Immunisation Advisory Centre experts are involved in a wide range of research projects focused on vaccination and respiratory viruses – to
inform vaccination policy, and improve immunisation access and
coverage in communities across Aotearoa New Zealand.
Principal investigator: Professor Nikki Turner, University of Auckland
Duration: January 2025 to December 2027
Funding: Flu Lab
Triple R is a national, equity focused programme aimed at reducing the impact of influenza and other respiratory viruses in Aotearoa New Zealand. Grounded in Te Tiriti o Waitangi and systems science, it promotes culturally responsive, strengths-based approaches to build positive, resilient health outcomes at all levels.
The project aims to develop and validate a novel Risk & Resilience Model, identify equitable mitigation strategies, design and integrate a scalable Triple R Tool, and pilot and refine the tool in real-world settings.
Principal investigator: Dr Samantha Marsh, University of Auckland
Duration: July 2024 to June 2026
Funding: Health Research Council of New Zealand
The Arotahi Study addresses critically low childhood immunisation rates in Aotearoa New Zealand through a Māori-led, hyper-local, and culturally grounded approach. Using kaupapa Māori principles and community-based system dynamics, the study explores localised drivers of vaccine hesitancy and access barriers.
The project aims to understand community-specific factors affecting immunisation uptake, capture whānau experiences across different time points of vaccine decision-making, develop a meta-narrative to identify leverage points for intervention, and build Māori research capacity through community engagement and employment.
The study supports equitable immunisation coverage by informing targeted interventions and contributing to reduced vaccine-preventable disease burden. Findings will guide policy and practice, with the potential to influence similar initiatives across Aotearoa.
Principal investigator: Professor Nikki Turner, University of Auckland
Duration: September 2024 to February 2026
Funding: Flu Lab
This project aims to investigate the incidence and impact of needle fear among New Zealand adults, including its effect on vaccine compliance and public health outcomes. It will gauge the prevalence of needle fear and pain in adults with and without underlying
health conditions, examine the relationship between needle fear and reduced vaccine uptake, and explore adult preferences for alternative vaccine administration delivery to reduce anxiety and improve compliance.
Understanding needle fear will help shape targeted interventions to improve adult vaccine coverage in New Zealand. By identifying psychological and demographic drivers of needle fear, the programme supports public health efforts, especially in managing vaccine- preventable diseases among at-risk populations.
PhD project: Briony Fanslow. Supervised by Dr Janine Payner, University of Auckland
Duration: September 2025
Funding: Flu Lab
This project will address key knowledge gaps about human metapneumovirus (hMPV) burden and risk factors among New Zealand’s paediatric population, and leverage national surveillance and administrative datasets to inform vaccination policy and resource allocation. It will examine the epidemiology and hospital burden in Auckland children of hMPV, versus RSV and influenza. The project will identify virus-specific risk factors, including chronic conditions, in paediatrics, evaluate NZ surveillance and health data for studying paediatric respiratory infections, and inform vaccine introduction policies for respiratory viruses in
children.
It will provide insights into epidemiological shifts after COVID-19, identify high-risk demographic and clinical groups, and collect data to support targeted vaccination and improve adolescent vaccine uptake. This research will guide New Zealand vaccination policy for respiratory viruses, raise awareness of virus-specific risks, promote equity for vulnerable children, and support efficient vaccine resource allocation amid funding challenges.
Principal investigators: Professor Nikki Turner, University of Auckland, and Professor Peter McIntyre, University of Otago
Duration: May 2021 to December 2025
Funding: Flu Lab
SHIVERS-V was a multidisciplinary New Zealand research programme that expanded on earlier SHIVERS studies and the NIH-funded WellKiwis cohort to track influenza and respiratory viruses in hospitals and communities and responses to the changes through the
COVID-19 pandemic New Zealand’s strict border controls created a natural experiment, offering insights into virus transmission, immunity, and seasonal disruptions.
Using enhanced surveillance including SARI data, genomic analysis, point-of-care testing, and machine learning, the programme highlighted inequities – with Māori and Pacific peoples disproportionately affected.
Community-led research focused on equity and practical tools for winter preparedness.
Key outcomes
By mid-2025, SHIVERS-V had completed all studies, published 9 papers, submitted 5, and had 14 in progress. Findings were shared at the 2025 NZ Influenza Symposium and continue to inform national and global policy, laying the groundwork for SHIVERS-VI and the Triple R (Risk, Resilience, and Response to influenza and respiratory disease) programme (see more information under ‘Current research projects’).
Principal investigators: Professor Nikki Turner, University of Auckland, and Associate Professor Esther Willings, University of Otago
Duration: September 2021 to November 2025
Funding: Health Research Council of New Zealand
The Vaccine Barriers Assessment Tool (VBAT) was adapted and validated for caregivers in Aotearoa New Zealand to identify and address both vaccine hesitancy and access barriers to childhood vaccines, particularly among Māori and Pacific whānau. Developed through a three-phase process involving expert input, cognitive interviews, national surveys, and validation against real immunisation data, the VBAT covers seven key domains influencing vaccine uptake.
Key outcomes
The final VBAT version has outperformed international tools like PACV (Parent Attitudes About Childhood Vaccines) in the NZ setting by incorporating culturally relevant and systemic factors unique to New Zealand. Two validated versions – a 14-item long form and a 6-item short form – are now available for use in health services, supporting equitable, evidence-based immunisation efforts across the country.
