Vaccination in Australia: Strategies and Implications for Future Research

This article discusses the importance of vaccination as a preventive healthcare measure in Australia. It explores various strategies and interventions to improve vaccination rates, particularly among low-income individuals. The article also highlights gaps in the evidence base and implications for future research.

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Vaccination in Australia
Name
Course
Instructor
Date

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Vaccination in Australia
Introduction
Preventive healthcare comprises of a set of measures that are undertaken to prevent the
occurrence of an illness. Disease and disability consists of a variety of mental and physical states
that are affected by disease agents, environmental factors, lifestyle choices and genetic
predisposition (Luo, Cook, Wu and Wilson, 2017). The prevention of illnesses thus depends on
anticipatory actions that could be classified as primary, secondary or tertiary preventive
measures. Preventive care is increasingly becoming an area of much interest within the
healthcare sector. Vaccination is currently on of the most effective public health disease
prevention initiatives (Barret et al. 2016). The latter involves the use of various methods to
prevent illnesses, educate populations and promote health (Hawk and Evans, 2013). There has
been low coverage of vaccination programs among the low-income Australian as compared to
the higher earning individuals.
Discussion
Vaccination is one of the main preventive strategies used to control the transmission of
communicable diseases (Barett, Bolan, Dawson, Ortmann, Resi and Saenz, 2016). The latter has
reduced the world mortality and morbidity rates associated with infectious diseases, protecting
up to 2.5 million lives annually according to the World Health Organization (WHO) statistics
(Link, 2017). Some vaccines confer herd immunity by protecting both the vaccinated individuals
and their close contacts. There are hypodermic needles of various sizes, lengths and gauges that
are used to administer vaccines. The bigger the gauge number, the smaller the needle diameter.
For instance, 0.5 mm diameter needle is gauge 25 while 0.6 mm needle is gauge 26 (Luo, Cook,

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Wu and Wilson, 2014). For infants and children between the ages of 2 months and 2 years of
age, needle types used for vaccination are 23 to 25 G and 25 mm in length.
The vaccines are usually administered intramuscularly, intradermallly, subcutaneously
and orally. The proper sires for pediatric vaccine injection are the anterolateral aspect of the
thigh muscle, intradermal part of the forearm, deltoid muscle of the arm, and orally (Link, 2014).
Some of the comfort measures that are used for pediatric children after vaccination include
applying cold packs on the injection sites, administering Paracetamol syrup 2.5 ml 8 hourly for
fever relief, distraction techniques and breastfeeding. The parents should be advised to hold or
apply pressure at the injection sites.
Vaccine Information Sheets (VISs) are sheets that are were produced by the CDC to
explain the benefits and risks of each vaccine to the recipients. Unfortunately, there exist no
vaccine records, so such records are often found at the clinics and doctor’s office (Link, 2014).
At birth, the child is usually given oral polio vaccine and BCG, while at two months a child is
vaccinated with oral polio vaccine, hepatitis B vaccine 2nd dose, diphtheria, tetanus and pertussis
(DPT), Haemophilus influenza type b (Hib), and Pneumococcal vaccine. At 2 years a child
should be provided with vitamin A supplement.
Child vaccination Issues
Most of the children from developing countries encounter death from diseases that could
get stopped through vaccination (Blume, 2017). Despite the efforts of the government to
introduce immunization programs, several factors have contributed to barriers to successful
immunization. Among the hindrances that have led to increased deaths among children include
low income, lack of education, and lack of access to adequate healthcare knowledge. The
situations have led to increased numbers of unvaccinated children. Based on the research

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analysis the best solution towards introducing vaccination in low and middle‐income countries is
using evidence-based discussions with community members.
The strategies guarantee creation of acceptable awareness about the significance of
vaccination to children (Duckett and Willcox, 2015). The strategy has better results compared to
health education. Alternative measures such as community meetings may act as an intervention
measure to the problem. However, the strategy is costly and expensive. Another solution is
adopting homecare health visits combined with regular immunization (Barett, Bolan, Dawson,
Ortmann, Resi and Saenz, 2016). The outreach immunization plan is an effective solution but not
enough data to access cost implications. The above solutions guarantee smaller impacts in
promoting vaccination however they are easy to manage and sustain for long periods. Using
incentives as motivation to accept vaccination has little or no significant influence. For example,
monetary incentives do not encourage immunization especially when other barriers exist.
Summary of Findings in Cochrane Review
The most effective strategies leading towards increasing number vaccinations on children
include the provision of community-oriented health education (Blume, 2017). The criteria for
creating awareness include the use of mass healthcare campaigns and facility‐based health
education. Parents, society, and other community members should have clear and concise
information about immunization through initiating health education. Various facilities such as
reminding communities concerning immunization are among the strategies that guarantee
effective responses to prevention care. Use of immunization reminding card and regular outreach
immunizations are among the strategies that should be adopted (Willis et al. 2012). Other
strategies that could improve the rate of childhood immunization include the use of healthcare

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home-based visits, household incentives, and integrating immunization process with adequate
accessibility means in the interior.
The study found that through providing information as well as discussing various benefits
of vaccinations with individual or group of parents and other members of community during
events such as village meetings or visiting homes guaranteed a moderate probability of
improving rate of immunization among children (Oya, Wiysonge, Oringanje, Nwachukwu,
Oduwole and Meremikwu, 2016). The research found that through providing vaccination
information direct to parents about significance of vaccines during their visit to healthcare clinics
and at the same time availing reminding cards to make them recall vaccines dates using
immunization cards guaranteed low‐certainty of improving immunization of children.
Another significant finding was that introducing regular immunization campaigns
through outreach services that include home visits as well as integrating of immunization process
with other essential health care services that include services such as preventive care for malaria
has a low‐certainty in improving rate immunization in children (Blume, 2017). It was also found
that there attaching incentives such as household gifts or monetary values both conditional or
unconditional transfer of cash had significant low‐certainty or equivalent little or no impact on
influencing improvements in the rate of immunization.
Objectives
The objectives of the study are to determine the impact of interventions and strategies
applied to boost and sustaining high rates of childhood immunization in low and middle-income
countries.

