{ "abstract": "Introduction\n\nChildhood vaccination is a highly cost-effective public health strategy, yet routine immunisation rates have declined yearly across Australia since the COVID-19 pandemic, especially among Aboriginal and Torres Strait Islander children. Survey instruments used to understand drivers of vaccination have not been developed with or validated for Aboriginal and Torres Strait Islander children and families and may not reflect their lived experiences or priorities. This study aimed to understand factors shaping access to and acceptance of childhood vaccination from Aboriginal and Torres Strait Islander family perspectives to inform targeted strategies and potential culturally appropriate survey tools.Methods\n\nFamily focus groups were conducted in the Hunter New England region of New South Wales and the Northern Territory with Aboriginal and Torres Strait Islander parents and carers of children aged 5 years and under. Indigenous social and research yarning methods were used to explore families' views and experiences of childhood vaccination. Data were analysed using inductive content analysis led by Aboriginal researchers to ensure cultural integrity and uphold Indigenous data governance principles.Results\n\nFamilies participating in the study generally expressed support for routine childhood vaccination as a way of protecting children. Negative experiences and misinformation during COVID-19 increased concerns about adult vaccines, while participants generally remained supportive of routine childhood vaccination. Findings are presented across four key domains: (i) vaccine knowledge and information sources, participants wanted clearer, culturally relevant information explaining the diseases and how vaccines work in plain English and Aboriginal and Torres Strait Islander languages; (ii) vaccine decision-making, trust was strengthened through cultural connection, continuity of care and respectful communication with healthcare workers; (iii) access barriers, including restricted clinic hours, inflexible booking systems, miscommunication and transport difficulties; and (iv) strategies to improve access, including reminder and recall systems, outreach services and transport support.Conclusions\n\nFamilies described a range of structural and health service barriers that made childhood vaccination harder to access, highlighting that childhood vaccination coverage is shaped by more than attitudes towards vaccines. Improving childhood immunisation coverage requires culturally grounded communication that puts families at the centre, builds trust with healthcare providers and addresses structural access barriers.", "abstract_shown": true, "affiliations": [ "Population Health, Hunter New England Local Health District, Tamworth, New South Wales, Australia.", "Menzies School of Health Research Global Health Division, Darwin, Northern Territory, Australia.", "Vaccine Uptake Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.", "The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia.", "Medicine and Public Health, The University of Newcastle Australia, Newcastle, New South Wales, Australia.", "Flinders University, Darwin, Flinders Health and Medical Research Institute, Darwin, Northern Territory, Australia.", "Hunter New England Population Health, Wallsend, New South Wales, Australia.", "Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia." ], "article_type": "research article", "arxiv": null, "author_total": 12, "authors": [ { "affs": [ 0 ], "name": "Kylie Taylor", "orcid": "0009-0001-7382-8146" }, { "affs": [ 0 ], "name": "Elizabeth Joyce Harwood", "orcid": "0009-0000-5685-3473" }, { "affs": [ 0 ], "name": "Katrina Clark" }, { "affs": [ 1 ], "name": "Gregoriana Parker" }, { "affs": [ 1 ], "name": "Bianca F Middleton" }, { "affs": [ 1 ], "name": "Caitlin Kent" }, { "affs": [ 1 ], "name": "Kelly McCrory" }, { "affs": [ 2 ], "name": "Jessica Kaufman", "orcid": "0000-0001-5139-4183" }, { "affs": [ 2, 3 ], "name": "Margie Danchin", "orcid": "0000-0002-7624-5691" }, { "affs": [ 4 ], "name": "David N Durrheim", "orcid": "0000-0001-9236-4861" }, { "affs": [ 5 ], "name": "Marita Hefler" }, { "affs": [ 6, 7 ], "name": "Kristy Crooks", "orcid": "0000-0001-7010-2473" } ], "bibtex": "https://research.draconitic.com/paper/947bpmtt2cm83.bib", "cited_by": 0, "doi": "10.1136/bmjph-2026-005896", "fulltext_url": "https://europepmc.org/articles/PMC13691903", "id": "947bpmtt2cm83", "issns": [ "2753-4294" ], "landing_url": "https://europepmc.org/article/MED/42921199", "language": "eng", "licence": "CC-BY-NC", "licence_label": "CC BY-NC", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/", "metadata_licence": null, "native_subjects": [ [ "lcc", "RA1-1270" ], [ "openalex", "3306|Vaccine Coverage and Hesitancy" ] ], "openalex": "W7223225443", "pdf_url": "https://europepmc.org/articles/PMC13691903?pdf=render", "pmcid": "PMC13691903", "pmid": "42921199", "published": "2026-10-22", "publisher": "BMJ Publishing Group", "ris": "https://research.draconitic.com/paper/947bpmtt2cm83.ris", "sources": [ { "first_seen": "2026-10-30T12:20:33Z", "native_id": "MED:42921199", "source": "europepmc", "url": "https://europepmc.org/article/MED/42921199" }, { "first_seen": "2026-10-30T13:43:04Z", "native_id": "57b83158aa934bee90dc01c368ad5b4e", "source": "doaj", "url": "https://doi.org/10.1136/bmjph-2026-005896" } ], "subjects": [ { "field": "medicine", "origin": "lcc:RA1-1270", "subfield": "epidemiology-public-health" } ], "title": "Strategies to strengthen childhood vaccination uptake: a qualitative study exploring Aboriginal and Torres Strait Islander families' perspectives.", "title_text": "Strategies to strengthen childhood vaccination uptake: a qualitative study exploring Aboriginal and Torres Strait Islander families' perspectives.", "type": "peer-reviewed", "updated_at": "2026-10-30T13:43:04Z", "url": "https://research.draconitic.com/paper/947bpmtt2cm83", "venue": "BMJ public health", "versions": [] }