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Background: Vaccination is important to reduce disease-associated morbidity and mortality in an ageing global population. While older adults are more likely than younger adults to accept vaccines, some remain hesitant. We sought to understand how traumatic events, psychological distress and social support contribute to older adults' intention to receive a COVID-19 vaccine and whether these experiences change with age., Methods: We analysed survey data collected as part of the Sax Institute's 45 and Up Study in a population of Australian adults aged 60 years and over. Data were derived from the COVID Insights study; a series of supplementary surveys about how participants experienced the COVID-19 pandemic., Results: Higher intention to receive a COVID-19 vaccine was associated with greater social support (adjusted odds ratio (aOR):1.08; 95%CI:1.06-1.11; p <.001) while lower intention was associated with personally experiencing a serious illness, injury or assault in the last 12 months (aOR:0.79; 95% CI:0.64-0.98; p =.03). Social support and the experience of traumatic events increased significantly with age, while psychological distress decreased., Conclusions: There may be factors beyond disease-associated risks that play a role in vaccine acceptance with age. Older Australians on the younger end of the age spectrum may have specific needs to address their hesitancy that may be overlooked., (© 2024. The Author(s).)

Issue Addressed: High levels of testing are crucial for minimising the spread of COVID-19. The aim of this study is to investigate what prevents people from getting a COVID-19 test when they are experiencing respiratory symptoms., Methods: Semi-structured, qualitative interviews were conducted with 14 purposively sampled adults between 20 November 2020 and 3 March 2021 in two capital cities of Australia and analysed thematically. The analysis included people who reported having respiratory symptoms but who did not undergo a COVID-19 test., Results: Participants appraised risks of having COVID-19, of infecting others or being infected whilst attending a testing site. They often weighed these appraisals against practical considerations of knowing where and how to get tested, inconvenience or financial loss., Conclusions: Clear public health messages communicating the importance of testing, even when symptoms are minor, may improve testing rates. Increasing the accessibility of testing centres, such as having them at transport hubs is important, as is providing adequate information about testing locations and queue lengths. SO WHAT?: The findings of our study suggest that more needs to be done to encourage people to get tested for COVID-19, especially when symptoms are minor. Clear communication about the importance of testing, along with easily accessible testing clinics, and financial support for those concerned about financial impacts may improve testing rates., (© 2022 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Objectives: We sought to identify associations between the experience of traumatic life events and vaccination intention to inform whether trauma-affected individuals require targeted interventions when addressing vaccine hesitancy., Study Design: We conducted an online cross-sectional survey to identify whether direct or indirect exposure to various traumatic life events and the presence of post-traumatic stress disorder (PTSD) symptoms are associated with willingness to receive a COVID-19 vaccine in an Australian sample., Methods: A national online questionnaire was administered to a representative sample of 1050 Australian adults in September 2021., Results: Lower willingness to receive a COVID-19 vaccine was associated with direct experience of a fire or explosion (adjusted odds ratio [aOR]: 0.42; 95% confidence interval [CI]: 0.23-0.78; P = 0.006), direct experience of severe human suffering (aOR:0.39; 95% CI: 0.21-0.71; P = 0.002) and screening positive for PTSD symptoms (aOR:0.52; 95% CI: 0.33-0.82; P = 0.005). Conversely, higher willingness to receive a COVID-19 vaccine was associated with indirect exposure to severe human suffering (aOR: 2.0; 95% CI: 1.21-3.22; P = 0.007)., Conclusions: Our findings suggest that the experience of traumatic events and the presence of PTSD symptoms can contribute to vaccination decisions. Our work adds to the growing recognition of the need to effectively mediate the influence of traumatic experiences on encounters within the medical setting and supports the importance of addressing the needs of trauma-affected individuals in their vaccination experiences., (Copyright © 2022 The Royal Society for Public Health. All rights reserved.)

Recent research illuminates the characteristics of non-vaccinating parents in well-defined geographic communities, however the process by which they came to reject vaccines is less clearly understood. Between September 11th, 2017 and February 20th, 2019, we recruited a nationally derived sample of Australian parents of children under 18 years who rejected some or all vaccines for semi-structured interviews. We used various strategies, including advertising on national radio, in community centres and playgrounds in low coverage areas, and snowballing. Grounded Theory methodology guided data collection and analysis. Twenty-one parents from regional and urban locations were interviewed. All spoke of wanting happy, healthy, robust children. All endorsed parenting values and approaches aligned with modern societal expectations of taking responsibility for their child's health. They varied, however, in their lifestyle and vaccination trajectories. Participants self-identified as situated along an 'alternative' to 'mainstream' lifestyle spectrum and had moved both away from and toward vaccination over time. Some had decided before birth that they never would vaccinate their children and had not changed. Others stopped vaccinating after perceived post-vaccine reactions in their children. Still others initially rejected vaccines, but eventually accepted them. The variation and dynamic nature of the vaccination trajectories described in this study suggests that vaccine refusal is not a static trait but rather the result of ever-changing experience and continual risk assessment; not all non-vaccinating parents fit the 'alternative lifestyle' stereotype. This suggests that nuanced personalised engagement with non-vaccinating parents is more appropriate than a one-size-fits-all approach., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Vaccination misinformation is associated with serious public health consequences, such as a decrease in vaccination rates and a risk of disease outbreaks. Although social media offers organisations promoting vaccination unparalleled opportunities to promote evidence and counterbalance misinformation, we know relatively little about their internal workings. The aim of this paper is to explore the strategies, perspectives and experiences of communicators working within such organisations as they promote vaccination and respond to misinformation on social media., Methods: Using qualitative methods, we purposively sampled 21 participants responsible for routine social media activity and strategy from Australian organisations actively promoting vaccination on social media, including government health departments, local health services, advocacy groups, professional associations and technical/scientific organisations. We conducted semi-structured, in-depth interviews to explore their perspectives and practices. Applying Risk Communication principles as a lens, we used Framework Analysis to explore the data both inductively and deductively., Results: Organisations promoting vaccination face multiple challenges on social media, including misinformation, anti-science sentiment, a complex vaccination narrative and anti-vaccine activists. They developed a range of sophisticated strategies in response, including communicating with openness in an evidence-informed way; creating safe spaces to encourage audience dialogue; fostering community partnerships; and countering misinformation with care., Conclusions: We recommend that communicators consider directly countering misinformation because of the potential influence on their silent audience, i.e. those observing but not openly commenting, liking or sharing posts. Refutations should be straightforward, succinct and avoid emphasizing misinformation. Communicators should consider pairing scientific evidence with stories that speak to audience beliefs and values. Finally, organisations could enhance vaccine promotion and their own credibility on social media by forming strong links with organisations sharing similar values and goals.

