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We analysed Australian Immunisation Register (AIR) data as at 31 March 2021 for children, adolescents and adults. This is the first time that adolescent and adult coverage data from the AIR have been included in our annual coverage report.
Brynley Hull, Alexandra Hendry, Aditi Dey et al.
This 9th annual immunisation coverage report shows data for 2015 derived from the Australian Childhood Immunisation Register and the National Human Papillomavirus (HPV) Vaccination Program Register. This report includes coverage data for ‘fully immunised’ and by individual vaccines at standard age milestones and timeliness of receipt at earlier ages according to Indigenous status. Overall, ‘fully immunised’ coverage has been mostly stable at the 12- and 24-month age milestones since late 2003, but at 60 months of age, coverage reached its highest ever level of 93% during 2015. As in previous years, coverage for ‘fully immunised’ at 12 and 24 months of age among Indigenous children was 3.4% and 3.3% lower than for non-Indigenous children overall, respectively. In 2015, 77.8% of Australian females aged 15 years had 3 documented doses of HPV vaccine (jurisdictional range 68.0–85.6%), and 86.2% had at least one dose, compared to 73.4% and 82.7%, respectively, in 2014. The differential of on-time vaccination between Indigenous and non-Indigenous children in 2015 diminished progressively from 18.4% for vaccines due at 12 months to 15.7% for those due at 24 months of age. In 2015, the proportion of children whose parents had registered an objection to vaccination was 1.2% at the national level, with large regional variations. This was a marked decrease from 1.8% in 2014 and the lowest rate of registered vaccination objection nationally since 2007 when it was 1.1%. Medical contraindication exemptions for Australia were more than double in 2015 compared with the previous year (635 to 1,401).
Brynley Hull, Alexandra Hendry, Aditi Dey et al.
This eleventh national annual immunisation coverage report focuses on data for the calendar year 2017 derived from the Australian Immunisation Register (AIR) and the National Human Papillomavirus (HPV) Vaccination Program Register. This is the first report to include data on HPV vaccine course completion in Aboriginal and Torres Strait Islander (Indigenous) adolescents. ‘Fully immunised’ vaccination coverage in 2017 increased at the 12-month assessment age reaching 93.8% in December 2017, and at the 60-month assessment age reaching 94.5%. ‘Fully immunised’ coverage at the 24-month assessment age decreased slightly to 89.8% in December 2017, following amendment in December 2016 to require the fourth DTPa vaccine dose at 18 months. ‘Fully immunised’ coverage at 12 and 60 months of age in Indigenous children reached the highest ever recorded levels of 93.2% and 96.9% in December 2017. Catch-up vaccination activity for the second dose of measles-mumps-rubella-containing vaccine was considerably higher in 2017 for Indigenous compared to non-Indigenous adolescents aged 10–19 years (20.3% vs. 6.4%, respectively, of those who had not previously received that dose). In 2017, 80.2% of females and 75.9% of males aged 15 years had received a full course of three doses of human papillomavirus (HPV) vaccine. Of those who received dose one, 79% and 77% respectively of Indigenous girls and boys aged 15 years in 2017 completed three doses, compared to 91% and 90% of non-Indigenous girls and boys, respectively. A separate future report is planned to present adult AIR data and to assess completeness of reporting.
Brynley Hull, Alexandra Hendry, Aditi Dey et al.
Australian Immunisation Register data have been analysed for children aged < 5 years, focusing on changes in coverage at key milestone ages (12, 24 and 60 months) between 2017 and 2018, while also documenting longer term trends. Fully vaccinated coverage increased at the 12- and 60-months milestones to 93.9% and 94.0%, respectively, but, in the context of additional antigens required, decreased to 90.1% at 24 months. Following the move to a two-dose rotavirus vaccine schedule across Australia from mid-2017, rotavirus vaccine coverage increased from 86.8% to 90.9%. In 2018, most jurisdictions funded influenza vaccine for non-Indigenous children aged 6 months to < 5 years; the National Immunisation Program has funded influenza vaccine for Aboriginal and Torres Strait Islander children and medically at-risk children since 2015 and 2010, respectively. Recorded influenza vaccine coverage in Aboriginal and Torres Strait Islander children doubled from 14.9% to 31.4%, and increased fivefold in non-Indigenous children from 5.0% to 25.9% in 2018. The timeliness of fully vaccinated coverage was also examined at earlier milestones (3 months after due date of last scheduled vaccine) of 9, 15, 21 and 51 months, by area of residence. For all children, coverage among those living in the least advantaged residential area quintile was 3–4% lower than that for those in the most advantaged quintile at the 9-, 15- and 21-month milestones. Importantly, although Aboriginal and Torres Strait Islander children had lower coverage for the second dose of measles-mumps-rubella vaccine at 24 months (91.8% versus 93.1% for non-Indigenous), coverage increased to 98.5% at 60 months; coverage was also high in non-Indigenous children at 96.2%, above the 95% target critical to measles control. These data demonstrate continuing improvements in immunisation coverage and suggest potential new coverage targets for earlier protection in the first two years of life.
