NCIRS launches new decision aid for children’s COVID vaccination

Despite a slow start, Australia’s COVID-19 vaccination rates have charged ahead, with 93.65% of people aged 12 and over having received at least two doses and 53.39% a booster shot.
 
But when it comes to children aged 5–11, there are concerns rates of uptake have plateaued.
 
Despite starting in January, only 50.41% of the cohort has received one dose, with less than 100,000 paediatric doses administered in the past three weeks compared to more than a million in the first month. Only 2011 doses were administered on 3 March.
 
These figures are in stark contrast to Australia’s overall reputation as a ‘vaccination nation’, with 95.22% coverage among five-year-old’s for non-COVID childhood immunisation.
 
While a number of reasons have been floated to help explain the low uptake, the trend has in part been attributed to a rise in medical misinformation.
 
To help combat this, the National Centre for Immunisation Research and Surveillance (NCIRS) has launched a COVID-19 vaccine decision aid to help parents and carers weigh up the risks and benefits of COVID-19 vaccination for their children aged 5–15.
 
Freely accessible online, the decision aid has five steps, starting with answers to frequently asked questions about the SARS-CoV-2 virus and the vaccines available for the cohort.
 
It then allows the user to select which age group and vaccine they would like to know more about – Pfizer for 5–11-year-olds, or Pfizer or Moderna for 12–15-year-olds – and provides a comparison of the risks and benefits. Parents and carers can then check their children’s personal risk profile.
 
Developed by Dr Jane Frawley, a Senior Lecturer in Public Health at the University of Technology Sydney, along with a team of public health researchers, social scientists and clinicians, the tool is informed by the latest data from clinical trials and AusVaxSafety.
 
Dr Frawley, who is also a member of the steering committee for the Collaboration on Social Science and Immunisation group and the Australian Regional Immunisation Alliance, told newsGP that while millions of children globally have now been vaccinated for COVID-19, concerns about safety still persist among parents.
 
‘There are still the concerns that it’s too fast, and how do we know it’s safe long-term?’ she said.
 
‘The other really big factor is the variant. Children have been spared the worst anyway and with Omicron … there’s been all of this messaging around it being safe to go back to school and that it is not that severe.
 
‘So parents are looking at that and thinking: “Well, should I even bother? Why give them another vaccine when we’re not really that concerned about it?”’
 
But when it comes to risks of COVID-19 among unvaccinated and vaccinated children aged 5–11, the tool notes that the risk of symptomatic COVID is 72% with a duration of 2–3 weeks for the former, compared to 58% for those who are vaccinated, with symptoms typically lasting just 1–3 days.
 
Nonetheless, GPs and other vaccine experts have acknowledged that a parent’s decision to vaccinate their child can be multilayered and complex.
 
To get to the heart of any concerns or reservations, the tool’s fourth step calls on parents and carers to reflect on what matters most to their family by filling out a checklist. They can then email themselves a consolidated list of what matters to them and concerns them most about vaccination.
 
Dr Frawley says it is a great conversation starter for a visit to the GP.
 
‘Often our messages around immunisation are around norming: everyone does it, it’s safe and effective,’ she said.
 
‘Whereas taking parents’ thoughts and feelings into consideration is really important because they do; that’s how they make these decisions for their child.
 
‘But when there’s a lot of noise and you’re getting lots of pieces of information, sometimes it can be really hard to distil that down into what it actually is that’s stopping you.
 
‘So it’s a really useful tool to consolidate that stuff, rather than ignore it.’
 
Dr Andrew Leech, a GP with a special interest in paediatrics, told newsGP that conversations with parents about COVID-19 vaccination can be particularly challenging, and that he sees great value in the tool.
 
‘Parents might have pre-conceived ideas from what they have heard elsewhere and tend to need lots of reassurance,’ he said.
 
‘These conversations take time [as] parents tend to have lots of questions, and in the busy world of general practice, time is not something we always have lots of.
 
‘[This tool] gives us a great reference point to guide parents to when they are trying to make up their mind or sitting on the fence about vaccination in their child. [It] will answer a large proportion of parents’ concerns, particularly in understanding the short-term and longer-term effects.’
 
The final step of the tool prompts parents to consider their final decision, and if they are still unsure to discuss some of their questions with their GP or family members.
 
To ensure the data is relevant for the Australia context, the tool is continually updated.
 
Currently vaccine side effects listed for Pfizer among 5–11-year-olds is only based on first doses, as just 1.01% have received a second dose.
 
‘But we will update that to be the second dose figures when we can, because generally the side effects are a bit higher,’ Dr Frawley said.
 
‘So we just want to be as transparent as possible in terms of those figures.’
 
The tool will also soon be updated with data on Moderna’s COVID-19 vaccine for children aged 6–11.
 
To ensure it is as accessible as possible, the team have also received funding to make the tool’s content available in a number of other languages, which is currently under development.
 
The decision aid for children aged 5–15 is available on the NCIRS website, along with a decision aid for people aged 16 and over.
 
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