Caregiver's intention and uptake of influenza vaccination for children in Australia before and after introduction of free vaccination.

Objectives: To investigate the change between 2017 and 2023 in caregiver-reported intention to vaccinate children aged 6 months-5 years against influenza and compare this to vaccine uptake in Australia, following the COVID-19 pandemic and the free influenza vaccine policy for young children by different states and territories since 2018 and nationally in 2020.

Study Design: Retrospective data analysis.

Methods: A retrospective data analysis was conducted using the Royal Children's Hospital National Child Health Poll data. The data were collected through online cross-sectional surveys of Australian caregivers' intention to vaccinate their children against influenza in 2017 and 2023. The proportion of parents who intended to vaccinate their children against influenza was weighted to reflect Australia's population distribution. We compared this to National Centre for Immunisation Research Surveillance (NCIRS) data on the percentage (%) of children registered as actually having had the influenza vaccine in 2017 and 2023.

Results: In children aged five years and under, an increase in intention to vaccinate of 34.7 percentage points from 27.4% (weighted, n = 307/1050) in 2017 to 62.1% (weighted, n = 457/743) in 2023 was observed. We compared intention with the NCIRS influenza vaccine uptake data, which recorded an increased uptake for children under five years of 23.3 percentage points from 6.2% in 2017 to 28.2% in 2023.

Conclusions: Between 2017 and 2023, there was a substantial increase in caregiver intention to vaccinate children against influenza, during which the national free influenza vaccine policy for young children was enacted and the COVID-19 pandemic began. There is a substantial gap between the intention to vaccinate and actual uptake of influenza vaccination, warranting further investigation into the barriers behind vaccination, beyond that of cost.