Falling vaccination rates are putting children at risk 

We have long forgotten the scarred faces of smallpox survivors, and the horror of polio wards, where children were tethered to iron lungs just to breathe. Seeing a child in hospital gasping for air with whooping cough, or suffering agonising fever and rashes from measles, has gone from routine to rare.

But while vaccines have wiped out some pathogens, many are ready to surge back as we let down our guard.

In just the past fortnight, there have been measles exposure sites in NSW and Western Australia, and data have been released showing whooping cough notifications are the highest since records began in 1991.

Every percentage point that Australian communities drop below herd immunity thresholds is an open invitation for measles, mumps, and rubella to return to our classrooms and playgrounds.

For an infant too young to be vaccinated, or a classmate with a compromised immune system, vaccination fatigue, suspicion, or complacency are high-stakes gambles with their lives.

With dramatic speed, we’re seeing the protective shield we spent decades building begin to crack, and the consequences will be more illness, hospitalisation, and preventable deaths.

National vaccination rates for one- and two-year-old children are at 10-year lows, and whooping cough notifications are four times higher than they were before the COVID pandemic.

Tasmania has one of the highest rates of vaccination, but it hasn’t been immune from national trends.

Grattan Institute analysis shows that vaccination protection has fallen in four-in-five Tasmanian communities since 2020, from inner-Hobart to the West Coast.

Some communities have recorded shocking plunges, such as the Meander Valley and West Tamar region, where the share of fully vaccinated one-year-olds has fallen from 93 per cent in 2020 to just 84 per cent today.

In 2020, half of Tasmanian communities were meeting vaccination targets for one-year-olds. By 2025, only Brighton and North East Hobart were, leaving 13 other areas below the target rate of 95 per cent.

Tasmania is not alone. Around Australia, and around the world, a legacy of the pandemic is rising suspicion and falling vaccination, spurred on by misinformation.

The good news is that last year Australia’s federal, state, and territory governments agreed on a national immunisation strategy to shore up our defences.

It aims to increase vaccination coverage, particularly for groups with low uptake. Governments have committed to build trust in vaccines, strengthen the immunisation workforce, use data to target effort, and increase accountability for getting results.

It is a good approach, but a strategy without a budget is just a wish list. To turn these goals into rising coverage, this year’s state and federal budgets must make serious investments. Ensuring people get vaccinated has become much harder, so governments must work much harder to protect Australians.

Prominent advertising and clear communication will help combat vaccine fatigue and hesitancy, but you cannot fight a constantly mutating, decentralised disinformation campaign with brochures, websites, and TV ads alone.

Australia also needs sophisticated tools to understand and combat emerging myths in real time and to tailor messages for different audiences, and we need specialised training for healthcare workers to help them initiate and navigate difficult conversations.

And effort is needed to make vaccination easier to get, from more workers, in more places.

But better messaging and easier access won’t be enough for the communities with the lowest trust in vaccines and the highest barriers to getting vaccinated.

To reflect the growing gulfs in vaccination coverage, our governments should set targets that lift the floor, not just the average.

Then they must improve data systems and analysis to help them identify and tackle the worst gaps.

And they should invest in more intensive, local engagement to help communities with the lowest rates turn them around.

Tasmania’s experience shows that some communities face much bigger challenges than others. The gap between the areas with the highest and lowest vaccination rates for one-year-olds was almost 13 percentage points in 2025, up from just 7 points in 2020.

Focused and tailored programs were effective during the pandemic, including through local outreach programs run by Aboriginal-controlled health organisations, and state government initiatives to support so-called community champions of vaccination.

In the past year, intensive, focused campaigns have helped New Zealand boost vaccination rates for children from Pacific Island backgrounds by almost 10 percentage points.

Australia has taken bold steps on the newest threats to children, with tough anti-vaping laws and a world-first ban on social media. But as technology raises new risks, ancient illnesses are making a comeback. Australia should lead the world here too, with a major boost to vaccination policy that aims to reverse the losses of the past five years.