Australia’s robust childhood immunisation program, long held up as a global benchmark, is showing troubling signs of backsliding. New figures released by the National Centre for Immunisation Research and Surveillance (NCIRS) reveal that vaccination coverage among infants, toddlers and adolescents has steadily fallen since the onset of the COVID-19 pandemic. With rates dipping below the thresholds required to maintain herd immunity against highly contagious diseases such as measles and whooping cough, experts warn that without swift and sustained intervention, preventable outbreaks—and even deaths—may follow.
Alarming Decline in Childhood Vaccinations
According to the NCIRS data published on 15 May, the proportion of Australian children fully up-to-date with their routine immunisations by key age milestones has decreased across the board over the past five years:
- By 12 months of age: Coverage dropped from 94.8 percent in 2020 to 91.6 percent in 2024.
- By age two: Fully immunised rates fell from 92.1 percent to 89.4 percent.
- By age five: The share of children having received all scheduled vaccines declined from 94.8 percent to 92.7 percent.
These downward trends span vaccines that protect against a spectrum of diseases—including diphtheria, tetanus, whooping cough (pertussis), rotavirus, pneumococcal disease, polio, hepatitis B, four serogroups of meningococcal disease, measles, mumps and rubella.
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Dr Gary Grohmann, director of the Immunisation Coalition and former World Health Organization consultant, described the figures as “absolutely alarming.” He cautioned that once childhood immunisation levels fall below approximately 95 percent—the benchmark for preventing sustained transmission of highly infectious pathogens—“we will see more hospitalisations and, tragically, some children may die of measles or other vaccine-preventable diseases.”
Impact on Herd Immunity
Herd immunity occurs when a sufficient proportion of the population is immune—either through vaccination or prior infection—thereby indirectly protecting those who are unvaccinated or immunocompromised. For diseases such as measles, with a basic reproductive number (R₀) of 12–18, epidemiologists estimate that at least 95 percent of the community must be immune to prevent outbreaks.
With current coverage for measles-mumps-rubella vaccines slipping below 92 percent among five-year-olds, Australia is perilously close to—or already below—the threshold required to avert large-scale measles epidemics. Indeed, the NCIRS report warns that “localized pockets of under-immunisation” in certain regions could serve as tinderboxes for rapid viral spread once the pathogen is introduced.
Specific Vaccination Coverage Trends
While declines are evident across most vaccines, two areas of particular concern stand out:
Whooping Cough (Pertussis)
Pertussis remains a leading cause of vaccine-preventable infant hospitalisation and death worldwide. After periodic outbreaks in the mid-2010s, Australia achieved high uptake of the primary pertussis series. However, NCIRS data indicate that coverage at 12 months has fallen from 94 percent in 2020 to under 91 percent in 2024, raising the spectre of enzootic transmission, particularly endangering unvaccinated newborns too young to complete their primary schedule.
HPV Vaccination in Adolescents
The human papillomavirus (HPV) vaccine—offered free to girls and boys in school-based programs—protects against cervical, anal and oropharyngeal cancers. Uptake among teenage girls has declined from 86.6 percent five years ago to 81.1 percent, while boys have fallen from 84.9 percent to 77.9 percent. Dr Grohmann warns that “when adolescent vaccination slips below 80 percent, it jeopardises community-wide protection against HPV-related cancers decades down the track.”
Regional Variations and Vulnerable Communities
National averages obscure more severe declines in certain areas. In parts of rural and remote Australia—where access to general practitioners is already stretched—immunisation rates among two-year-olds have dipped as low as 75 percent. These under-immunised pockets often coincide with lower socioeconomic status, limited healthcare infrastructure and communities with historically lower engagement in preventive services.
Indigenous children, who face higher burdens of invasive pneumococcal and meningococcal disease, are also at heightened risk. While targeted programs achieved strong uptake in the early 2010s, the recent decline threatens to widen health inequities, leaving Aboriginal and Torres Strait Islander communities vulnerable to severe disease and poorer outcomes.
Real-Life Consequences: The Langoulant Family Story
Bruce and Ashley Langoulant know firsthand the devastating impact of a vaccine-preventable illness. In 1989, six-month-old Ashley contracted pneumococcal meningitis—at that time an unvaccinated disease—and suffered seizures, profound disability, cerebral palsy, epilepsy and hearing loss.
“My daughter Ash is non-verbal, uses a wheelchair, and lives with intense medical needs,” Mr Langoulant recounts. “When the pneumococcal vaccine became available in the early 2000s, I helped push for its inclusion in the National Immunisation Program. But now, to see parents decline free vaccines for their children—is heartbreaking.”