Two publications are in the process of completion and submission for publication.
Principal investigators: Dr Samantha Marsh, University of Auckland, and Dr Amber Young, University of Otago
Duration: February 2023 to April 2024
Funding: Cure Kids
This study explored why some pēpi (infants) are not enrolled in primary healthcare by the milestone age of 6 weeks, focusing especially on Māori whānau who face lower enrolment rates and greater health inequities. Researchers reviewed national documents, surveyed 424 health professionals, conducted interviews with 27 stakeholders and 20 māmā, and identified multiple barriers including lack of awareness about enrolment processes, limited clinic capacity, no access to transport, and whānau mistrust or fear of immunisation.
Key enablers included designating staff for enrolment, building respectful clinic-to-whānau relationships, and improving communication and cultural safety.
Key outcomes
Findings contributed to health policy changes, including extension of the pre-enrolment period, and were shared widely through conference presentations, videos (e.g., He Taonga te Mokopuna), and media. Partnerships with Hāpai Te Hauora and Ngati Porou Oranga were central, and follow-up work is underway to co-develop community-focused solutions and increase on-time immunisation coverage for pēpi Māori.
Principal investigator: Dr Anna Howe, University of Auckland
Duration: November 2022 to November 2023
Funding: Health New Zealand | Te Whatu Ora
This research examined COVID-19 vaccine uptake and the relative effectiveness of three versus two doses of the Pfizer mRNA vaccine in Aotearoa New Zealand during 2022, a period marked by the emergence of the Omicron variant in a largely infection-naïve
population.
By February 2022, before widespread community transmission, over half of adults and 80% of those aged 65+ had received a third dose, though significant disparities existed by age, ethnicity, and socioeconomic status – particularly among Māori, Pacific Peoples, and those in more deprived areas.
The study found that three doses offered significantly greater protection against severe outcomes (hospitalisation and death) compared to two doses, with consistent or higher effectiveness in Māori and Pacific groups, suggesting that booster vaccination played a key role in mitigating health inequities. However, some waning of effectiveness was observed over time.
Key outcomes
The findings support the value of targeted, culturally appropriate strategies – such as whānau-based vaccination approaches – to boost uptake and inform future vaccination policies, especially for underserved communities. One manuscript has been published, and another is in the process of completion and submission.
Principal investigator: Dr Samantha Marsh, University of Auckland
Duration: September 2023 to July 2024
Funding: Health Research Council of New Zealand
This research established ImmCoR, an immunisation delivery research network in New Zealand that brings together over 50 members including researchers, clinicians, community partners, and government agencies to collaboratively identify and address evolving research priorities that support effective, equitable vaccine uptake and coverage.
Guided by the principles of Te Tiriti o Waitangi, the network monitors emerging community trends, develops responsive research agendas, seeks funding, and works to translate findings into practice, all with the goal of advancing timely and equitable disease prevention nationwide.
Key outcomes
The network’s first project was a national vaccinator survey designed to understand the barriers and enablers to childhood vaccination from the perspective of frontline workers, and to identify emerging trends. The intention is to repeat this survey regularly so New Zealand researchers can respond quickly to the needs of the community and vaccinators, with research that delivers meaningful impact for vaccinators, whānau, and children.
If you wish to join ImmCoR, please email samantha.marsh@auckland.ac.nz
MBCHB MPH DIB OBS DCH MD FRNZCGP FNZCPHM (HON)
Professor Nikki Turner is an academic General Practitioner. She is a Professor in the Department of General Practice and Primary Care and Principal Medical Advisor for the Immunisation Advisory Centre.
She works part time as a General Practitioner in Wellington and is based in Wellington.
She has over 20 years' experience in academic research and service delivery with vaccine preventable disease, national immunisation programmes and vaccine service delivery both in New Zealand and internationally.
Dr Janine Paynter is a senior research fellow at the School of Population Health. She is a scientist with broad research experience which includes research on communicable and non-communicable disease, tobacco control. Equity is a valued theme across all Janine’s research. Her recent research projects have a focus on vaccine safety (Global Vaccine Data Network), pertussis epidemiology in adults (PEA funded by GSK), gender bias in ethnic/minority communities (HRC Explorer grant), and equity in the cardiovascular care continuum (Manawataki Fatu Fatu), Pacific Infant Care practices (HRC) and Developing an assessment tool to gauge barriers to vaccination (VBAT, HRC). Janine’s strengths are in study design, quantitative data analysis, team work and data linkage.
Samantha Marsh is a Senior Research Fellow in the Department of General Practice and Primary Care, and has been a faculty member in the School of Population Health since 2016. Her research combines quantitative and qualitative methods to explore how people behave and make health decisions in contexts of risk and uncertainty. Her current work focuses on vaccine uptake in Aotearoa New Zealand, with a particular interest in the role of needle anxiety in influencing vaccination behaviour.
Lorraine is currently the Research Programme Manager at IMAC, leading multiple health research projects focused on improving outcomes and advancing equity. Lorraine is a psychologist with over 20 years' experience working across the health sector, with expertise in public health, mental health, suicide prevention, and child and youth mortality prevention. Her career spans roles in health boards and academia, driving initiatives that translate research into meaningful policy and practice impact.