Brynley Hull, Alexandra Hendry, Aditi Dey et al.
This tenth annual immunisation coverage report shows data for the calendar year 2016 derived from the Australian Immunisation Register (AIR) and the National Human Papillomavirus (HPV) Vaccination Program Register. After a decade of being largely stable at around 90%, ‘fully immunised’ coverage at the 12-month assessment age increased in 2016 to reach 93.7% for the age assessment quarterly data point in December 2016, similar to the 93.4% for the age assessment quarterly data point in December 2016 for 60 months of age. Implementation of the ‘No Jab No Pay’ policy may have contributed to these increases. While ‘fully immunised’ coverage at the 24-month age assessment milestone decreased marginally from 90.8%, in December 2015, to 89.6% for the age assessment quarterly data point in December 2016, this was likely due to the assessment algorithm being amended in December 2016 to include four doses of DTPa vaccine instead of three, following reintroduction of the 18-month booster dose. Among Indigenous children, the gap in coverage assessed at 12 months of age decreased fourfold, from 6.7 percentage points in March 2013 to only 1.7 percentage points lower than non-Indigenous children in December 2016. Since late 2012, ‘fully immunised’ coverage among Indigenous children at 60 months of age has been higher than for non-Indigenous children. Vaccine coverage for the nationally funded seasonal influenza vaccine program for Indigenous children aged 6 months to <5 years, which commenced in 2015, remained suboptimal nationally in 2016 at 11.6%. Changes in MMR coverage in adolescents were evaluated for the first time. Of the 411,157 ten- to nineteen-year-olds who were not recorded as receiving a second dose of MMR vaccine by 31 December 2015, 43,103 (10.5%) of them had received it by the end of 2016. Many of these catch-up doses are likely to have been administered as a result of the introduction on 1 January 2016 of the Australian Government’s ‘No Jab No Pay’ policy. In 2016, 78.6% of girls aged 15 years had three documented doses of HPV vaccine (jurisdictional range 67.8–82.9%), whereas 72.9% of boys (up from 67.1 % in 2015) had received three doses.
Brynley Hull, Alexandra Hendry, Aditi Dey et al.
Australian Immunisation Register data have been analysed for children aged < 5 years, focusing on changes in vaccination coverage at standard age milestones (12, 24 and 60 months) between 2018 and 2019. ‘Fully vaccinated’ coverage in 2019 increased by 0.1–0.4% at the three age milestones to 94.3% at 12 months, 90.2% at 24 months (in the context of additional antigens required at 24 months) and 94.2% at 60 months. Rotavirus vaccine coverage (2 doses) increased from 90.9% in 2018 to 91.9% in 2019. ‘Fully vaccinated’ coverage in Aboriginal and Torres Strait Islander (hereafter respectfully referred to as Indigenous) children increased by 0.5–1.1% in 2019, reaching 92.9% at 12 months, 88.9% at 24 months and 96.9% at the 60 months (2.7 percentage points higher than in children overall). Recorded influenza vaccination coverage in children aged 6 months to < 5 years increased by 11.4 percentage points to 42.7% in Indigenous children in 2019, and by 15.6 percentage points to 41.8% in children overall. Longstanding issues with timeliness of vaccination in Indigenous children persisted, although the disparity between Indigenous and non-Indigenous children in on-time coverage (within 30 days of due date), for vaccines due at 4 months of age, decreased from 10.4–10.7 to 9.6–9.8 percentage points between 2018 and 2019. The timeliness of ‘fully vaccinated’ coverage was also examined at earlier age milestones (3 months after due date of last scheduled vaccine) of 9, 15, 21 and 51 months, by Indigenous status, socioeconomic status and remoteness of area of residence. Coverage in children living in the least-advantaged residential area quintile was 2.6–2.7% lower than that for those living in the most-advantaged quintile at the 9-, 15- and 21-month milestones, although these disparities were 0.5–1.5 percentage points lower than in 2018. Coverage at the earlier milestones in Indigenous children in remote areas was 1.5–6.7% percentage points lower than that for Indigenous children in major cities and regional areas, although there were some improvements since 2018. Importantly, although Indigenous children had lower coverage for the second dose of measles-mumps-rubella vaccine at 24 months (92.7% versus 93.3% overall), coverage increased to 98.8% at 60 months; coverage was also high overall at 96.4%, above the 95% target critical to measles control. In conclusion, this report demonstrates continuing improvements across a range of immunisation indicators in Australia in 2019. However, some issues with timeliness persist, particularly in Indigenous and socioeconomically disadvantaged children. New coverage targets for earlier protection in the first 2 years of life may be indicated, along with a review of current ‘fully vaccinated’ assessment algorithms, particularly at the 60-month age milestone.
