The first-ever New Zealand study to examine what influences fathers’ decision-making to get their infants vaccinated on time recommends immunisation information is delivered to the entire family, not just mothers.

The research, published in the journal Human Vaccines and Immunotherapeutics, drew on information provided by more than 4,000 fathers in this country’s largest longitudinal study, Growing Up in New Zealand.

It found that only a third of fathers received vaccination information prior to the birth of their children in 2009/10, and of these only 65% received material that encouraged vaccination.

The source and type of information fathers received was important and had a bearing on the likelihood of a child getting timely vaccinations.  

Lecturer at the University of Auckland’s Faculty of Medical and Health Sciences, Dr Catherine Gilchrist, says vaccination is one of the world’s most effective public health interventions and it’s important to understand what drives both mothers and fathers’ decision-making around infant immunisation.    

“Most previous research has looked at mothers’ experience of vaccination information, uptake and timeliness, but fathers can play a strong role in influencing a mothers’ health decisions during pregnancy, including vaccination,” she says.

“We also know that educational interventions which target fathers can improve infant outcomes and influence the mother’s choices so it’s important that we understand the sort of information fathers are receiving about vaccination and what their responses are.”

Fathers in the Growing Up in New Zealand study were asked if they had received vaccination information when their partners were pregnant; from what sources; and whether the information was encouraging, discouraging or conflicting.  

This information was then cross-referenced with the National Immunisation Register to determine whether infants had had their vaccinations and whether they had them on time.

The research revealed:

• One third of fathers recalled receiving vaccination information.
• Of fathers who received vaccination information:
• 64% received information encouraging vaccination.
• 16% received information discouraging vaccination.
• 20% received conflicting information about vaccination.
• Information provided by family and friends and the media was more likely to be discouraging of vaccination than information provided by healthcare sources.
• The infants of Māori fathers were less likely to receive all of their vaccinations on time, compared with the infants of European fathers.

Dr Gilchrist says the infants of fathers who received conflicting or discouraging information about vaccination were less likely to have all their vaccinations on time.

She says that during pregnancy one-on-one conversations with healthcare providers about vaccination may improve immunisation uptake.  She believes these conversations need to happen with both parents.

“Antenatal appointments provide an ideal opportunity for both parents to receive accurate vaccination information from a trustworthy source.  Midwives and Lead Maternity Carers (LMCs) should consider engaging fathers during perinatal care as an important part of their role,” she says.

Dr Gilchrist says more work could also be done to engage with Māori fathers in a bid to increase vaccination rates for Māori infants.
In 2019, only 63% of Māori infants were fully vaccinated at six months compared with 84% of European infants, 76% of Pacific infants, and 91% of Asian infants.

“The wider whānau is often important in immunisation decisions for Māori, so including fathers and the whānau in antenatal care to provide accurate vaccination information could help to address concerns and potentially improve infant vaccination uptake,” she says.  

Since this study, New Zealand has introduced influenza and whooping cough vaccinations for women during pregnancy.

Dr Gilchrist says this means LMCs now have an important role in promoting and administering antenatal vaccines which also provides an opportunity to discuss infant immunisation with expectant parents.  

She says the study team is now interested in determining whether there is an association between the mother’s antenatal immunisation uptake and infant immunisation uptake and timeliness.  

You can read the full paper Vaccination information fathers receive during pregnancy and determinants of infant vaccination timeliness here.

New Dad convinced of the benefits of infant vaccination

New dad Zin Khant Aung and his wife Rose made sure to vaccinate their nine-month-old daughter, Mon, after receiving lots of information about the importance of infant immunisation.  

The Dunedin resident was pleased to be included in discussions about vaccination with his wife and their midwife at routine antenatal appointments.  

He says it was important to him that he had access to the same information about vaccination as his wife when they were preparing for the arrival of their first baby.  

“Our midwife and our GP gave us lots of information about vaccination for Mon and we also found the pamphlets provided useful information.  All of the information we received was encouraging and we were very convinced of the benefits of vaccination for our baby,” he says.

Zin says he and Rose discussed their vaccination plans together and ensured that Mon received all of her vaccinations on time according to the Ministry of Health vaccination schedule.

Zin was born in Myanmar and spent his childhood there before moving to New Zealand.  He says this also influenced his decision-making around vaccination.  

“Myanmar is a poor country and vaccination isn’t widely available do you see and hear first-hand the suffering that can occur when babies are not vaccinated against preventable diseases,” he says.

Zin hopes it becomes more commonplace to include fathers in vaccination conversations, especially with healthcare providers.

“I think it’s really good to include fathers in conversations about vaccinations because there’s a lot of misleading information out there and people can be genuinely uncertain.  It’s reassuring for both mums and dads to receive informed and expert information from health professionals,” he says.

‍