title: Vaccination uptake by vaccine-hesitant parents attending a specialist immunization clinic in Australia.
abstract: Vaccine hesitancy (VH) is an issue of global concern. The quality of communication between healthcare providers and parents can influence parental immunization acceptance. We aimed to describe immunization uptake following specialist immunization clinic (SIC) consultation for Australian children of VH parents as a cohort, and according to pre-clinic parental position on immunization. At a single tertiary pediatric SIC (RCH, Melbourne) a retrospective descriptive study classified VH families according to 3 proposed parental positions on immunization at initial clinic attendance. Immunization status at follow up was ascertained via the Australian Children's Immunization Register and National HPV Program Register and compared between groups. Of the VH cohort, 13/38 (34%) families were classified as hesitant, 21 (55%) as late/selective vaccinators and 4 (11%) as vaccine refusers. Mean follow up post-SIC attendance was 14.5 months. For the overall VH cohort, the majority chose selective immunization (42%) following SIC consultation. When analyzed by pre-clinic parental position on immunization, there was a trend for hesitant families to proceed with full immunization, selective families to continue selective immunization and refusing families to remain unimmunised (p < 0.0001). The most commonly omitted vaccines were hepatitis B (66%) and Haemophilus influenzae type B (55%), followed by the meningococcal C conjugate vaccine (53%) and measles, mumps and rubella vaccine (53%). Immunization outcome appears to correlate with pre-clinic parental position on immunization for the majority of families attending a SIC in Australia, with selective immunization the most common outcome. Tailored communication approaches based on parental position on immunization may optimise clinic resources and engagement of families, but require prospective research evaluation.
authors.affiliation: a Department of Nephrology ; Royal Children's Hospital ; Parkville , Victoria , Australia.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Forbes
authors.affiliation: b SAEFVIC and Vaccine and Immunisation Research Group; Murdoch Children's Research Institute ; Parkville , VIC Australia.
authors.forename: Alissa
authors.initials: A
authors.lastname: McMinn
authors.affiliation: b SAEFVIC and Vaccine and Immunisation Research Group; Murdoch Children's Research Institute ; Parkville , VIC Australia.|c Department of General Medicine ; Royal Children's Hospital ; Parkville , Victoria , Australia.|d Murdoch Childrens Research Institute; Parkville, Victoria, Australia ; Department of Pediatrics and School of Population and Global Health; University of Melbourne ; Parkville , VIC Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Crawford
authors.affiliation: e School of Public health; University of Sydney ; New South Wales , Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Leask
authors.affiliation: b SAEFVIC and Vaccine and Immunisation Research Group; Murdoch Children's Research Institute ; Parkville , VIC Australia.|c Department of General Medicine ; Royal Children's Hospital ; Parkville , Victoria , Australia.|d Murdoch Childrens Research Institute; Parkville, Victoria, Australia ; Department of Pediatrics and School of Population and Global Health; University of Melbourne ; Parkville , VIC Australia.
authors.forename: Margie
authors.initials: M
authors.lastname: Danchin
mesh_terms: D000293:Adolescent; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D016312:Treatment Refusal / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data*
keywords: communication; resources; specialist immunisation clinic; vaccine hesitancy; vaccine uptake