When Being Late Isn’t an Option
Title: When Being Late Isn’t an Option
Childhood vaccination should be simple. Book the appointment, show up, get protected. Yet in Perth, it increasingly isn’t happening on time. Coverage has slipped to 89.7 percent by age two, well below Australia’s 95 percent benchmark, and the consequences are not theoretical. Measles, pertussis, and other vaccine-preventable diseases do not wait politely for children to catch up. What makes this problem frustrating is that it is not driven by hesitancy. It is driven by logistics, inequities, and the everyday chaos of family life. When the system makes it difficult to get vaccinated, people fall through the cracks.
For Aboriginal families in Perth, the Boorloo Public Health Unit already provides a comprehensive support programme that actually works. Regular calls, help with bookings, transport assistance, and home visits make timely vaccination achievable. But scaling the same model to the much larger non-Aboriginal population is impossible with current resources. That gap created the need for a smarter, data-driven solution, one that identifies who needs support and when. This is where the Imms-on-Time project steps in.
The project team, funded by WA’s Future Health Research and Innovation Fund, are building a predictive system using machine learning and linked datasets. By drawing on routinely collected information such as maternal age, language spoken at home, socioeconomic indicators, and previous vaccination history, the model identifies children most likely to miss vaccinations before it happens. These data come from the Child Development Information System and the Australian Immunisation Register, offering a comprehensive view of risk across all births in metropolitan Perth since 2018. The goal is precision: support the right families early enough to change outcomes.
Once identified, families receive targeted, practical assistance. This includes reminders, appointment booking support, transport help, and, when needed, home visits. The design mirrors the strengths of the Boorloo PHU’s existing programme but allocates resources only to those most at risk, making the model scalable and sustainable. Importantly, this is not simply a technical exercise. Consumer representatives - parents of young children - are embedded in the project to shape the programme, refine communication, and ensure the system responds to real-world needs.
The potential impact is substantial. Timely vaccination prevents outbreaks, protects vulnerable groups, and reduces pressure on health systems. By addressing both access barriers and social determinants of delayed vaccination, this approach reduces inequities rather than reinforcing them. The model is designed to be replicable across WA, across Australia, and even internationally in regions where logistical barriers, not scepticism, drive under-vaccination. A targeted, predictive system allows health services to deliver resources where they matter most, rather than where they happen to be available.
Imms-on-Time is ultimately a reminder that childhood vaccination is not just a clinical act. It is a system challenge that demands coordination, technology, and community engagement. When the system becomes smarter, fairer, and more responsive, more children get vaccinated on time. And when children are vaccinated on time, the whole community is safer.
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