title: Barriers to childhood immunisation: Findings from the Longitudinal Study of Australian Children.
abstract: OBJECTIVE
  To examine barriers to childhood immunisation experienced by parents in Australia.
  
  
  METHODS
  Cross-sectional analysis of secondary data.
  
  
  METHODS
  Nationally representative Longitudinal Study of Australian Children (LSAC).
  
  
  METHODS
  Five thousand one hundred seven infants aged 3-19 months in 2004.
  
  
  METHODS
  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.
authors.affiliation: Population, Policy and Practice, UCL Institute of Child Health, University College London, London, United Kingdom; School of Population Health, University of Adelaide, South Australia, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Pearce
authors.affiliation: School of Population Health, University of Adelaide, South Australia, Australia; Robinson Research Institute and School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia; Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, South Australia, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Marshall
authors.affiliation: Population, Policy and Practice, UCL Institute of Child Health, University College London, London, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Bedford
authors.affiliation: School of Population Health, University of Adelaide, South Australia, Australia; School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Lynch
mesh_terms: D001315:Australia; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D012959:Socioeconomic Factors; D014611:Vaccination / Q000191:economics / Q000523:psychology
keywords: Health inequalities; Infants; Population health; Social disadvantage; Vaccination