Safety concerns biggest barrier to vaccination for parents
· Medical Xpressby Murdoch Children's Research Institute
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Most vaccine-hesitant parents aren't opposed to vaccination but simply desire to protect their children from all harms, according to a review.
A clinical practice review by Murdoch Children's Research Institute Professor Margie Danchin and University of Colorado Anschutz School of Medicine Associate Professor Sean O'Leary for the New England Journal of Medicine explained that vaccine hesitancy exists on a spectrum, with safety concerns the biggest barrier.
They described decades of evidence showing that routine childhood vaccines recommended by the American Academy of Pediatrics have dramatically reduced serious infectious diseases and have an overwhelmingly excellent safety record. The same results have been produced by Australia's National Immunisation Program (NIP).
What is key to improving vaccine uptake?
The piece states that health professionals such as GPs, immunization nurses and pharmacists play a critical role in supporting vaccination, as clinicians remain the most trusted source of vaccine information for parents. Clear, confident recommendations from trusted clinicians are strongly associated with higher vaccine uptake.
They noted that communication style matters. Presumptive approaches, which present vaccination as the expected norm, are more effective than open-ended discussions, particularly when concerns are met with respectful, two-way dialogue.
Empathy-based, patient-centered strategies help clinicians address misinformation, acknowledge parental concerns and build trust. The review also includes step-by-step consultation guides and pointers to aid effective vaccine communication.
Professor Danchin said ensuring respectful communication and always leaving the door open when a vaccination is delayed or declined could influence future decisions and improve long-term immunization outcomes.
Strengthening trust and intention to vaccinate
The review is based on years of clinical experience and vaccine-communication research underpinning the global Vaccine Champions program, which aims to build trust and vaccine uptake. The program, supported by the Australian government and UNICEF and co-designed by MCRI, the University of Sydney, UNSW, local ministries of health, regional partners and Australian regional immunization alliance researchers, trains health care workers and community leaders to discuss and promote vaccination programs and address misinformation.
The review comes as newly published MCRI-led research found the program in Vietnam, co-designed with the Vietnamese Ministry of Health, strengthened trust in vaccines and the health system and increased community intention to vaccinate in provinces with historically low coverage.
Published in the Annals of Global Health, the study found that of those who attended the education sessions, 86% reported an increased intention to vaccinate, highlighting the program's impact on vaccine confidence in a community. They also reported high satisfaction with the sessions and material.
Supporting public health priorities
Importantly, the vaccine champions in Vietnam have continued to run education sessions beyond the initial program period and are being used by the Ministry of Health to support other public health priorities, including nutrition and maternal and child health.
MCRI researcher Belle Overmars said the findings demonstrate that a structured, multi-level model could strengthen vaccine confidence, empower local leaders and help reduce pressure on the health care workforce.
Publication details
Isabella Overmars et al, Pragmatic RE-AIM Evaluation of the Train-the-Trainer Vaccine Champions Program in Vietnam, Annals of Global Health (2026). DOI: 10.5334/aogh.5116
Journal information: New England Journal of Medicine
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PediatricsChildren's healthPreventive medicineCommon illnesses & Prevention Provided by Murdoch Children's Research Institute Who's behind this story?
Gaby Clark
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