Immunisation and vaccination is an Australia's health topic

Immunisation is a safe and effective way to protect against harmful communicable 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. See Infectious and communicable diseases.

The Australian Government provides free vaccines to eligible people, including young children, older Australians, Aboriginal and Torres Strait Islander 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.

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).

Childhood immunisation coverage

All 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 all the scheduled vaccinations appropriate for their age.

What is meant by ‘fully immunised’?

All 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 2021, the following definitions applied:

  • At 1 year, ‘fully immunised’ included vaccinations for hepatitis B, diphtheria, tetanus, 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).

In 2021, the immunisation coverage rate for all children aged 1 was 94.6%; it was 92.6% for 2-year-olds and 95.0% for 5-year-olds (Figure 1). For Indigenous children in 2021, the national immunisation coverage rates for children aged 1 and 2 were lower than the coverage rates for all children, at 92.4% and 91.4%, respectively. In contrast, the coverage rate for 5-year-old Indigenous children (96.8%) was higher than the coverage rate for all children.

 

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 Aboriginal and Torres Strait Islander children are slightly lower than those for all children at ages 1 and 2, but higher than those for all children at age 5.

 

The immunisation coverage rate for:

  • 1-year-olds remained relatively stable between 2001 and 2012. The slight fall in the rate for 2013 and 2014 may have been due to a change in the definition of ‘fully immunised’. The coverage rate has since increased to almost 95%.
  • 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.
  • 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 available data suggest that the COVID-19 pandemic had little impact on routine childhood vaccination in 2020 and 2021 (NCIRS 2020).

See Health of children.

Adolescent immunisation coverage

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 2020, 80.5% of girls and 77.6% of boys were fully immunised against HPV. Coverage rates among Indigenous adolescents were lower at 75.0% of girls and 68.0% of boys in 2020 (NCIRS 2021).

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 2020, 77% had received their dTpa booster dose and 68% had received the meningococcal vaccine (NCIRS 2021). Coverage rates were lower in 2020 than in 2019, likely due to COVID-19 pandemic-related disruption to school-based programs (NCIRS 2021).

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 renamed following its expansion in 2016. Data on adult vaccination coverage from the AIR were reported for the first time in 2021. The results showed that, in 2020:

  • Zoster (shingles) vaccine coverage among adults aged 70 was 30%.
  • Influenza vaccine coverage was 23% in adults aged 20–49 years, 36% in adults aged 50–64, 64% in adults aged 65–74 and 70% in adults aged 75 and over (NCIRS 2021).

The National Centre for Immunisation Research and Surveillance (NCIRS) suggests that the true coverage rates for the zoster vaccine and for the influenza vaccine in younger adults are likely to be higher than this, due to under-reporting. Although the AIR was expanded in 2016 to allow inclusion of information on adult vaccinations, reporting of these data by vaccination providers was not made mandatory until 2021.

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 to COVID-19 (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, Aboriginal and Torres Strait Islander people aged 55 and over, and people aged 18 and over with disability or an underlying high-risk medical condition. The rollout was 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 is for 2 doses, with a third dose in people who are severely immunocompromised. A booster dose is recommended for people aged 16 and over. For older people, residents of disability or aged care facilities, and people aged 16 and over who are severely immunocompromised, a second booster dose delivered 4 months after the first is now recommended to increase vaccine protection over winter (ATAGI 2022). COVID-19 vaccination status for individuals aged 16 and over is considered ‘up to date’ if they have received a booster dose between 3 and 6 months after completing their primary course.

By the end of April 2022, almost 58 million doses of COVID-19 vaccines had been administered, with 95.5% of Australians aged 16 and over and 80.4% of those aged 12–15 having received 2 doses. Over two-thirds (69.3%) of eligible people had received a third dose. Among children aged 5–11, 52.8% had received their first dose and 36.9% had received 2 doses (Department of Health 2022b).

See also 'Chapter 1 The impact of a new disease: COVID-19 from 2020, 2021 and into 2022’ in Australia’s health 2022 data insights.

Where do I go for more information?

For more information on immunisation and vaccination, see:

Visit Immunisation for more on this topic.

References

AIHW (Australian Institute of Health and Welfare) (2019) The burden of vaccine preventable diseases in Australia, AIHW, Australian Government, accessed 11 February 2022.

ATAGI (Australian Technical Advisory Group on Immunisation) (2022) ATAGI statement on recommendations on a winter booster dose of COVID-19 vaccine, Department of Health website, accessed 22 April 2022.

Department of Health (2022a) Childhood immunisation coverage, Department of Health website, accessed 22 April 2022.

Department of Health (2022b) COVID-19 vaccination daily rollout update – 1 May 2022, Department of Health website, accessed 6 May 2022.

NCIRS (National Centre for Immunisation Research and Surveillance) (2020) COVID-19: Impact on routine childhood vaccination uptake in Australia, NCIRS, accessed 30 March 2022.

NCIRS (2021) Annual immunisation coverage report 2020, NCIRS, accessed 11 February 2022.

O’Brien ED, Sam GA and Mead C (1998) ‘Methodology for measuring Australia's childhood immunisation coverage’, Communicable Diseases Intelligence 22(3):36–37, accessed 30 March 2022.