. Qualitative interviews will be undertaken with a small sample of parents and carers from priority groups with low vaccine uptake.

The study is employing an innovative survey, the Vaccine Barriers Assessment Tool (VBAT). The MCRI-developed VBAT – created by a team led by Professor Margie Danchin – is the first validated tool designed to measure both vaccine access and acceptance in children aged under 5 years. 

The interviews will utilise the Behavioural and Social Drivers of vaccination (BeSD) guides on qualitative interviewing. This approach, which was developed and validated for use among adults by a World Health Organization global working group chaired by Professor Julie Leask, will enable an in-depth understanding of participants’ perspectives, experiences and attitudes relating to vaccination. 

Next steps

The Vaccination Insights project has strong potential to become an ongoing routine, annual or bi-annual surveillance activity and to include additional vaccines and populations in future. An annual or bi-annual program of work could allow the monitoring of fluctuations in drivers over time, as well as targeted, timely responses to these. 

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.

Project contributors