‘Concerning’ decline in child vaccination coverage

Jolyon Attwooll

14/12/2023 4:10:22 PM

The reasons behind the downward trend, which has been seen since the pandemic began, need to be closely monitored according to immunisation experts.

Child being vaccinated
Immunisation experts have said that deteriorating access may be contributing to a fall in coverage.

Child vaccination coverage in Australia has continued to decline, a new report from the National Centre for Immunisation Research and Surveillance (NCIRS) has found.
The NCIRS Annual Immunisation Coverage Report 2022 noted that the rates in Australia remained relatively high in global terms and said the ‘modest’ decrease was likely due to the effects of COVID-19.
Associate Professor Frank Beard, an Associate Director at NCIRS who used to work as a GP, described the study as ‘the first comprehensive stocktake of the ongoing impact of the pandemic on vaccination coverage’.
‘Importantly, it highlights a concerning downward trend in fully vaccinated coverage in children,’ he said.
From 2021 to 2022, coverage fell for each of the age milestones, from 94.2% to 93.3% of children fully vaccinated at 12 months, 92.1% to 91% at 24 months and 94% to 93.4% at 60 months.
According to the report, the decrease in coverage was sharper in Aboriginal and Torres Strait Islander children and adolescents, with authors saying vaccination timeliness is ‘an ongoing issue exacerbated by the pandemic’.
‘Limited evidence suggests the lower coverage in children and adolescents is due to a combination of acceptance and access factors,’ they wrote.  
Australia’s immunisation coverage target stands at 95%.
In 2021, record rates of childhood immunisation were registered in the first part of that year, taking the coverage rate for five-year-old children to of 95.22%.
The NCIRS said improving scheduled and catch-up vaccinations is key to getting back to that target.
‘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,’ Associate Professor Beard said.  
The NCIRS said more investigation is also required to understand barriers to vaccine uptake, which are likely to include access and hesitancy.
‘Particularly given the evidence that these modest declines in coverage have continued into the first half of 2023, further exploration is needed to better understand these factors and inform approaches to effectively address barriers and increase vaccine uptake,’ the report said.
Authors also note an increase in adult coverage in 2022 – which it says is likely in part to be due to new mandatory reporting to the Australian Immunisation Register (AIR) resulting in more accurate estimates – but its authors describe this rate as ‘suboptimal’.
Coverage for a dose of the influenza vaccine and an adult dose of 13vPCV in the past 12 months stood at 31.3% overall for adults turning 71 in 2022, 9.8 percentage points more than in 2021.
For Aboriginal and Torres Strait Islander adults of the same age it was 33.6% in 2022, 12.3 percentage points higher than for the previous year.
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Dr Simon Holliday   17/12/2023 12:05:45 PM

I suspect the fragmentation of care has a lot to do with this decline.

In our country town, the midwife clinic assumes they will take over all antenatal care. The state public system then funnels the newborns into the community health centre vaccination and newborn clinics. Often our initial GP consult with the baby is many months down the track at a time when the baby is acutely unwell.

Many pharmacies are also providing childhood vaccines. I hope that doesn't work like the COVID vaccination programme.

I emailed a pharmacist this week who had provided three COVID vaccines to a patient. One was within two months of a COVID infection and both the others had not allowed 6 months to pass since the previous one. (The patient's most recent shot had been 6 weeks early thus denying him prompt access to the XBB.15 option).

Another driver may result from how younger people are spending much time on social media. Here click-bait rules and so anti-vax messages reinforce each other.