Impact of funding on influenza vaccine uptake in Australian children
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Published on: August 14, 2019
Zachary L Howard1, Craig B Dalton1, Sandra Carlson2
1Population Health, Hunter New England Local Health District, Newcastle, NSW, Australia; School of Psychological Science, University of Western Australia, Perth, WA; zach.howard@uwa.edu.au.
Insights
Government-funded seasonal influenza vaccines significantly increased uptake in young Australian children. This policy also led to higher vaccination rates in older children and adults.
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- Young children face higher risks of severe influenza outcomes.
- Historically, Australia has seen low seasonal influenza vaccine uptake in children under 5.
- Government-funded vaccine programs were introduced in 2018 to address this gap.
Purpose of the Study:
- To evaluate the success of funded influenza vaccine programs in Australia.
- To compare vaccination rates in children and adults before and after program implementation.
- To assess the impact of policy changes on community-level vaccine uptake.
Main Methods:
- Utilized Flutracking, an email-based surveillance tool for influenza-like illness and vaccination status.
- Analyzed historical data (2014-2017) for baseline vaccination rates.
- Compared self-reported vaccine uptake in various age groups (under 5, 5-17, 18-64, 65+) in 2018-2019 across Australian jurisdictions.
- Employed mixed-effects logistic regressions to identify predictors of vaccination.
Main Results:
- Significant increases in vaccine uptake were observed for children under 5 following program implementation.
- Vaccination rates for young children rose 2.7-4.2-fold in funded jurisdictions.
- Eligibility for funded vaccines was strongly associated with higher vaccination odds (OR 4.75).
- Positive spillover effects were noted, with increased vaccination in older children and younger adults.
Conclusions:
- Government-funded influenza vaccines are effective in increasing uptake among targeted young children.
- These programs demonstrate substantial benefits, including near five-fold increases in self-reported vaccination.
- Funded childhood vaccination may encourage higher uptake among caregivers and older children.
Abstract:
Objectives and importance of study: Young children are at higher risk for serious influenza outcomes but, historically, Australian children aged less than 5 years have had low seasonal influenza vaccine uptake. In 2018, most Australian jurisdictions implemented funded influenza vaccine programs targeted at improving vaccine uptake in this age group. Our aim was to determine how successful these programs were at improving self-reported seasonal influenza vaccine uptake at the community level by comparing vaccination rates in each Australian jurisdiction before and after the introduction of funded vaccines for children aged 6 months to less than 5 years, as well as other age groups.
Study Type:
Volunteer observational cohort study.
Methods:
Flutracking is an email-based surveillance tool for influenza-like illness that collects information about symptoms and influenza vaccination. We used historical data from 2014 to 2017 to estimate baseline vaccination status before funding of childhood influenza vaccines was introduced. We compared self-reported vaccine uptake in children younger than 5 years, children aged 5-17 years and adults (18-64 years, and 65 years and older) in 2018 and 2019 by state or territory. Mixed effects logistic regressions were used to measure the association between vaccination and a number of predictors, including whether the child was eligible for free vaccines, and whether adults resided with children or not.
Results:
We found large increases in vaccine uptake for children younger than 5 years in 2018 in all jurisdictions except Western Australia (where vaccines were already funded) and the Northern Territory (where funded vaccines were not introduced until 2019) that coincided with vaccine policy changes. Self-reported vaccination rates for young children in 2018 increased 2.7-4.2-fold in jurisdictions that funded the vaccine (compared with the previous, unfunded period). Being eligible for the funded vaccine was associated with much higher odds (odds ratio [OR] 4.75; 95% confidence interval [CI] 4.57, 4.79) of a young child being vaccinated. Older children and adults younger than 65 years were also more likely to receive the vaccine following policy changes.
Conclusion:
The seasonal influenza vaccine is an important protective measure for those at risk of serious outcomes, including young children. Flutracking data demonstrates that government-funded vaccines can lead to an almost five-fold increase in self-reported vaccine uptake of the targeted age group, as well as previously unreported flow-on effects to older children. This suggests that funded vaccines for young children may encourage caregivers to also vaccinate themselves and their older children.
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