UPTAKE of COVID-19 vaccines in Australia has been fast, with vaccination rates for younger children initially mirroring that of adults and adolescents, but plateauing in March 2022, with only 51% of Australian children aged 5–11 years receiving a first dose by October 2022.
General practice, argue the authors of a Perspective published today by the Medical Journal of Australia, is the ideal setting for promoting an increase in the vaccination rate of children.
“Although the reasons for plateauing are unclear, increasing paediatric infection rates since early 2022, mostly associated with mild COVID-19, may have reduced parental perceived urgency or need for vaccination,” wrote the authors, led by Dr Katelyn Barnes, a Senior Research Officer with the Australian National University.
“The proportion of Australian children vaccinated against COVID-19 is much lower than for longstanding scheduled childhood immunisations, with more than 95% of all Australian children (5 years of age or older) vaccinated against diphtheria, tetanus, pertussis, and poliomyelitis,” Dr Barnes and colleagues wrote.
“However, the COVID-19 vaccination rate among Australian children (5 years of age or older) is greater than the proportion vaccinated against influenza (approximately 30% in 2020, up 3% from 2019), suggesting COVID-19 vaccine promotion has rapidly gained traction despite challenges.
“Greater vaccine coverage among Australian children is important to reduce the potential for COVID-19 related disruptions in child development. Accordingly, strategies are needed to counter relative delays in COVID-19 vaccine uptake for children.”
Dr Barnes and colleagues listed several reasons for COVID-19 vaccine delay in children, including caregiver concerns regarding the safety and effectiveness of vaccines, or misunderstanding of the risks of COVID-19 infection and benefits of vaccination for children; communication challenges and changing information may be problematic in high-risk culturally and linguistically diverse groups; access to vaccination and follow-up for subsequent doses has proved challenging for socio-economically disadvantaged groups.
“General practice is the ideal setting to promote childhood COVID-19 vaccine acceptance and uptake in Australia,” they wrote.
“To date, Australian primary care settings have delivered over 60% of COVID-19 vaccines administered nationally, with 6884 sites located in general practices (n = 3896), community pharmacies (n = 2776), Aboriginal Community Controlled Health Services (n = 136) and Commonwealth vaccination clinics (n = 76) led by GPs.
“About 50% of Australia’s total 63 million vaccine doses were administered through general practices.
“GPs and general practice nurses are trusted vaccine providers and information sources, who have established relationships with children and their family members.
“They are trained in techniques for difficult vaccinations, such as needle phobia or sensory sensitivities, have the capacity and experience to manage complications, and can coordinate care and referral for patients who require increased support or specialised interventions.”
Dr Barnes and colleagues said broader strategies to help general practice reduce vaccine hesitancy included “primary care sites partnering with community leaders and local media (when possible) and even social media (when relevant) to support tailored but consistent messaging about the importance, safety and effectiveness of COVID-19 vaccines alongside individual and community benefits of being vaccinated”.
“Messaging should be clear and presented in multiple formats and languages. Partnering with community leaders will help to shape clear and meaningful messages and inspire trust, particularly for culturally and linguistically diverse groups.
“Consistent messaging to promote COVID-19 vaccine acceptance should be provided in all health settings (general practice, community pharmacy, and hospitals) as well as general community settings (schools and community centres).
“Primary care has an important role in supporting childhood COVID-19 vaccine acceptance and access,” Dr Barnes and colleagues concluded.
“General practice is a key setting in which trusted relationships with patients, families and the community can be leveraged to increase and sustain COVID-19 vaccine acceptance and uptake among Australian children.”