Vaccination coverage in children

In 2023, there continued to be modest but concerning declines in vaccination coverage among children in Australia relative to pre-COVID-19 pandemic peaks.

Decreases of similar magnitude have been seen in comparable high-income countries such as the UK and NZ.

Factors contributing to these declines likely include a combination of acceptance issues (concerns about, and reduced confidence in, vaccination) and access issues (including difficulty organising appointments and prioritisation by parents in relation to other competing issues).

Note: Given standard assessment time points are 6–18 months after vaccines are due, fully vaccinated coverage figures for 2023 predominantly reflect vaccinations due in 2022, when COVID-19 pandemic-related restrictions had largely been removed.

Fully vaccinated coverage in children

Fully vaccinated coverage for both children overall and Indigenous children decreased at all three standard age milestones (12 months, 24 months and 60 months of age).

These decreases were marginally larger in children overall than in Indigenous children.

While decreases in coverage have been greater in Indigenous children since the onset of the pandemic, fully vaccinated coverage at 60 months of age remains higher in Indigenous children (95.0%) than in children overall (93.3%).

See Table 1 in the full Annual Immunisation Coverage Report 2023 (p. 14) for more detail. Definitions of ‘fully vaccinated’ and age cohorts can be found in Table A2 in the Appendix (p. 73).

Measles-mumps-rubella (MMR) vaccination coverage

Coverage of the first dose of MMR-containing vaccine in children at 24 months of age decreased by 0.4 of a percentage point from 2022 to 2023 for both Indigenous children and children overall – falling below the national target of 95% for both groups.

Although Indigenous children had lower coverage for the second dose of MMR-containing vaccine when assessed at 24 months of age (90.7% vs 92.5% overall in 2023), coverage increased to 98.3% (96.4% overall) when assessed at 60 months of age – showing MMR catch-up vaccination activity is occurring, especially among Indigenous children.

For the second dose of MMR-containing vaccine assessed at 24 months of age, only 11.5% (38/330) of Statistical Area Level 3 (SA3) areas in Australia achieved coverage above the 95% target. Higher and more timely vaccination coverage is important, given widespread measles outbreaks seen overseas due to pandemic-related decreases in vaccination coverage.
 

See Table 1 in the full Annual Immunisation Coverage Report 2023 (p. 14) for vaccination coverage estimates (%) in children by age assessment milestone, vaccine/antigen and Indigenous status in Australia in 2022 vs 2023. 

Diphtheria-tetanus-pertussis (DTPa) vaccination coverage

Coverage of the third dose of DTPa-containing vaccine in children at 12 months of age was 93.3% overall in 2023, 0.6 of a percentage point lower than in 2022 and remaining below the national target of 95%.

Although Indigenous children had lower coverage for the third dose of DTPa-containing vaccine when assessed at 12 months of age (89.9% vs 93.3% overall in 2023), coverage for the fourth or fifth dose was higher for Indigenous children (95.3% vs 93.5% overall in 2023) when assessed at 60 months of age.

See Table 1 in the full Annual Immunisation Coverage Report 2023 (p. 14) for vaccination coverage estimates (%) in children by age assessment milestone, vaccine/antigen and Indigenous status in Australia in 2022 vs 2023.

On-time vaccination coverage

Although on-time vaccination stabilised in 2023, it remains lower than prior to the pandemic.

Quarterly on-time (i.e. within 30 days of recommended age) vaccination coverage of both the second dose of DTPa-containing vaccine and the first dose of MMR-containing vaccine decreased from mid-2020, before stabilising from mid-2023, but at a lower level than before the pandemic.

See Figures 9 and 10 in the full Annual Immunisation Coverage Report 2023 (pp. 28–29) for more detail.

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