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Norman DA, Danchin M, Blyth CC, Palasanthiran P, Tran D, Macartney KK, Wadia U, Moore HC, Seale H. Australian hospital paediatricians and nurses' perspectives and practices for influenza vaccine delivery in children with medical comorbidities. PLoS One 2022; 17:e0277874. [PMID: 36508402 PMCID: PMC9744269 DOI: 10.1371/journal.pone.0277874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 11/06/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Influenza vaccination of children with medical comorbidities is critical due their increased risks for severe influenza disease. In Australia, hospitals are an avenue for influenza vaccine delivery to children with comorbidities but are not always effectively utilised. Qualitative enquiry sought to ascertainment the barriers and enablers for influenza vaccination recommendation, delivery, and recording of these children at Australian hospitals. METHODS Semi-structured interviews and discussion group sessions were conducted with paediatricians and nurses at four tertiary paediatric specialist hospitals and two general community hospitals in three Australian states. Transcripts from interviews and group sessions were inductively analysed for themes. The Capability, Opportunity, Motivation, and Behaviour (COM-B) model was used to explore the elements of each theme and identify potential interventions to increase influenza vaccination recommendation and delivery behaviours by providers. RESULTS Fifteen discussion sessions with 28 paediatricians and 26 nurses, and nine in-depth interviews (five paediatricians and four nurses) were conducted. Two central thematic domains were identified: 1. The interaction between hospital staff and parents/patients for influenza vaccine recommendation, and 2. Vaccination delivery and recording in the hospital environment. Six themes across these domains emerged detailing the importance of dedicated immunisation services, hospital leadership, paediatricians' vaccine recommendation role, the impact of comorbidities, vaccination recording, and cocooning vaccinations. Supportive hospital leadership, engaged providers, and dedicated immunisation services were identified as essential for influenza vaccination of children with comorbidities in Australian hospital. CONCLUSION Recommendation of influenza vaccination for Australian children with comorbidities is impacted by the beliefs of paediatricians and the perceived impact of influenza disease on children's comorbidities. Dedicated immunisation services and supportive hospital leadership were drivers for influenza vaccine delivery at hospitals. Future interventions targeting hospital-based influenza vaccine delivery for children with comorbidities should take a rounded approach targeting providers' attitudes, the hospital environment and leadership support.
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Affiliation(s)
- Daniel A. Norman
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Crawley, Western, Australia
- School of Medicine, University of Western Australia, Crawley, Western, Australia
- * E-mail:
| | - Margie Danchin
- Department of General Medicine, The Royal Children’s Hospital, Parkville, Victoria, Australia
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher C. Blyth
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Crawley, Western, Australia
- School of Medicine, University of Western Australia, Crawley, Western, Australia
- Department of Infectious Diseases, Perth Children’s Hospital, Nedlands, Western, Australia
- Department of Microbiology, PathWest Laboratory Medicine, Nedlands, Western, Australia
| | - Pamela Palasanthiran
- School of Women’s and Children’s Health, University of New South Wales, Sydney, New South Wales, Australia
- Infectious Diseases Service, Sydney Children’s Hospitals Network, Randwick, New South Wales, Australia
| | - David Tran
- Department of Paediatrics, Northern Health, Epping, Victoria, Australia
| | - Kristine K. Macartney
- National Centre for Immunisation Research and Surveillance, University of Sydney, Sydney, New South Wales, Australia
- Department of Infectious Diseases and Microbiology, Children’s Hospital Westmead, Westmead, New South Wales, Australia
- School of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ushma Wadia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Crawley, Western, Australia
- Department of Paediatrics, Fiona Stanley Hospital, Murdoch, Western, Australia
| | - Hannah C. Moore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Crawley, Western, Australia
| | - Holly Seale
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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