Falling vaccination rates endanger us all

Don’t be so sure. Australia’s vaccination rates are falling and that leaves us vulnerable. It’s easy to be complacent, given our strong record of protecting children from illnesses such as measles, hepatitis and whooping cough. Australia’s child vaccination rates have been among the best in the world. By 2020, rates for five-year-olds had reached the national target of 95 per cent. At this level, it’s difficult even for highly infectious diseases such as measles to spread in the community, protecting both the vaccinated and unvaccinated.
These vaccines are safe and they get results. In the decade to 2015, illness caused by vaccine-preventable diseases fell by nearly 40 per cent for children under five.

But that success is now evaporating. Child vaccination rates have been falling every year since the pandemic. There are more than 20 communities in NSW alone where more than 10 per cent of two-year-olds aren’t fully vaccinated. In Dural-Wisemans Ferry and in the Tweed Valley, about 15 per cent of two-year-olds aren’t vaccinated for measles. In coastal Richmond Valley, one in five aren’t; an even lower vaccination rate than the Texas county grappling with an outbreak.

The risks to children are not hypothetical. Residents of Lismore in the Richmond Valley hinterland were put on alert this month after someone carrying the measles virus visited shops and the hospital. Lismore is in the bottom five communities in NSW for measles vaccination.

It’s not just measles. Across Australia, every single child vaccine on the National Immunisation Schedule had lower uptake in 2024 than in 2020. It’s not just children either. All the way from the womb to the grave, we’re missing opportunities to protect people against disease. A new study suggests vaccination during pregnancy may be falling. Grattan Institute research has shown that far too many older people are missing out on vaccines for COVID, pneumococcal and shingles.

And a disgraceful number of aged care residents aren’t getting potentially life-saving protection. In 55 per cent of NSW aged care homes, less than half of residents have been vaccinated for COVID in the past six months. Shockingly, there are nine aged care homes in NSW, including four in Sydney, where fewer than one in 10 residents have been vaccinated in the past year.

Our problems are part of a global trend. Many wealthy countries, including the US, Britain and New Zealand, are seeing similar declines in vaccination. The timing of the slide, starting in the pandemic, suggests COVID vaccine misinformation and COVID vaccination fatigue are part of the reason.

Almost half of Australian parents with unvaccinated children believe vaccines are not safe for their child, and four in 10 believe vaccines don’t work. There are other barriers to vaccination too, including practical ones. One in 10 parents with unvaccinated children said cost and difficulty getting an appointment were barriers to vaccinating their children.

It’s clear that not getting vaccinated can be due to many things. It could be too little time, awareness or trust in vaccines. Given the troubling decline in vaccination, Australia needs a vaccination reset to deal with all of the barriers. Governments should run advertising campaigns explaining the benefits of vaccination and send SMS reminders to get vaccinated. Those efforts should be designed to combat vaccine hesitancy and misinformation.

On top of these broad-brush initiatives, we should use data to guide more focused efforts. GPs and pharmacies should regularly get reports showing how their patient vaccination rates compare with their peers, and which groups in their community are missing out. Primary Health Networks should give training and staff to GPs and pharmacies to help them increase vaccination rates for migrant groups, disadvantaged people and other under-vaccinated groups. States and local governments should do the same with their vaccination programs.

Local communities with the lowest levels of vaccination all have different barriers and strengths, so there’s no one-size-fits-all answer. But the pandemic response showed that tailored programs developed with local communities can work well. To make those programs happen, governments should set tougher vaccination targets for parts of the country that are being left behind and provide targeted funding for local programs where they’re needed most.
Strong infrastructure should guide these efforts. The Albanese government’s promised Centre for Disease Control won’t be fully set up until next year. The next five-year national vaccination strategy is still being developed.
In this new world of declining vaccination, they must have the ambition, teeth and resources to get the job done.