Comparison of general practitioner and practice nurse perceived barriers to immunisation uptake

Abstract

Objective: To understand immunisation issues confronting New Zealand general practitioners (GPs) and practice nurses (PNs), particularly comparing their perceptions of barriers to achieving high immunisation coverage in childhood and their knowledge of immunisation contraindications. Methods: National computer-assisted telephone survey comparing responses of 150 randomly selected GPs and 150 randomly selected PNs. A triangulated multimethod approach was used by converging both quantitative and qualitative text data. Results: Both GPs and PNs identified parental fear and misinformation about vaccine safety as the major barrier to immunisation uptake, but not access to services, lack of staff time or provider knowledge. Lack of funding was identified as a greater barrier by GPs than PNs. Many practitioners had poor knowledge on contraindications to vaccination but did not perceive the need for educational update. They desired user-friendly, evidence-based resources to communicate the relative benefits and risks of the scheduled vaccines to parents. Conclusions: GPs and PNs identifying parental fear and misinformation as the greatest barriers to childhood vaccination is consistent with research on NZ mothers which found a pervasive underlying fear of vaccines and perceived side-effects. Difficulties in accessing services was perceived as a minor barrier to improving uptake. Practitioner misinformation on contraindications to vaccination may lead to missed vaccination opportunities. Implications: Strategies that focus on primary health care provider support and education are more likely to gain high coverage than those that are primarily directed at overcoming access barriers.