Supporting Equitable Immunisation Across Culturally and Linguistically Diverse Communities in Australia: Perspectives from Community Members and Healthcare Workers

Background: Immunisation coverage among culturally and linguistically diverse (CALD) communities in Australia is heterogeneous, with barriers shaped by language, trust, health-system navigation, affordability, and access to vaccination services. This study explored how adults from diverse CALD backgrounds and professionals working with CALD communities understand vaccine decision-making, with particular attention to adult vaccination, and identified opportunities to support vaccination through routine and community-based health-care interactions. Methods: We conducted 24 semi-structured interviews with CALD community members, healthcare professionals, and multicultural service workers living or working in New South Wales, Western Australia, and the Northern Territory. We analysed the data using reflexive thematic analysis. Results: Participants generally expressed strong support for childhood vaccination, whereas views about adult vaccination were more conditional and varied. Key themes included strengthening vaccine literacy; recognising heterogeneity within CALD communities; using social media to support accurate, timely health communication; building trust between health-care providers and community members; engaging cultural and religious leaders while maintaining clinically led vaccine communication; and expanding community-based opportunities to support participation in immunisation programs. Participants identified childhood vaccination appointments, primary care consultations, community organisations, migrant resource centres, English-language classes, and broader health programs as potential opportunities to discuss and offer adult vaccines. Conclusions: Supporting equitable immunisation among CALD communities requires approaches that address both vaccine decision-making and practical access to services. Future research should co-design and evaluate strategies that integrate adult vaccination discussions and delivery into trusted health and community settings, while addressing language, trust, eligibility, cost, vaccination records, and health-system navigation.