Abstract Background Cameroon adopted a single-dose gender-neutral human papillomavirus (HPV) vaccination schedule in January 2023. Girls’ first-dose coverage rose sharply to 68% in 2023 before declining to 36% in 2024 and further to 30% in 2025, representing a net two-year decline of 38 percentage points from the 2023 peak. The central analytical question was what operational, policy, and system factors plausibly account for this trajectory. Methods We conducted a health policy analysis informed by Walt and Gilson’s health policy triangle and a root-cause-to-intervention logic model to address this question and propose an evidence-informed girls-first recovery framework. Primary data were WHO and UNICEF Estimates of National Immunization Coverage (WUENIC) 2025 revision estimates for Cameroon, including HPV first dose and completed series among girls from 2020 to 2025, and coverage for 11 comparator antigens with stable indicator definitions across the 2024 and 2025 revisions. WUENIC Estimate Descriptions and WHO/UNICEF 2025 revision notes were reviewed for documented stockout events and reporting-method context. Results Under the former two-dose schedule, dose-completion attrition was marked: estimated dropout was 76% in 2021 and 70% in 2022. An apparent 2023 supply paradox suggests a plausible role for policy, delivery, and demand-side factors: despite a four-month national and subnational stockout affecting the first and third doses of diphtheria-tetanus-pertussis-containing vaccine, HPV coverage nearly tripled that year. By 2025, all 11 comparator antigens had improved from 2024 while remaining substantially higher than HPV coverage; the HPV-specific coverage gap widened for every comparator antigen assessed. This pattern is consistent with an HPV/adolescent-specific delivery and sustainability barrier rather than general immunisation-system weakness. Conclusions The analysis suggests that renewed recovery may depend on reliable supply, protected school-based delivery, strategic communication, outreach for underserved girls, multi-year faith-sector engagement, and time-limited girls-first prioritisation until enabling conditions for gender-neutral vaccination are restored.
We analysed Australian Immunisation Register (AIR) data, predominantly for National Immunisation Program (NIP) funded vaccines, as at 4 February 2024 for children, adolescents and adults, focusing on the calendar year 2023 and trends from previous years. This report aims to provide comprehensive analysis and interpretation of vaccination coverage data to inform immunisation policy and programs. ChildrenFully vaccinated coverage in Australian children in 2023 was lower than in 2022 at the 12-month (92.8%, down from 93.3%), 24-month (90.8%, down from 91.0%) and 60-month (93.3%, down from 93.4%) age assessment milestones. This follows the 1.1–1.5 percentage point decrease at these three milestones between the 2020 and 2022 reports, which came after eight years of generally increasing coverage. Fully vaccinated coverage in Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) children was also slightly lower in 2023 than in 2022 at the 12-month (89.7%, down from 90.0%), 24-month (87.8%, down from 87.9%) and 60-month (95.0%, down from 95.1%) milestones, following a 1.9–3.3 percentage point decrease between the 2020 and 2022 reports. Due to the lag time involved in assessment, fully vaccinated coverage figures for 2023 predominantly reflect vaccinations due in 2022, when COVID-19 pandemic-related restrictions had largely been removed. Factors contributing to this ongoing decline in coverage in children include a combination of acceptance and access issues. AdolescentsAmong adolescents turning 15 years in 2023, 84.2% of girls and 81.8% of boys (80.9% and 75.0% of Indigenous girls and boys) had received at least one dose of human papillomavirus (HPV) vaccine by their fifteenth birthday, 1.1 and 1.3 percentage points lower than in 2022, respectively (2.1–3.1 percentage points lower for Indigenous adolescents). Coverage of an adolescent dose of meningococcal ACWY vaccine in adolescents turning 17 years in 2023 was 72.8% overall and 62.3% in Indigenous adolescents, 3.1 and 3.3 percentage points lower than in 2022, respectively. These decreases reflect impacts of the pandemic on school-based programs in 2020–2021. To provide an early insight into any immediate impacts on coverage of moving to the NIP single-dose HPV vaccine schedule in 2023 (offered in Year 7 in all jurisdictions), we calculated coverage of at least one dose of HPV vaccine by 31 December in adolescents turning 13 years, with South Australia excluded due to change of delivery from Year 8 in 2022, and found it to be around 3 percentage