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No Vax? No Visit: A Study of Social Connectedness and Mental Health Impacts

The issue: "No Vax, No Visit" (NVNV) is a parent-led, socially negotiated health protection practice aimed at reducing newborns' risk of exposure to pertussis (whooping cough) by encouraging visitors to be up to date with tetanus–diphtheria–pertussis (Tdap/dTpa) vaccination prior to contact. While consistent with Australian cocooning guidance, NVNV shifts responsibility for communication and enforcement onto parents. Despite Department of Health recommendations for adult household members and close contacts of infants to receive the whooping cough vaccine, and over 57,000 nationally notified cases in 2024 (the highest since 1991), many parents face vaccine hesitancy or refusal in their support networks. New parents are already at heightened risk of postnatal depression, social isolation, and loneliness, which may be compounded by NVNV conversations and resistance from family and friends.

Project summary: This mixed-methods study employs a sequential exploratory design to develop evidence-informed health promotion strategies that address the impact of NVNV on the social connectedness and mental health of new parents in Australia. The study combines analysis of social media posts from parenting forums with online surveys targeting parents of young children (0–5 years), their extended family members and support networks, and healthcare workers.

Target groups:

Primary: Parents and legal guardians of children aged 0–5 living in Australia
Secondary: Extended family members and close friends of parents/legal guardians of children aged 0–5 living in Australia
Tertiary: Healthcare workers who work with parents and/or children under 5 years of age in metropolitan and regional/rural Australia

Study objectives:

Identify barriers and enablers to vaccination promotion and new parents acquiring social support during the postnatal period
Explore attitudes towards vaccines and experiences with NVNV among target groups
Analyse associations between vaccination attitudes, experiences with NVNV, and social connectedness and mental health outcomes among target groups
Develop recommendations for health promotion strategies that promote both infant protection and parental social connectedness and mental health

Who is involved?

Dr Krysten Blackford (Project Lead / Chief Investigator)
Prof Sharyn Burns (Co-Investigator)
Dr Daniel Rudaizky (Co-Investigator)
A/Prof Jun Chih (Co-Investigator)
Dr Rochelle Tobin (Co-Investigator)
Dr Ashton Hay (Research Assistant)
Elijah Sonu (Research Assistant)

Progress:

The survey of parents and legal guardians of children aged 0–5 in Australia has closed. Results have been published in the Health Promotion Journal of Australia: https://doi.org/10.1002/hpja.70203
The survey of extended family members and close friends of children aged 0–5 in Australia has closed and results are currently being analysed.
The healthcare worker survey will commence in 2026.

More Information: Please email Dr Krysten Blackford (k.blackford@curtin.edu.au).

Ethics approval: This research has been approved by Curtin University Human Research Ethics Committee (HRE2025-0439).