New research urges coordinated action to reverse Australia’s declining childhood vaccination rates

Out-of-pocket costs, limited appointment availability, lack of opportunities to discuss vaccination with providers and eroding trust in information from immunisation providers are stopping some Australian parents and caregivers from vaccinating their kids on time, but a new research paper published today outlines practical strategies to help improve childhood vaccine uptake.

The paper, led by researchers from the National Vaccination Insights project, has been published in the Australian and New Zealand Journal of Public Health.  

Lead author Dr Kasia Bolsewicz, Social Science Research Fellow at the National Centre for Immunisation Research and Surveillance (NCIRS), said that the declining childhood vaccination rates in Australia are extremely concerning and emphasised that urgent, coordinated action across policy, program, healthcare provider and community settings is required.  

‘Childhood vaccination rates have declined each year since the start of the COVID-19 pandemic. The latest analysis from NCIRS confirms that coverage has remained below the national target of 95% across all three standard age milestones. Prioritising catch-up vaccinations for children who are overdue for their recommended doses is essential to protect them from potentially life-threatening, vaccine-preventable diseases.’  

The new paper builds on a 2024 national survey of 2,000 parents that identified key childhood vaccination barriers.  

‘Practical difficulties related to booking vaccination appointments and the costs associated with vaccinations were common reasons children fell behind on timely vaccination,’ said Dr Maryke Steffens, Social Science Research Fellow at NCIRS.

‘Barriers related to beliefs about the safety and effectiveness of vaccines and mistrust in information about vaccines provided by healthcare professionals were also identified as critical to address,’ Dr Steffens added.  

In other words, the survey indicated that barriers parents experience are multi-faceted.  

Drawing on evidence and extensive consultations with immunisation experts and stakeholders, the project team identified multiple strategies to improve childhood vaccination coverage.  

These strategies, which align with the National Immunisation Strategy For Australia 2025–2030, were grouped into four priority actions.

Improve access to vaccination, for example by:  

• increasing bulk billing of vaccination appointments  
• delivering vaccines after work hours and in different settings (general practice, community clinics, pharmacies, community events).

Support provider education and advocacy, for example by:    

• funding healthcare providers’ dedicated time for vaccination conversations  
• embedding communication training in healthcare providers’ professional development.  

Support parent and caregiver knowledge and confidence, for example by:  

• engaging communities in designing and sharing of vaccination messages using trusted community advocates  
• automating vaccination reminder systems to alert patients of upcoming vaccinations.  

Facilitate access to data, for example by:    

• changing the Australian Immunisation Register Act 2015 to enable better sharing of local coverage data with immunisation stakeholders (Primary Health Networks, healthcare providers, Public Health Units)
• funding stakeholder training on how to use these data  
• supporting the ongoing collection and sharing of behavioural data to inform program planning. 

‘Because barriers to childhood vaccination are multi-faceted, no single intervention alone will solve this problem. We need coordinated, multi-sector action,’ stressed Dr Steffens.  

‘We urge those responsible for immunisation policy and program funding to adopt a comprehensive set of strategies that makes it easier for parents to vaccinate their children,’ said Dr Jess Kaufman, Principal Research Fellow in the Vaccine Uptake Group at the Murdoch Children's Research Institute.

‘These strategies are grounded in evidence and shaped by the voice of community members, healthcare professionals and policymakers – giving us confidence in their relevance and effectiveness,’ emphasised Dr Bolsewicz.

Adjunct Professor Terry Slevin, CEO, Public Health Association of Australia, says that reversing the decline in childhood vaccination coverage is a public health priority.  

‘The power and reach of social media, the challenges raised by COVID-19 and misinformation around immunisation coming out of the USA mean it has never been more important to boost access to and confidence in vaccines. This important paper paves a practical way for Australia to reverse a concerning trend.  

‘We expect that boosting vaccine uptake will be a priority for the Australian Centre for Disease Control when it is permanently established next year. It’s estimated that over 150 million lives worldwide have been saved by vaccination – but young Australian lives will be at stake if childhood immunisation rates continue to fall.’  

The project team is conducting annual data collection, analysis and reporting based on national parent surveys and interviews. This work aims to deepen understanding of the barriers to childhood vaccination, monitor changes over time, and inform evidence-based strategies to strengthen policy and program efforts that support improved vaccine uptake in Australia. 

Access the paper here