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PICOT table for the selection criteria
The various interventions considered in the studies involved evaluating the impact of
integrating immunization services, community‐based health education, household monetary
incentives, home visit, and facility‐based health education in preventing natural deaths in
children.
P I C O T
Children
who
received
DTP3 at
age of one
year
Assessing impacts of
health education,
applying or a
combining use of
cards during
healthcare
education, as well as
testing impact of
monetary incentive.
Research
compared
recipient‐
oriented
interventions
with standard
care
Outcomes included that
there was low‐certainty
evidence that providing
facility‐based healthcare
education combined with a
redesigned reminding
systems such as
immunization card may
improve DTP3 coverage
1 year
Children
subjected
to all types
of vaccines
aged 12 to
23 months
Checking the
outcomes of children
who received all
recommended
vaccines
The session
compared
monetary
incentives and
disincentives
with lack of
interventions
Outcomes indicated that
there was low‐certainty
evidence on providing
monetary incentives such
incentives have little or no
impact in improving rate of
vaccination on children
2
years

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Key criteria for assessing the risks of biasness
The steps applied in analyzing the risks involved pooling data from reviewed research
studies that had similar interventions such as participant or community, care provider, health
system (Oya, Wiysonge, Oringanje, Nwachukwu, Oduwole and Meremikwu, 2016). The
approach applied involved a meta-analysis process using the whereby a random‐effects model
was applied in the process of selecting participants.
The process of dealing with reported studies that had estimates with uncertainty measures
as well as lacking numbers of participants and numbers of events, the procedure for assessing
biases involved the use of generic inverse variance approach the reported study approach applied
level and slope strategy to report (Oya, Wiysonge, Oringanje, Nwachukwu, Oduwole and
Meremikwu, 2016). The criteria used analyzed data based on the following subcategories. The
first strategy involved setting up the study scope in the rural and urban centers. The process also
applied the concept of individuals or group interventions. It also involved multi‐faceted, single
and integrated intervention with non‐conditional and conditional incentives (Lin et al. 2014).
Finally the analysis integrated community or facility oriented interventions.
Interventions Identified in the Cochrane Review
Among the interventions for promoting immunization among children inducing
communication interventions, The intention of the strategy is informing and educating target
groups, communities, individuals, and care givers or involving a including targeted groups
through one on one dialogues interactions through systems such as printed material and mass
media among other systems. The purpose of intervention is to improve understanding concerning
vaccination. It focuses on developing and explaining relevant benefits as well as risks associated
with vaccination. The strategy provides essential information such as where, when, and how to

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acquire vaccination services as well as defining who is legible to receive vaccine services.
Recipients should receive signals that enable them to recall by reminding them through face to
face interactions, initiating a telephone call or sending e-mails (Hawk and Evans, 2013). The
strategy would help in reminding those who have reached overdue for the vaccine in for the
purpose of reducing the drop‐out rate.
The caregivers should be provided with sufficient training to help them in acquiring
knowledge on vaccination as well as improving their skills. Training enables them to have a
positive attitude towards clients and to develop ethical aspects that help clients to avoid missing
opportunities for vaccination. Interventions such auditing caregivers are essential for ensuring
delivery of quality vaccination services (Estes, Calleja, Theobald, and Harvey, 2015). Clients
should provide feedback to access levels of satisfaction with services provided. Healthcare
systems should have well-developed infrastructures to facilitate easy access to health facilities.
Among the structures provided include construction of good roads that guarantee access to health
facilities.
Health care systems should establish adequate service delivery strategies such as outreach
movements that involve home visits, and integrating the vaccine process with other services such
as charity work (Boxall and Gillepsie, 2013). Outreach services are essential because they
improve access to vaccination services. Facilitating activities such as home visits help in
reminding parents about vaccines as well as identifying unimmunized children for immunization.
Integrating various services help in encouraging vaccine uptake
Implications for Future Research
According to the analysis presented by various authors, they found that the relevant
studies have not adequately addressed people’s financial capacity such as the capability to afford

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and sustain the strategies. The impact of the study revealed that the situation was highly
heterogeneous based on specific environmental settings as well as outcomes of the study. The
study has limited facts for effective comparability. Another reason is that researchers identified
insufficient data and information that could allow drawing appropriate conclusions in terms of
cost‐effectiveness that could enable health workers to intervene in the process of promoting
vaccination uptake. Most of the studies reviewed have specifically concentrated on health
outcomes (Martin, 2018). They failed to effectively illustrate the extent to which various
stakeholders such as government and non-government institutional affect communities.
Governance, as well as other sources of financial supports, has an impact on the sustainability of
vaccination processes (Willis et al. 2012). These limitations trigger the need for future research
as well as the establishment of reliable outcomes.
Gaps in the Evidence Base
According to the research analysis, it is true that most of the pieces of evidence obtained
were characterized by low certainty as well as the insignificant probability of events. Therefore
implementing the obtained results has a high likelihood of that implied high chances that the
acceptable effect and actions suggested have a high likelihood of providing different results
(Kozier, Erb, Berman, Snyder, Levett and Dwyer, 2014). The impact implies that scholars,
researchers, and other stakeholders need to conduct further randomized controlled trials to assess
verify, and validate the impact of factors associated with improving children immunization
perceptions in low‐ and middle‐income countries. The research analyzed has not identified any
certain factor that promotes high rates of immunization.

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