Thursday 14 December 2023

A new report from the National Centre for Immunisation Research and Surveillance (NCIRS) shows vaccination coverage in children has continued to decrease since the onset of the COVID-19 pandemic, highlighting the need for further targeted strategies to increase vaccine uptake and protect more Australians from vaccine preventable diseases.

NCIRS’ Annual Immunisation Coverage Report 2022 – which focuses on changes in vaccination rates since the previous (2021) report – is the first study of its kind to thoroughly examine the continuing impacts of the pandemic on vaccination coverage in children, adolescents and adults across Australia.

‘This represents the first comprehensive stocktake of the ongoing impact of the pandemic on vaccination coverage in Australia,’ Associate Professor Frank Beard, Associate Director, Surveillance, Coverage, Evaluation and Social Science at NCIRS, said. ‘Importantly, it highlights a concerning downward trend in fully vaccinated coverage in children.’

Children – overall

Between 2021 and 2022, during the height of the COVID-19 pandemic, fully vaccinated coverage among children declined across Australia.

Looking at all three standard age assessment milestones – 12 months (for vaccines due at 6 months), 24 months (for vaccines due at 6, 12 and 18 months) and 60 months (for vaccines due at 4 years) – vaccine coverage decreased from 2021 to 2022; specifically, from 94.2% to 93.3% at 12 months, 92.1% to 91.0% at 24 months and 94.0% to 93.4% at 60 months.

Children – Indigenous

For the same three age assessment milestones, decreases in fully vaccinated coverage were greater in Indigenous children than in children overall: specifically, from 91.6% to 90.0% at 12 months, from 90.1% to 87.9% at 24 months and from 96.3% to 95.1% at 60 months.

At 12 and 24 months of age, larger disparities in fully vaccinated coverage were found in Indigenous children than in children overall, underscoring the differential impacts of the COVID-19 pandemic.

‘The larger decreases in vaccination coverage among Indigenous children, particularly those in remote areas, highlight the need to improve on-time vaccination,’ Associate Professor Beard added.

Measles-mumps-rubella (MMR) vaccination coverage

Among children overall, the NCIRS report shows that in 2022, MMR vaccination coverage at 24 months of age was 95.1% for the first dose and dropped to 92.7% for the second dose. At 60 months, it increased to 96.3% for the second dose. However, only 13.8% of areas achieved the national immunisation coverage target of 95% for the second dose of MMR vaccine at 24 months of age.

Risks posed by measles outbreaks

A newly released World Health Organization and Centers for Disease Control and Prevention (US) report has shown millions of children missed MMR vaccinations during the pandemic, resulting in an 18% increase in measles cases and a 43% increase in measles-related deaths globally in 2022 compared to 2021.

Based on Australian Government Department of Health and Aged Care data, there were no cases of measles in Australia in 2021, while there have been 7 and 24 confirmed cases in 2022 and 2023, respectively, related to large overseas outbreaks and increasing international travel.

Measles infection is highly transmissible, is often severe and has a greater risk of complications in adults and in children under 5 years of age. On-time MMR vaccination for the first dose (at 12 months) and second dose (at 18 months) significantly reduces the risk of children contracting the measles virus and spreading it to others.

‘Younger children are generally more at risk of severe disease, and Aboriginal and Torres Strait Islander and socio-economically disadvantaged children even more so. Vaccination at the earliest appropriate age, in line with the National Immunisation Program schedule, is important to protect these children,’ said Associate Professor Beard.

Timeliness of vaccination

Missed or delayed vaccinations remain a persistent issue in Australia – and the NCIRS report shows this has been exacerbated by the COVID-19 pandemic, particularly in remote areas with a high proportion of Indigenous people.

On-time vaccination is defined as receipt of the scheduled vaccination within 30 days of the recommended age.

Where this does not occur, the goal of catch-up vaccination is to provide optimal protection against disease by completing the recommended vaccinations in the shortest and most effective timeframe possible.

Improving on-time and catch-up vaccinations is a key element of the national goal to meet and exceed Australia’s aspirational immunisation coverage target of 95%.

Associate Professor Beard noted, ‘It’s critical that we continue to monitor and report vaccination coverage data to ensure that strategies to address pandemic-related declines and equity gaps are implemented effectively.’

Strategies to increase vaccination coverage

Given declining vaccination coverage during the COVID-19 pandemic, further investigation is needed to better understand barriers to vaccine uptake, which are likely to include a combination of lack of access to vaccination services and vaccine hesitancy.

NCIRS is working to improve immunisation coverage rates in Australia through several initiatives. For example:

  • the recently launched Vaccination Insights project – a collaboration between NCIRS, the Murdoch Children’s Research Institute and the University of Sydney – which is investigating the drivers of under-vaccination in Australian children aged under 5 years
  • Sharing Knowledge About Immunisation (SKAI), an online platform that provides accessible, respectful, evidence-based resources and tools that are helping healthcare professionals have better conversations about vaccination with parents and carers.

Click here to view the Annual Immunisation Coverage Report 2022

Click here to view the Annual Immunisation Coverage Report 2022 – Summary


Media enquiries

Please contact the NCIRS media team: | 0429 350 279

Last updated January 2024