Dr Dorothy Ling1, Thi Nguyen1
1Northern Health, Epping, Australia
Biography:
Dorothy Ling is an infectious diseases physician with a special interest in infection prevention and control.
Abstract:
Background
Vaccine-preventable diseases (VPD), including influenza and respiratory syncytial virus (RSV), disproportionately affect high-risk populations, contributing to avoidable morbidity, hospitalisations, and health system burden. Despite strong evidence supporting vaccination, no antenatal vaccines had been administered in our health service in the past five years, contributing to local coverage rates below the state average (20%), highlighting a critical gap in delivering preventative care in hospitals.
Solution
Using a Learning Health System (LHS) framework, we engaged consumers and clinicians to identify priorities and barriers. Key barriers included missed vaccination opportunities, logistical barriers, and access inequities. In response, we co-designed a nurse-led, hospital-based immunisation clinic that is integrated into routine antenatal workflows. Existing literature supported this model as effective in addressing structural access barriers and mild vaccine hesitancy.
Results
The pilot clinic launched in April 2025 and delivered over 300 vaccinations within two months. The service received strong support from patients and clinicians. However, the clinic is scheduled for discontinuation due to lack of sustainable funding.
Lessons
Despite strong outcomes and support, the lack of aligned funding mechanisms remains a significant barrier to sustaining preventative care in hospitals. Preventative services are often ineligible for both National Weighted Activity Unit (NWAU) and Medicare Benefits Schedule (MBS) reimbursement. Embedding these services successfully requires system-level reform, deliberate funding advocacy, and early integration with cost-coding and finance teams during service design.
Conclusion
In-hospital immunisation models are feasible and effective. Broader implementation depends on structural funding reform, scale up to additional high-risk patient groups, and multi-site economic analysis.