Barriers to childhood immunisation: Findings from the Longitudinal Study of Australian Children

OBJECTIVES: To examine barriers to childhood immunisation experienced by parents in Australia. DESIGN: Cross-sectional analysis of secondary data. SETTING: Nationally representative Longitudinal Study of Australian Children (LSAC). PARTICIPANTS: Five thousand one hundred seven infants aged 3–19 months in 2004. MAIN OUTCOME MEASURE: Maternal report of immunisation status: incompletely or fully immunised. RESULTS: Overall, 9.3% (473) of infants were incompletely immunised; of these just 16% had mothers who disagreed with immunisation. Remaining analyses focussed on infants whose mother did not disagree with immunisation (N = 4994) (of whom 8% [398] were incompletely immunised). Fifteen variables representing potential immunisation barriers and facilitators were available in LSAC; these were entered into a latent class model to identify distinct clusters (or ‘classes’) of barriers experienced by families. Five classes were identified: (1) ‘minimal barriers’, (2) ‘lone parent, mobile families with good support’, (3) ‘low social contact and service information; psychological distress’, (4) ‘larger families, not using formal childcare’, (5) ‘child health issues/concerns’. Compared to infants from families experiencing minimal barriers, all other barrier classes had a higher risk of incomplete immunisation. For example, the adjusted risk ratio (RR) for incomplete immunisation was 1.51 (95% confidence interval: 1.08–2.10) among those characterised by ‘low social contact and service information; psychological distress’, and 2.47 (1.87–3.25) among ‘larger families, not using formal childcare’. CONCLUSIONS: Using the most recent data available for examining these issues in Australia, we found that the majority of incompletely immunised infants (in 2004) did not have a mother who disagreed with immunisation. Barriers to immunisation are heterogeneous, suggesting a need for tailored interventions.