Persistent declines in routine childhood vaccination are ‘absolutely alarming’, say experts.
Health authorities continue to express concern over persistent declines in routine childhood vaccination coverage that have been observed since the start of the covid pandemic.
These declines were evident across all paediatric age groups, with adolescents experiencing the greatest setbacks, interim data from the Annual Immunisation Coverage Report 2024 released this week revealed.
Immunisation Coalition director and consultant virologist Professor Gary Grohmann told Allergy & Respiratory Republic there needs to be an urgent national effort to turn the tide on the falling vaccination rates.
“It’s absolutely alarming,” he said.
“This is definitely going to lead to increases in outbreaks of disease, particularly in the vulnerable, which are children and the older person and those with underlying conditions.
“We really must get our national immunisation program back on track. We’ve got kids going to daycare, kids going to school, particularly primary school kids – they really all need to be vaccinated.
“These diseases are not trivial – that’s why we make vaccines for them. Measles, mumps, rubella, whooping cough, tetanus, diptheria, pneumococcal just to name a few, are very, very serious diseases and they will spread in the community among the unvaccinated.”
The National Centre for Immunisation Research and Surveillance (NCIRS) report analysed Australian Immunisation Register data for children, adolescents and adults, and found on-time vaccination rates remain significantly below pre-pandemic levels.
Fully vaccinated coverage for children continued to decrease in 2024 at all three age milestones (12, 24 and 60 months of age). The largest decrease was at 12 months, with coverage dropping by 3.2 percentage points since 2020 (from 94.8% in 2020 to 91.6% in 2024).
Coverage at 24 months dropped below 90% for the first time since 2016 (92.1% in 2020 to 89.4% in 2024), while coverage at 60 months remained higher than at the other age milestones, although still in decline (94.8% in 2020 to 92.7% in 2024).
Concerningly, one in three children received their first dose of the measles-mumps-rubella (MMR) vaccine late, and one in five children received their second dose of a diphtheria-tetanus-pertussis (DTP)-containing vaccine late.
Vaccination delays are also prominent among adolescents, including:
- In 2020 86.6% or girls had received at least one dose of human papillomavirus (HPV) vaccine dose by 15 years. This percentage fell to 81.1% in 2024. The decline was even bigger in the boys’ cohort – in 2020 84.9% had received at least one dose of human papillomavirus (HPV) vaccine dose by 15 years. This percentage fell to 77.9% in 2024.
- Coverage of adolescent meningococcal ACWY vaccine in adolescents turning 17 years of age was 74.3% in 2020 and in 2024 it fell to 71.3%.
Fully vaccinated coverage for Aboriginal and Torres Strait Islander children continued to decrease in 2024 at all three age milestones (12, 24 and 60 months of age).
The largest decrease was at 24 months of age, with coverage dropping by 4.5 percentage points since 2020 (91.2% to 86.7% in 2024). Coverage at 12 months was 89.2% in 2024, down from 93.1% in 2020. Coverage at 60 months was 94.4% in 2024, down from 97% in 2020.
Levels of on-time vaccination (within 30 days of the recommended age) remained lower in young Aboriginal and Torres Strait Islander children than before the covid pandemic.
In the last quarter of 2024, on-time coverage of the second dose of DTP-containing vaccine was 7.8 percentage points lower than in the first quarter of 2020. On-time coverage of the first dose of MMR vaccine was 14.2 percentage points lower in the last quarter of 2024 than in the first quarter of 2020.
The picture did not get any brighter when it comes to influenza vaccine – a worry as Australia heads into winter. Influenza vaccination coverage was lower in all age groups in 2024 than in 2023. Age break downs included:
- Six months to five years (27.6% vaccinated in 2024, down from 30.3% in 2023);
- Five to 10 years (15.6% vaccinated in 2024, down from 17.9% in 2023);
- 10 to 20 years (13.3% vaccinated in 2024, down from 15.2% in 2023);
- 20 to 50 years (22.3% vaccinated in 2024, down from 24.2% in 2023);
- 50 to 65 years (33.3% vaccinated in 2024, down from 37.4% in 2023);
- Over 65 years (61.7% vaccinated in 2024, down from 64.3% in 2023).
“Annual influenza vaccination is NIP-funded for children aged 6 months to less than 5 years and adults aged 65 years and over. However, less than one-third of children and just under two-thirds of adults in these age groups received an influenza vaccine in 2024,” the report said.
Speaking at an Australian Science Media Centre briefing earlier this month, Professor Julie Leask, professor of public health and a social scientist at the University of Sydney’s Infectious Diseases Institute said Australia’s influenza vaccination coverage was “perpetually low”.
“Our influenza vaccination rates in Australia are dire and they’re not improving,” Professor Leask said.
The forum, as reported in ARR’s sister publication The Medical Republic, was held in response to high influenza case numbers, which are already tracking above the five-year average.
Latest data from the National Notifiable Disease Surveillance System shows there have been 78,536 cases of laboratory confirmed influenza cases in Australia as of 16 May.
“Some people are being hospitalised or even dying from a disease that is potentially preventable. The vaccine isn’t perfect but it’s much better than zero, which is what you’re looking at if you don’t have a vaccine,” said Professor Leask
“Of course, there are other measures to reduce the risk of respiratory infections, but nothing matches the effectiveness of even between 50% and 70%, and even better in children having that vaccine.”
In April, immunisation data available through the DoDHA highlighted the vaccination rates by Primary Health Network across Australia. This analysis has shown a number of PHNs have vaccination rates below 90% in one and two-year-olds.
Rates pick up in five-year-olds, with only two PHNs falling under the 90% mark – the North Coast (NSW) and the Gold Coast (Queensland). However more than half of the nation’s PHNs have vaccination rates under 95% for five-year-olds.
Professor Leask told ARR there needed to be a major national effort to boost vaccination rates across the board.
She said making vaccination as accessible and cost-free as possible were integral to any approach. Primary care across the board, including general practice, community health and primary care health networks had a major role to play, with support from state and federal governments.
“One major thing that we know improves coverage is reminders to vaccinate, before a vaccine is due,” she said.
“If a practice has that capacity to send out reminders for any vaccine for their patients, that can be a powerful method to simply remind people to remember to vaccinate themselves or their children in a timely way.”
Professor Leask said she believed a diverse range of models of delivering vaccination needed to be looked at.
“There has been a heavy reliance on general practice in the last few years and that has worked very well for Australia, until we then started to see huge pressure on general practice, difficulty getting appointments or in some cases loss of bulk billing,” she said.
“There are inherent risks in a system that relies on private vaccination and there are certainly public clinics that have been boosted up, such as a drop-in service for parents who find it difficult to make appointments and keep them.”
Professor Leask called out the Hunter New England Public Health Unit for the work it was doing to increase vaccination rates in Maitland, NSW.
“There were lots of under-vaccinated kids there,” she said.
“They [staff from the health unit] interviewed members of the community, including parents and providers and key stakeholders, found out what their issues are, and worked to at least try to help address them, not solve them, but address them.
“They’ve actually improved vaccination rates with an immunisation program approach.”
The full and online summary versions of the Annual Immunisation Coverage Report 2024 will be published later in 2025.
Read the interim report in full here.
