Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care

A picture speaks a thousand words: evaluation of a pictorial post-vaccination care resource in Australia

Hammad Ali A C , Holly Seale A , Kirsten Ward B and Nicholas Zwar A
+ Author Affiliations
- Author Affiliations

A School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.

B General Practice New South Wales, GPO Box 5433, Sydney, NSW 2001, Australia.

C Corresponding author. Email:

Australian Journal of Primary Health 16(3) 246-251
Published: 6 September 2010


Evaluating the ‘Common Reactions to Vaccination’ post-vaccination care resource was seen as an opportunity to contribute to the limited literature base in this important area, learn from the strengths and weaknesses of the resource and gain insight into post-vaccination care practices. Semi-structured in-depth interviews were conducted with 12 general practitioners and 29 practice nurses in New South Wales and Australian Capital Territory, Australia. Structured interview guides were used and data was analysed thematically. A self-administered survey was also distributed to parents or guardians during routine childhood vaccination visits. When compared with previous resources, participants felt the new resource was more appropriate as it had a simple layout; it was colourful, incorporated pictures and had basic and practical information. Information about post-vaccination care and common reactions to vaccination must be provided in written form accompanied by a verbal reinforcement so that patients can revisit the information at a later stage if required. The ‘Common Reactions to Vaccination’ post-vaccination care resource provides comprehensive information in an easy-to-understand pictorial way and was appreciated by both vaccination providers and patients.

Additional keywords: general practice, immunisation.


The authors are grateful to Dr Alan Leeb, Anna Billingham, the Illawarra Division of General Practice and Barwon Division of General Practice for their support in piloting the interviews. Thanks also to the divisions who participated in this evaluation, namely: Shire GPs, GP Access, Central Sydney General Practice Network, Macarthur Division of General Practice, Went West Ltd, Hawksbury Hills DGP, Riverina Division of General Practice, ACT Division of General Practice, South East Sydney Division of General Practice, Shoalhaven Division of General Practice, NSW Central West Division of General Practice, Northern Rivers General Practice Network and the Blue Mountains Division of General Practice. The project was supported by the General Practice NSW Immunisation Program, which receives funding from the Commonwealth Government, Department of Health and Ageing.


Best Practice (2010) An evolution in GP software. Available at [Verified 8 May 2010]

Bond L, Nolan T, Pattison P, Carlin J (1998) Vaccine preventable diseases and immunisations: a qualitative study of mothers? Perceptions of severity, susceptibility, benefits and barriers. Australian and New Zealand Journal of Public Health 22, 441–446.
CrossRef | PubMed |

Borras E, Dominguez A, Fuentes M, Batalla J, Cardenosa N, Plasencia A (2009) Parental knowledge of paediatric vaccination. BMC Public Health 9, 154.
CrossRef | PubMed |

Davis TC, Fredrickson DD, Arnold CL, Cross JT, Humiston SG, Green KW, Bocchini JA (2001) Childhood vaccine risk/benefit communication in private practice office settings: a national survey. Pediatrics 107(2), e17.
CrossRef | PubMed |

Forrest JM, Burgess MA, McIntyre PB (2000) Factors influencing vaccination uptake. Workshop Report. Communicable Diseases Intelligence 24, 51–53.
PubMed |

Fraenkel J , Wallen N (1993) ‘How to design and evaluate research in education.’ (McGraw-Hill: New York)

Freed GL, Clark SJ, Butchart AT, Singer DC, Davis MM (2010) Parental Vaccine Safety Concerns in 2009. Pediatrics 125(4), 654–659.
CrossRef | PubMed |

Hamilton M, Corwin P, Gower S, Rogers S (2004) Why do parents choose not to immunise their children? Journal of the New Zealand Medical Association 117, 1189.

Health Communications Network (2010) Medical Director. Available at [Verified 8 May 2010]

Houts PS, Doak CC, Doak LG, Loscalzo MJ (2006) The role of pictures in improving health communication: A review of research on attention, comprehension, recall, and adherence. Patient Education and Counseling 61, 173–190.
CrossRef | PubMed |

Jacobson RM, Swan A, Adegbenro A, Ludington SL, Wollan PC, Poland GA, Vaccine Research Group (2001) Making vaccines more acceptable – methods to prevent and minimize pain and other common adverse events associated with vaccines. Vaccine 19, 2418–2427.
CrossRef | PubMed |

Luthy KE, Beckstrand RL, Clark Callister L (2010) Parental Hesitation in Immunizing Children in Utah. Public Health Nursing (Boston, Mass.) 27(1), 25–31.
CrossRef | PubMed |

National Health & Medical Research Council (2008) ‘The Australian immunisation handbook.’ 9th edn. (Department of Health & Ageing: Canberra) Available at [Verified 8 May 2010]

New South Wales Health (2007) ‘Personal health record (the blue book).’ Available at [Verified 8 May 2010]

Petousis-Harris H, Goodyear-Smith F, Godinet S, Turner N (2002) Barriers to childhood immunisation among New Zealand mothers. The New Zealand Family Physician 29, 396–401.

Smith MJ, Woods CR, Marshall GS (2009) Parental vaccine concerns in Kentucky. The Journal of the Kentucky Medical Association 107(9), 342–349.
PubMed |

St-Amour M, Guay M, Perron L, Clement P, Baron G , et al. (2006) Are vaccination information leaflets useful for vaccinators and parents? Vaccine 24, 2491–2496.
CrossRef | PubMed |

Streefland PH (2001) Public doubts about vaccination safety and resistance against vaccination. Health Policy 55, 159–172.
CrossRef |

Taylor JA, Darden PM, Brooks DA, Hendricks JW, Wasserman RC, Bocian AB (2002) Association between parents’ preferences and perceptions of barriers to vaccination and the immunization status of their children: a study from Pediatric Research in Office Settings and the National Medical Association. Pediatrics 110(6), 1110–1116.
CrossRef | PubMed |

Wengraf T (2001) ‘Qualitative research interviewing: Biographic narrative and semi-structured methods.’ (Sage Publications Ltd: London)

Export Citation Cited By (3)