Vaccination and disease burden in people experiencing homelessness, a data linkage approach
Australian and New Zealand journal of public health, Vol.50(Supplement 1), pp.S17-S17
2026
Background and Aim
People experiencing homelessness experience higher rates of communicable and vaccine-preventable diseases (VPDs) yet remain largely excluded from routine immunisation surveillance. Barriers to access, outreach, and documentation were highlighted during the COVID-19 pandemic and continue to limit understanding of vaccine coverage and disease burden in this population. This study aims to establish and apply a linked administrative data framework to quantify immunisation coverage and VPD burden among people experiencing homelessness in Western Australia, with an initial focus on influenza and COVID-19.
Methods and Analysis
We have constructed a large, longitudinal cohort using linked primary care, hospital, emergency department, and mortality data from the Home2Health program. Probabilistic linkage methods have been used to link these administrative datasets for the period 2010 - 2026. Existing data support preliminary analyses of influenza and COVID-19 vaccination coverage delivered in primary care and notifiable vaccine preventable disease data from pathology results. The dataset is being strengthened through linkage to the Australian Immunisation Register (AIR) and the WA Notifiable Infectious Disease Database (WANIDD) to enable comprehensive assessment of historic vaccinations and notifiable VPDs. Planned analyses include descriptive coverage estimates, temporal trends, predictors of uptake, missed opportunities for vaccination, disease incidence, hospitalisation, and vaccine effectiveness where feasible.
Outcomes
Primary outcomes to be presented include cohort size and characteristics, linkage methods, success and data completeness, and preliminary estimates of influenza and COVID-19 vaccination coverage. Secondary outcomes include burden of disease estimation (infection and hospitalisation) and vaccine effectiveness analyses.
Conclusion and Future Actions
This study explores the feasibility of using linked administrative data to support immunisation and disease surveillance in a structurally excluded population. Ongoing analyses incorporating AIR and WANIDD data will inform equitable vaccine policy, service delivery strategies, and future linkage-based research in vulnerable populations.
- Vaccination and disease burden in people experiencing homelessness, a data linkage approach
- Lauren Bloomfield - The University of Notre Dame AustraliaMatthew Tuson - The University of Notre Dame AustraliaJocelyn Tan - The University of Notre Dame AustraliaPaul Effler - Government of Western Australia Department of HealthLisa Wood - The University of Notre Dame Australia
- Australian and New Zealand journal of public health, Vol.50(Supplement 1), pp.S17-S17
- Elsevier B.V
- 991005896083807891
- © 2026 Published by Elsevier B.V.
- School of Allied Health
- English
- Abstract
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