points lower in 2023 than 2022, and 6 percentage points lower in Indigenous girls, with patterns of diphtheria-tetanus-pertussis vaccination (also single-dose at this age) and HPV vaccination coverage broadly similar. This decrease in vaccinations due in school programs after pandemic restrictions had been removed could be due to impacts of the single-dose HPV transition (i.e. if fewer opportunities for vaccination are provided due to fewer school visits) or may be due to other factors that have changed or disrupted previous school immunisation program operations or reduced parental confidence in vaccination. It is important to promote catch-up vaccination and to monitor renewed efforts to ensure equitable coverage is achieved, particularly given HPV vaccine coverage by 15 years of age in 2023 was 4–8 percentage points lower in adolescents residing in socio-economically disadvantaged and remote areas. AdultsZoster vaccination coverage in adults turning 71 years was 41.0% overall in 2023, down from 41.3% in 2022, and 36.1% in Indigenous adults, down from 36.5%. However, the availability of the new (non-live) protein-based herpes zoster vaccine (Shingrix) from 1 November 2023 has resulted in increased uptake for the larger eligible cohort. Coverage of 13-valent pneumococcal conjugate vaccine (13vPCV) in adults turning 71 years was 37.6% in 2023, up from 33.8% in 2022, and 43.0% in Indigenous adults, up from 37.7%. Coverage of 13vPCV was lower among Indigenous adults turning 50–59 years (17.5%) and 60–69 years (23.4%) in 2023, despite this vaccine being funded under the NIP. Influenza vaccination coverage decreased across all adult age groups in 2023, both overall and in Indigenous adults, with decreases ranging from 5–11 percentage points. ConclusionsThere have continued to be modest but concerning declines in vaccination coverage in children and adolescents relative to pre-pandemic peaks, with decreases greater in Indigenous children and adolescents. Evidence suggests that the factors contributing to these ongoing declines are complex and variable but include both vaccine acceptance and access issues. The picture for adult coverage is more mixed, with coverage increasing for 13vPCV, stable for zoster and decreasing for influenza vaccination, though consistently suboptimal across all vaccines. Ongoing monitoring of vaccination coverage, and further exploration of the reasons underpinning these decreases and suboptimal coverage, are needed to inform approaches to address barriers effectively and to increase vaccine uptake and equity of coverage.
Introduction: Immunisation coverage is a vital strategy adopted by most programs on child survival globally. A robust immunisation coverage program goes a long way in controlling the Vaccine Preventable Disease (VPDs). It is very important to analyse the factors which are detrimental in achieving 100% immunisation among children. Aim: To find the extent of immunisation coverage and to identify the factors for failure of immunisation among children in the rural field practice area of Mysore Medical College & Research Institute, Mysuru. Materials and Methods: A cross-sectional was carried out from November 2019 to January 2020 on children between 0-2 years of age using the World Health Organisation (WHO) thirty clusters sampling method. The sample size was estimated to be 210. Identification of clusters was done as per the WHO manual on 30×7 cluster survey. Interview was conducted using a structured interview format in selected households with study subjects. Data was entered in Microsoft Excel sheet and analysed using chi-square test. Statistical Package for Social Sciences(SPSS) software version 23.0 was used for analysis of data. Results: Among the study participants, 131 (86%) were fully immunised and 29 (14%) were partially immunised (those who did not receive all the due vaccines till two years of age). Religion, educational status of parents and the presence or absence of immunisation card had significant (p-values=0.01, <0.05, <0.05 respectively) association with the immunisation status. The main reasons for partial immunisation were: parents being unaware of the need for returning for subsequent doses 13 (44.8%), fear of side-effects 12 (41.3%), and vaccine not being available 7 (24.1%). Coverage of all individual vaccines among the children (0-2 years) were mostly above 199 (95%). Conclusion: This study observed higher immunisation coverage as compared to that of the national immunisation coverage of 62%. In spite of efforts to increase the immunisation coverage in the country there are regional differences in the extent of this coverage which points to the need for better strategies to tackle this problem.
