Immunisation and vaccination is an Australia's health topic

Immunisation is a safe and effective way to protect against harmful infectious diseases and, at the population level, prevent the spread of these diseases among the community. Several vaccine-preventable diseases, such as measles, rubella and diphtheria, are now rare in Australia as a result of Australia’s high immunisation rates.

The Australian Government provides free vaccines to eligible people, including young children, older Australians, Aboriginal and Torres Strait Islander (First Nations) people, and others who are at greater risk of serious harm from vaccine-preventable diseases, such as pregnant women. Additional vaccines may also be funded through state and territory programs, through the workplace or bought privately by prescription.

It is important to maintain high immunisation coverage rates to ensure that these diseases cannot spread through the community.

For more information, see Infectious and communicable diseases.

The impact of vaccination in Australia

The Burden of Vaccine Preventable Diseases in Australia study estimated the immediate and future burden (including premature death) of newly diagnosed cases of diseases for which vaccines are provided under the National Immunisation Program. It found that the rate of burden had decreased by nearly one-third between 2005 and 2015. The decrease was driven by falls for diseases for which vaccines had been introduced in the previous 20 years, such as human papillomavirus (HPV), pneumococcal disease and rotavirus. The rate of burden decreased considerably among infants, children, and adolescents and young adults – age groups which are the focus of national and state and territory vaccination programs (AIHW 2019).

Some vaccines may also have effects beyond the immediate and future burden of diseases for which vaccines are provided, including protective and therapeutic effects against post-acute infection conditions (Byambasuren et al. 2023).

Childhood immunisation coverage

Australian children are recommended to have received specific immunisations by a certain age according to the National Immunisation Program Schedule. Fully immunised status is measured at ages 1, 2 and 5 and means that a child has received certain specific vaccine or antigen (component of vaccine) doses appropriate for their age.

What is meant by ‘fully immunised’?

Australian children are expected to have received specific immunisations by a certain age according to recommendations in the National Immunisation Program Schedule to ensure that children have maximum protection if they come into contact with harmful viruses and bacteria.

The specific vaccines included in the definition of ‘fully immunised’ may change from time to time as the recommendations under the National Immunisation Program change, or new vaccines are introduced. In 2023, the following definitions applied:

  • At 1 year, ‘fully immunised’ included vaccinations for hepatitis B, diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b (Hib) and pneumococcal disease.
  • At 2 years, it included vaccinations for meningococcal disease, measles, mumps, rubella, pneumococcal disease, Hib, chickenpox, diphtheria, tetanus and whooping cough. 
  • At 5 years, it included vaccinations for diphtheria, tetanus, whooping cough and polio.

Details of how coverage rates are calculated are provided in O’Brien et al. (1998).

The immunisation coverage rate for:

  • 1-year-olds remained relatively stable between 2001 and 2012. The slight fall in rates in 2013 and 2014 may have been due to a change in the definition of ‘fully immunised’. The coverage rate has steadily increased from 92.3% in 2015 to 94.6% 2021, before slightly declining to 93.8% in 2022. The slight decline in the rate for 2022 may reflect the impact of COVID-19 on routine childhood vaccination.
  • 2-year-olds increased markedly from 1999 to 2004 and remained relatively stable above 90% until 2013. Changes in the definition of ‘fully immunised’, made in 2014, may have contributed to the drop in 2015, which has now recovered. Despite the significant impact of COVID-19, we have only seen a slight decrease in the rate from 92.6% in 2021 to 92% in 2022.
  • 5-year-olds increased from 74.4% in 2005 to 95.0% in 2021. Children who have had catch-up immunisations are included as ‘fully immunised’ even if they were not fully immunised when they were aged 1 or 2. The coverage rate has slightly decreased from 95% in 2021 to 94.3% in 2022.

For First Nations children in 2022, the national immunisation coverage rates for children aged 1 and 2 were lower than the coverage rates for other Australian children, at 91.1% and 89.1%, respectively, compared with 94.0% and 92.2% (Figure 1). In contrast, the coverage rate for 5-year-old First Nations children (96.1%) was higher than the coverage rate for other Australian children (94.1%). Vaccine coverage rates declined notably in 2022 compared with 2021 among First Nations children aged 1 and 2. For First Nations children aged 1, vaccine coverage declined by 1.3% during this period, compared with 0.8% for other Australian children. For First Nations children aged 2, vaccine coverage declined by 2.3%, whereas it decreased by 0.5% for other Australian children during the same period (AIHW & NIAA 2024).

Figure 1: Childhood immunisation coverage rates by Indigenous status for children aged 1, 2 and 5, 1999 to 2022

The chart shows the percentage of children that are fully immunised has improved over time, and has remained relatively stable above 90%. A national immunisation target has been set at 95% of all children to be fully immunised. Coverage rates for First Nations children are slightly lower than those for all children at ages 1 and 2, but higher than those for all children at age 5.

 For more information, see Health of children.

Adolescent immunisation coverage

HPV is a common viral infection that is sexually transmitted. HPV can cause cancers in both men and women, particularly cancer of the cervix (in females), other anogenital cancers and certain cancers of the mouth and throat (in both males and females). A national HPV vaccination program (using the quadrivalent HPV vaccine, which protects against 4 types of HPV) was introduced for school-aged girls in 2007 and extended to boys in 2013. A new vaccine was introduced in 2018, protecting against 9 types of HPV. Among young people turning 15 in 2022, 85.3% of girls and 83.1% of boys had received at least one dose of HPV vaccine before their 15th birthday. Coverage rates among First Nations adolescents were lower, with 83.0% of girls and 78.1% of boys having received at least one dose of HPV vaccine before their 15th birthday in 2022 (NCIRS 2023).

