• Anna Pearce, Helen Marshall, Helen Bedford, and John Lynch.
• 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.
• Vaccine. 2015 Jun 26; 33 (29): 3377-83.

ObjectivesTo examine barriers to childhood immunisation experienced by parents in Australia.DesignCross-sectional analysis of secondary data.SettingNationally representative Longitudinal Study of Australian Children (LSAC).ParticipantsFive thousand one hundred seven infants aged 3-19 months in 2004.Main Outcome MeasureMaternal report of immunisation status: incompletely or fully immunised.ResultsOverall, 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'.ConclusionsUsing 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.Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

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