Last week, the Australian government announced a new National Immunisation Strategy for 2025-30. This strategy sets out the government's priorities for improving vaccine uptake for children, adolescents and adults over the next five years.
Authors
- Jessica Kaufman
Research Fellow, Vaccine Uptake Group, Murdoch Children's Research Institute
- Julie Leask
Professor, School of Public Health, University of Sydney
It comes at an important moment. Childhood vaccination coverage has been declining consistently since 2020 .
So what are the key goals of this new strategy, and will it be able to reverse the drop in vaccination rates among Australian children?
Declining vaccination coverage since the pandemic
While overall vaccination coverage remains high by global standards - at 92% for one-year-olds - this is down from a high of nearly 95% in 2020 . The reasons for the drop include access challenges and concerns among some parents about vaccine safety and effectiveness.
Many children are missing out on timely vaccines that prevent diseases such as whooping cough and meningitis. Aboriginal and Torres Strait Islander children, who also have lower vaccination coverage rates at one and two years old, bear a disproportionate burden of these diseases .
And it's not just children missing out. Among adolescents, HPV coverage at age 15 has dropped by 5% in girls (down to 81%) and 7% in boys (down to 78%) since 2020.
Influenza vaccination coverage has declined year on year since 2022 and remains at very low levels. Coverage in 2024 was 62% for people aged 65 and older, and under 30% for the rest of the population.
Across six key priority areas , the new immunisation strategy seeks to reduce vaccine hesitancy and improve access to vaccinations, particularly in priority groups such as Aboriginal and Torres Strait Islander communities. A few key points stood out to us.
1. Emphasis on trust and community engagement
We need to strengthen trust in vaccines and the people and systems that deliver them because low levels of trust are associated with vaccine scepticism and refusal. Even though Australians' trust in childhood vaccines is generally high , there have been some bumps in recent years.
The pandemic left some people with lingering questions and misperceptions about vaccines, supercharged by misinformation and increasing political polarisation of vaccination.
The strategy rightly emphasises the need to engage with communities and build trust in vaccination and the health system.
However, relationships with communities can't be stood up at a moment's notice - they take time and effort to sustain. State and federal governments invested in these relationships with diverse communities during the COVID vaccine rollout, but many of these initiatives have since been dissolved due to lack of sustained funding and commitment.
Recently, there have been positive indications some governments are reinvesting in these efforts. Hopefully this strategy will encourage more to do the same.
2. Addressing equity and access
Too often government leaders and media headlines blame individual laziness or hesitancy for our uptake problems, failing to acknowledge the very real problems with service convenience and access that are also present.
The strategy makes clear that the government and immunisation service providers should make vaccination accessible and equitable. As a part of this commitment, it highlights the importance of ensuring all health-care professionals who are able to deliver vaccines are being utilised to their full potential.
Pharmacists are specifically mentioned, but there is no reference to the largest group of immunisation providers : nurses. They should be better recognised and we need reform to enable nurses to vaccinate more independently.
3. Recognising the importance of data
When vaccination rates are low, it's essential to know why. This comes from both talking with communities and collecting robust data.
We are part of the National Vaccination Insights project , which carries out yearly monitoring using surveys and interviews with the public to better understand the drivers of vaccine uptake.
The strategy proposes a live dashboard of vaccine uptake data, which would be valuable, but we also encourage the addition of social and behavioural data. The dashboard should also report rates of vaccination in pregnancy. This information is newly available, thanks to the recent addition of a field to record pregnancy status in the Australian Immunisation Register.
4. Commitment to consider vaccine injury compensation
Maintaining trust in vaccination means being able to acknowledge when vaccines can very occasionally cause harm. People tend to be more confident in vaccines when you tell them what to expect, what the common minor side effects are, as well as the rare serious ones.
When those rare serious side effects become a reality for a handful of people, they may have to take time off work, incur medical expenses, and very occasionally, manage long-term complications. So it's essential these people are financially compensated by government.
We had such a compensation scheme during the pandemic for COVID vaccines, but this ended in September 2024. We welcome the government's plan to explore whether establishing a compensation scheme is feasible for all vaccines on the national program.
A comprehensive no-fault vaccine injury compensation scheme is overdue and, with thoughtful and consultative planning, would make our already robust vaccination system more trustworthy.
Where to from here?
The new national immunisation strategy is comprehensive and informed by evidence. But its impact will ultimately come down to its funding and implementation, which are not described in this document. Finalising these key plans and putting them into action must happen soon to arrest declining vaccination coverage and keep people well protected from serious diseases.
Jessica Kaufman receives funding from the NHMRC, MRFF, Australian government, Victorian government, and UNICEF. She is a member of the Collaboration on Social Science and Immunisation (COSSI).
Julie Leask receives funding from NHMRC, WHO, US CDC, NSW Ministry of Health. She received funding from Sanofi for travel to an overseas meeting in 2024.