Adolescent HPV vaccination is administered by state and territory health services through school vaccination programs, which also include vaccinations for diphtheria, tetanus and whooping cough (dTpa) and meningococcal disease (types ACWY). Among young people turning 15 in 2022, 86.9% had received an adolescent dTpa dose (NCIRS 2023). Coverage rates for First Nations adolescents were lower at 82.6%. In 2022, 75.9% of all adolescents compared with 65.6% of First Nations adolescents turning 17 years had received a dose of meningococcal ACWY vaccine (NCIRS 2023). 

Coverage rates for HPV vaccination were slightly lower in 2022 than in 2021 for all adolescents, which is likely due to nation-wide COVID-19 pandemic-related disruption to school-based programs. However, among First Nations adolescents, pandemic-related disruptions have resulted in notable declines in HPV vaccination coverage (HPV vaccination coverage declined by over 3% for First Nations girls and 2.5% for First Nations boys during this period) (NCIRS 2023). 

For more information, see Health of young people.

Adult vaccination

Until recently there has been no regular and nationally consistent source of data with which to estimate vaccination coverage in adolescents and adults. Population surveys have previously been used to estimate vaccination coverage in the adult population or in selected population groups. In 2009, the Adult Vaccination Survey estimated that 3 in 4 (75%) Australians aged 65 and over were vaccinated against influenza. The same survey showed that pneumococcal vaccine coverage among people aged 65 and over was 54% (AIHW 2011).

The Australian Immunisation Register (AIR) is a national register that details all funded vaccinations and most privately purchased vaccines given to individuals of all ages who live in Australia. It was set up in 1996 as the Australian Childhood Immunisation Register and was renamed following its expansion in 2016 to cover all vaccinations. It is mandatory for vaccination providers to report all COVID-19, influenza, National Immunisation Program (NIP) and Japanese encephalitis virus vaccinations to the AIR (Department of Health and Aged Care 2024). 

Data on adult vaccination coverage from the AIR showed that:

  • Zoster (shingles) vaccine coverage among adults aged 70 increased from 38.7% in 2021 to 41.3% in 2022. Zoster vaccine coverage for First Nations adults aged 70 increased from 32.9% in 2021 to 36.5% over the same period. 
  • 13-valent pneumococcal conjugate vaccine (13vPCV) for pneumococcal disease coverage rose from 23.9% in 2021 to 33.8% in 2022. 13vPCV coverage in First Nations adults increased from 25.1% in 2021 to 37.7% in 2022.
  • Influenza vaccine coverage in adults aged 20–49 years increased from 23.9% in 2021 to 30.5% in 2022. It increased from 38.2% in 2021 to 46.8% in 2022 in adults aged 50–64, from 62.1% to 67.5% in adults aged 65–74, and from 68.5% to 73% in adults aged 75 and over (NCIRS 2023).

The COVID-19 vaccination program

On 22 February 2021, Australia began a staged rollout of COVID-19 vaccines, beginning with priority groups at greatest risk of exposure (quarantine and border workers, frontline health care workers, and aged care and disability staff and residents). This was extended on 22 March 2021 to other adults at high risk of exposure and/or severe disease, including other health care workers, critical and high-risk workers (such as police, emergency services and meat processing workers), people aged 70 and over, First Nations people aged 55 and over, and people aged 18 and over with disability or an underlying high-risk medical condition. The rollout was later extended to include other adults and then teenagers. Children aged 5–11 became eligible for a smaller dose of the vaccine on 10 January 2022. 

The primary course was initially 2 doses, with a third dose in people who were considered severely immunocompromised. A booster dose was recommended for people aged 16 and over. For older people, residents of disability or aged care facilities, and people aged 16 and over who were severely immunocompromised, a second booster dose delivered 4 months after the first was recommended to increase vaccine protection over winter (ATAGI 2022). A COVID-19 vaccination status for individuals aged 16 and over was initially displayed on an individual’s immunisation history statement. This status was removed in 2023 as the vaccine rollout progressed. By February 2023, over 95% of Australians aged 16 and over had received at least 2 doses and more than 70% had received 3 doses. About 45% of the eligible population (aged 30 over) had received a fourth dose (Department of Health and Aged Care 2023a).

The 2023 COVID-19 Booster program formally commenced on 20 February 2023, in accordance with latest policy advice from the Australian Technical Advisory Group on Immunisation (ATAGI). The program counts the number of vaccine doses administered to individuals aged 18 years and over who have received their third or higher dose in sequence in 2023 (Department of Health and Aged Care 2023b). Between October 2023 and March 2024, 36% of Australians over 75 years of age (over 687,000 individuals), and 21% of individuals aged 65 to 74 years (over 519,000 individuals) received a 2023 Booster dose (Department of Health and Aged Care 2023b).

For more information, see COVID-19 and Australia’s health 2022: data insights article The impact of a new disease: COVID-19 from 2020, 2021 and into 2022.

Where do I go for more information?

For more information on immunisation and vaccination, see:

For more on this topic, see Immunisation.