For the Langoulant family, Ashley’s experience is a living legacy of why high immunisation coverage matters. “Ash was the unprotected child thirty-six years ago. We have no choice but to live with her disabilities,” he says. “Today’s parents do have a choice—and they must choose to vaccinate.”
Barriers to Vaccination Uptake
Public-health experts identify multiple factors contributing to the recent decline:
- Disruption from COVID-19: Pandemic lockdowns, temporary clinic closures and the diversion of healthcare resources disrupted routine childhood immunisation schedules in 2020–21.
- Reduced School-Based Programs: Ongoing school avoidance and remote learning reduce opportunities for in-school HPV immunisations, contributing to steep drops among adolescents.
- Access and Affordability Issues: A National Vaccination Insights survey, conducted in collaboration with NCIRS, found that one in ten parents cited out-of-pocket costs for medical appointments as a barrier, while a similar proportion struggled to secure timely clinic bookings.
- Vaccine Hesitancy and Misinformation: Nearly half of parents with unvaccinated children admitted they “would not feel guilty” if their child fell ill with a vaccine-preventable disease, and 48 percent doubted vaccine safety—a reflection of persisting anti-vaccine narratives proliferating online.
- Emotional Distress: Six in ten respondents reported “feeling distressed” at the prospect of vaccinating their child, underscoring the need for empathetic communication and supportive environments.
Strategies to Reverse the Trend
Experts urge a multifaceted response to restore and exceed pre-pandemic vaccination levels:
Expand Pop-Up and Mobile Clinics
Reinstating the mass-vaccination sites and after-hours clinics that proved effective during the pandemic could bridge gaps for families who struggle to attend standard GP appointments. Mobile immunisation units, particularly in regional and remote areas, can deliver vaccines directly to schools, community centres and workplaces.
Strengthen School-Based Programs
With schools serving as critical access points for adolescent vaccines, efforts must focus on increasing attendance at immunisation days—through catch-up clinics, parent-teacher outreach and flexible scheduling that accommodates students in remote or hybrid learning.
Enhance Healthcare Provider Engagement
General practitioners, practice nurses and pharmacists play a pivotal role in addressing parental concerns. Targeted training on motivational interviewing, empathetic listening and clear communication of vaccine benefits can counteract hesitancy. Proactive reminder-recall systems (text messages, phone calls) have also demonstrated efficacy in prompting overdue immunisations.
Public Awareness Campaigns
Nationwide multimedia campaigns, featuring real-life testimonials from families like the Langoulants, can underscore the real-world stakes of under-immunisation. Collaboration with trusted community leaders—Indigenous elders, migrant-community advocates, faith-group heads—can tailor messaging to diverse audiences.
Policy and Funding Support
At a federal level, re-investing in the NCIRS and state-territory immunisation programs, ensuring stable funding for outreach initiatives and removing any financial barriers to vaccine delivery will be essential. Policymakers should also consider mandates where appropriate, such as linking certain benefits or school enrolments to up-to-date vaccination status, while safeguarding medical and conscientious exemptions through transparent processes.
Expert Recommendations
Dr Gary Grohmann urges a return to the community-wide momentum seen before the pandemic: “We need to mobilise a surge in immunisation activity. It’s not just about catching up one cohort; we must embed resilience in our system so that routine vaccination is as unmissable as basic schooling.”
Dr Frank Beard, associate director at NCIRS, highlights the importance of ongoing surveillance: “Accurate, real-time data on coverage and outbreak hotspots will guide targeted interventions. We cannot afford to wait for a large outbreak to spur action.”
Conclusion
Australia’s childhood immunisation program has saved countless lives and prevented severe disability for decades. Yet the recent decline in coverage—exacerbated by pandemic disruptions, access challenges and vaccine hesitancy—threatens to reverse these hard-won gains. With herd-immunity thresholds under threat, the risk of resurgent measles, pertussis and other diseases is real and urgent.
A coordinated, well-resourced effort is required to boost vaccine uptake: expanding access through pop-up clinics, re-energising school-based programs, equipping healthcare providers with communication tools, and launching compelling public-education campaigns. Families like the Langoulants remind us that behind every statistic lies a child’s future—and sometimes a lifetime of preventable hardship.
In the words of Dr Grohmann, “Vaccination protects not just individual children, but entire communities. Our collective health depends on every parent choosing to vaccinate.” The time to act is now—to secure the health of Australia’s children today and for generations to come.