Background: Pregnant women and their unborn children are at high risk from both pandemic and seasonal influenza., Aim: To explore views about influenza vaccination during pregnancy, in a pandemic and immediate post-pandemic context, among mothers and other carers of young children., Methods: In a mixed methods study, caregivers from 16 childcare centres in Sydney, Australia, were surveyed in November and December 2009, and interviews were conducted with caregivers from six childcare centres between June 2009 and May 2011., Findings: Emerging themes from 41 interviews conducted with mothers included: 'pregnancy as a protected state', 'risk negotiation' and 'centrality of healthcare worker interaction'. Of 972 surveys distributed, 431 were completed (a response rate of 44%). Respondents perceived pandemic influenza risks to be greater for pregnant women than for their unborn children. Only 2% (9/383) of women reported being vaccinated against swine flu during pregnancy and 45% (168/383) indicated intent to receive swine flu vaccination in a future pregnancy., Discussion: The low rates of maternal influenza vaccination revealed in this study contrast to recent gains in vaccine uptake. Vaccination decision-making in pregnancy can be complex and contextually driven for some women. Healthcare workers, including midwives, have a key role in addressing women's concerns about maternal influenza vaccination in both pandemic and interpandemic periods., Conclusions: Policy makers need to be cognisant of women's concerns and develop resources for both pregnant women and healthcare workers as part of both future pandemic planning and seasonal vaccination efforts., (Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

Background: Effective public health messaging is essential in both the planning phase and duration of a pandemic., Objectives: This study aimed to gain an understanding of parental information seeking, trusted sources and needs in relation to pandemic influenza A 2009 (pH1N1) to inform future policy planning and resource development., Patients/methods: We conducted a mixed methods study; parents from 16 childcare centres in Sydney, Australia, were surveyed between 16 November and 9 December 2009, and interviews were conducted with participants from six childcare centres between June 2009 and May 2011., Results: From 972 surveys distributed, 431 were completed; a response rate of 44%. Most parents (90%) reported that doctors were "trusted a lot" as a source of influenza information, followed by nurses (59%), government (56%) and childcare centres (52%). Less trusted sources included media (7% selected "trusted a lot"), antivaccination groups (6%) and celebrities (1%). Parents identified a range of key search terms for influenza infection and vaccine. From 42 in-depth interviews, key themes were as follows: "Action trigger," "In an emergency, think Emergency," "Fright to hype" and "Dr Google and beyond." Parents relied heavily on media messages, but cynicism emerged when the pandemic was milder than expected. Parents viewed a range of information sources as trustworthy, including doctors, authoritative hospital or government websites, and childcare centres and schools., Conclusions: A user-centred orientation is vital for pandemic communications including tailored information provision, via trusted sources based on what parents want to know and how they can find it., (© 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.)

Objectives: To determine influenza vaccination coverage among pregnant women in New South Wales, and factors associated with vaccine uptake during pregnancy., Design, Setting and Participants: Quantitative self-administered survey of pregnant women, using a non-random, stratified sample from antenatal clinics at three demographically diverse hospitals in NSW during the influenza season of 2011., Main Outcome Measures: Self-reported influenza vaccine uptake while pregnant; and attitudes, barriers and facilitators to vaccine acceptance during pregnancy., Results: Of 939 women approached, 815 participated (87%). Influenza vaccine uptake in pregnant women was 27%. Women who had received a recommendation to have the vaccine were 20.0 times (95% CI, 10.9-36.9) more likely to have been vaccinated. Forty-two per cent recalled receiving a recommendation to be vaccinated. Other factors associated with vaccination were study site, perceived infection severity, overall feelings toward vaccination during pregnancy, vaccine accessibility, and willingness to take up the vaccine if recommended. Concern about the baby's safety was negatively associated with vaccination (odds ratio, 0.5; 95% CI, 0.2-0.9), but 68% (95% CI, 63%-71%) of women who expressed concern agreed they would have the vaccine if their health care professional recommended it., Conclusion: Recommendation from a health care provider is strongly associated with influenza vaccine uptake among pregnant women and can overcome their concerns about safety, but less than half the women surveyed reported receiving such a recommendation. Educational material targeting pregnant women and professional education and support for antenatal health care providers are needed to increase awareness and recommendation.