Impact of funding influenza vaccination on coverage among Australian children: a national study using MedicineInsight, a large general practice database

Abstract

Influenza contributes to morbidity and mortality worldwide. Children are at a higher risk of influenzarelated complications and vaccination promotes direct protection and limits transmission. This study aimed to explore influenza vaccination coverage among children in Australian general practice from 2015 to 2018, and patterns in coverage before and after the implementation of state-funded immunization programs. Data from 196,520 'active' patients (3+ consultations in two consecutive years) aged <5 years from 542 Australian general practices were included (MedicineInsight database). Logistic regression models were used to identify associations between vaccination with patient and practice characteristics. The overall vaccination coverage increased more than five times from 2015 (3.9%) to 2018 (19.6%) and varied among states. Children attending practices located in the wealthiest areas were more likely to receive the vaccine and appeared to benefit most from the funding, as the increase in coverage from 2017 to 2018 was greater among them than those attending practices in the least advantaged areas (17 vs. 11 percentage points, respectively). This relationship was not evident when analyzing the patient's socioeconomic level. In conclusion, free influenza vaccinations increase coverage in at-risk populations. Promotional campaigns may be required to maintain higher coverage and target practices located in low-income areas.

Barriers to influenza vaccination of children hospitalised for acute respiratory illness: A cross‐sectional survey

“…This survey identified that socio‐economic status, based on SEIFA decile categorisation, ability to pay for influenza vaccines, and smoking status of household members, was not associated with influenza vaccination of children. This finding correlates with the results from a national study in Australia using a general practice database of approximately 200 000 children aged <5 years; the authors identified that socio‐economic status was not associated with influenza vaccination of children in this age group in 2015–2018, but rather whether or not children attended general practice clinics in wealthy areas 28 …”

Impact of funding on influenza vaccine uptake in Australian children

“…However, we caution against generalising learnings from seasonal influenza to the unprecedented pandemic conditions. Taken alongside other measures 10,13 our results suggest that funding the seasonal influenza vaccine for children aged 6 months to less than 5 years can be effective at encouraging vaccine uptake across children of all ages, and parents/caregivers as well. Recently, WA announced the introduction of funded influenza vaccines for all primary school-aged children.…”

“…When accounting for all funding initiatives (2018, 2019 and Aboriginal and/or Torres Strait Islander-focused funding schemes), funded vaccines were associated with a 4.75-fold increase in vaccine uptake for children aged less than 5 years in the Flutracking data, reflecting the magnitude and immediacy of the change observed in the targeted group, concurring with earlier findings. 10,12,13 These large changes in vaccination rates alongside policy changes highlight the success of the state-based policy changes introduced in 2018 and 2019.…”

“…Preliminary evidence using data in the Australian Immunisation Register (AIR) showed an increase in vaccine coverage from 2017 (unfunded in most jurisdictions) to 2018 (funded in most jurisdictions) 10 , and others have reported similar findings. 12,13 These results are encouraging, suggesting that government funding initiatives can greatly improve influenza vaccine coverage in at-risk populations. However, as noted by both Beard et al 10 and Moberley et al 12 , it is plausible that the increases reported in earlier studies at least partly resulted from a response to the comparatively severe 2017 influenza season (which received substantial media coverage).…”

“…14,15 More recently, significant increases in vaccine uptake in children younger than 5 years were found in jurisdictions where funded vaccines were introduced, using general practitioner surveillance. 13 However, these data relate only to the subset of patients presenting to a medical practitioner, may not capture all vaccinations (e.g. pharmacy, community health services) and may also be affected by selective reporting.…”