Is immunisation for children and young people in statutory care in Victoria ‘all too hard’? A qualitative study with health professionals
Katherine Thornton A B , Susan Webster A and Meredith Temple-Smith AA Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Vic. 3053, Australia.
B Corresponding author. Email: katherine.thornton@unimelb.edu.au
Australian Journal of Primary Health 25(2) 131-136 https://doi.org/10.1071/PY18096
Submitted: 23 June 2018 Accepted: 22 January 2019 Published: 9 April 2019
Abstract
This formative study aimed to identify health professionals’ perspectives on vaccination issues among children in statutory out-of-home care in Victoria. Eight health professionals, drawn from a purposive Victorian sample known to be proactive in addressing the vaccination needs of children in out-of-home care, took part in semi-structured interviews. Questions addressed participants’ views about roles and responsibilities, barriers and enabling factors affecting vaccination, and ideas about systems improvements. Interview transcripts were analysed thematically. The main themes that emerged were health professionals’ observations about vaccine hesitancy among significant adults in the out-of-home care sector, the paucity of child medical history information available and diffuse responsibility for the provision of legal consent to vaccination. More accurate immunisation status monitoring appears warranted for children in out-of-home care. Unless the collection and maintenance of child medical records improves and vaccination consent processes are streamlined, health professionals will be limited in their capacity to provide efficient vaccination services to these children. Research on vaccine hesitancy among staff and carers in the statutory care sector may be of value. This study supports other Australian research that indicates these children may require more targeted, inter-sectoral immunisation approaches.
Additional keywords: health assessment, paediatrics, vaccination.
References
Arora N, Kaltner M, Williams J (2014) Health needs of regional Australian children in out-of-home care. Journal of Paediatrics and Child Health 50, 782–786.| Health needs of regional Australian children in out-of-home care.Crossref | GoogleScholarGoogle Scholar | 25288239PubMed |
Australian Government Department of Health (2013) National Immunisation for Australia Strategy 2013–2018. (Department of Health: Canberra, ACT, Australia) Available at http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/B2D3E81EEDF2346ACA257D4D0081E4BC/$File/nat-immune-strategy-2013-18-final.pdf [Verified 6 June 2018]
Australian Government Department of Health (2018) Australian Immunisation Register. (Department of Health: Canberra, ACT, Australia) Available at https://www.humanservices.gov.au/individuals/services/medicare/australian-immunisation-register [Verified 6 June 2018]
Australian Institute of Health and Welfare (2007) Child protection Australia 2005–06. Child Welfare Series No. 40, Cat No. CWS28. (AIHW: Canberra, ACT, Australia)
Australian Institute of Health and Welfare (2017) Indicator reporting for the National Framework for Protecting Australia’s Children. (AIHW: Canberra, ACT, Australia) Available at https://www.aihw.gov.au/reports/child-protection/nfpac/contents/national-standards-indicators-dynamic-data-displays [Verified 6 June 2018]
Australian Institute of Health and Welfare (2018) Child protection Australia 2016–17. Child Welfare Series No. 68, Cat No. 63. (AIHW: Canberra, ACT, Australia) Available at https://www.aihw.gov.au/reports/child-protection/child-protection-australia-2016-17/contents/table-of-contents-print-report [Verified 6 June 2018]
Chambers MF, Saunders AM, New BD, Williams CL, Stachurska A (2010) Assessment of children coming into care: processes, pitfalls and partnerships. Clinical Child Psychology and Psychiatry 15, 511–527.
| Assessment of children coming into care: processes, pitfalls and partnerships.Crossref | GoogleScholarGoogle Scholar | 20923900PubMed |
Department of Health and Human Services (2018) Vulnerable children, children in out of home care, Pathway to Good Health. (DHHS: Melbourne, Vic., Australia) Available at https://www2.health.vic.gov.au/about/populations/vulnerable-children [Verified 6 June 2018]
Government of South Australia, SA Health (2018) Immunisation calculator. (SA Health: Adelaide, SA, Australia) Available at https://immunisationcalculator.sahealth.sa.gov.au/ImmuCalculator.aspx [Verified 6 June 2018]
Jarrett C, Wilson R, O’Leary M, Eckersberger E, Larson HJ;, the SAGE Working Group on Vaccine Hesitancy (2015) Strategies for addressing vaccine hesitancy: a systematic review. Vaccine 33, 4180–4190.
| Strategies for addressing vaccine hesitancy: a systematic review.Crossref | GoogleScholarGoogle Scholar | 25896377PubMed |
Kaltner M, Rissel K (2011) Health of Australian children in out-of-home care: needs and carer recognition. Journal of Paediatrics and Child Health 47, 122–126.
| Health of Australian children in out-of-home care: needs and carer recognition.Crossref | GoogleScholarGoogle Scholar | 21091584PubMed |
Leask J, Kinnersley P, Jackson C, Cheater F, Bedford H, Rowles G (2012) Communicating with parents about vaccination: a framework for health professionals. BMC Pediatrics 12, 154
| Communicating with parents about vaccination: a framework for health professionals.Crossref | GoogleScholarGoogle Scholar | 22998654PubMed |
MacDonald NE (2015) Vaccine hesitancy: definition, scope and determinants. Vaccine 33, 4161–4164.
| Vaccine hesitancy: definition, scope and determinants.Crossref | GoogleScholarGoogle Scholar | 25896383PubMed |
Nathanson D, Tzioumi D (2007) Health needs of Australian children living in out-of-home care. Journal of Paediatrics and Child Health 43, 695–699.
| Health needs of Australian children living in out-of-home care.Crossref | GoogleScholarGoogle Scholar | 17854456PubMed |
Raman S, Reynolds S, Khan R (2011) Addressing the well-being of Aboriginal children in out-of-home care: are we there yet? Journal of Paediatrics and Child Health 47, 806–811.
| Addressing the well-being of Aboriginal children in out-of-home care: are we there yet?Crossref | GoogleScholarGoogle Scholar | 21435073PubMed |
Royal Australasian College of Physicians (2008) Health of children in out-of-home care. (RACP: Melbourne, Vic., Australia) Available at: https://www.racp.edu.au/docs/default-source/advocacy-library/health-of-children-in-out-of-home-care.pdf [Verified 6 June 2018]
Tremellen S, Van Doorn H (2011) General practice: role as providers of comprehensive health assessment for children and young people in out-of-home care. Developing Practice: The Child, Youth and Family Work Journal 30, 40–48.
Vimpani G, Boland K, Barr M, Marshall J (2012) Children in OOHC in NSW: what do their care files tell us about their health care? Developing Practice: The Child, Youth and Family Work Journal 30, 51–62.
Webster SM (2014) Fostering health: an Australian health policy and systems study of health assessment for children and young people in Out-of-Home Care, PhD thesis, University of Melbourne. (University of Melbourne: Melbourne, Vic., Australia) Available at https://minerva-access.unimelb.edu.au/handle/11343/42189 [Verified 1 March 2019]