Harshini Suresh, Mansoor Ahmed
We analysed Australian Immunisation Register (AIR) data for children, adolescents and adults as at 2 February 2025, concentrating primarily on National Immunisation Program (NIP)–funded vaccines. Our focus was on the calendar year 2024 and trends from previous years. This report provides comprehensive analyses and interpretation of vaccination coverage data to inform immunisation policy and programs in Australia. Along with the results outlined below, the report also includes a range of other data for vaccines given across the lifespan, including data on timeliness and vaccination provider settings. Population overall Children Fully vaccinated coverage decreased between 2023 and 2024 at all three standard age milestones: 12 months (from 92.8% to 91.6%); 24 months (from 90.8% to 89.4%); and 60 months (from 93.3% to 92.7%). This follows the 1.2–2.0 percentage point decrease in vaccination coverage uptake at these three milestones between the 2020 and 2023 reports. A combination of acceptance and access factors have contributed to this ongoing decline. Adolescents Coverage of a dose of HPV vaccine by the fifteenth birthday decreased in 2024 to 81.1% in girls and 77.9% boys; these values were 3.1 and 3.9 percentage points lower, respectively, than in 2023 and 5.5 and 7.0 percentage points lower than in 2020. In girls and boys turning 15 years of age in 2024, respectively 83.4% and 80.9% had received an adolescent dose of diphtheria-tetanus-pertussis vaccine by 31 December 2024. Overall, 68.5% of girls and 64.4% of boys turning 16 years of age in 2024 had received an adolescent dose of meningococcal ACWY vaccine by 31 December 2024. Adults Zoster vaccination coverage (one dose of Zostavax or two doses of Shingrix given at least 4 weeks apart) was 45.9% for adults aged ≥ 65 years in 2024. Coverage of an adult dose of 13vPCV was 38.6% for adults turning 71 years of age in 2024, which was 1.0 percentage point higher than in 2023; and 41.5% for adults aged ≥ 70 years, which was 6.9 percentage points higher than in 2023. Influenza vaccination coverage decreased in 2024 across all adult age groups. Aboriginal and Torres Strait Islander peoples Children Fully vaccinated coverage for Aboriginal and Torres Strait Islander children decreased between 2023 and 2024 at all three age milestones: 12 months (from 89.7% to 89.2%), 24 months (from 87.8% to 86.7%) and 60 months (from 95.0% to 94.4%), following a 2.0–3.4 percentage point decrease between the 2020 and 2023 reports. However, coverage of meningococcal B vaccine, which was introduced onto the NIP for all Aboriginal and Torres Strait Islander children in July 2020, was higher in 2024 than 2023: namely, 83.0% versus 81.0% for the first dose; 80.9% versus 80.0% for the second dose; and 75.0% versus 71.7% for the third dose. Adolescents Coverage of a dose of HPV vaccine by the fifteenth birthday decreased in 2024 in Aboriginal and Torres Strait Islander adolescents to 76.7% for girls and 69.2% for boys; these values were 4.2 and 5.8 percentage points lower, respectively, than in 2023 and 11.1 and 13.8 percentage points lower than in 2020. In Aboriginal and Torres Strait Islander girls and boys turning 15 years of age in 2024, respectively 79.3% and 73.0% had received an adolescent dose of diphtheria-tetanus-pertussis vaccine by 31 December 2024. Coverage of an adolescent dose of meningococcal ACWY vaccine received by 31 December 2024 in Aboriginal and Torres Strait Islander adolescents turning 16 years of age in 2024 was 52.7% for girls and 47.1% for boys. Adults Zoster vaccination coverage (one dose of Zostavax or two doses of Shingrix given at least 4 weeks apart) was 42.2% for Aboriginal and Torres Strait Islander adults aged ≥ 65 years in 2024. Coverage of an adult dose of 13vPCV was 48.7% for Aboriginal and Torres Strait Islander adults turning 71 years of age in 2024, which was 5.7 percentage points higher than in 2023, and 47.8% for those aged ≥ 70 years, which was 8.1 percentage points higher than in 2023. However, it was only 23.2% for those aged 50–69 years. Influenza vaccination coverage decreased in 2024 across all Aboriginal and Torres Strait Islander adult age groups. Conclusions There have been concerning and persistent downward trends in childhood and adolescent vaccination coverage in Australia since 2020, with further declines in 2024. The picture for adult coverage is more mixed, but consistently suboptimal across all vaccines. National surveys of parents of young children and adults have identified a range of access and acceptance barriers that may be contributing to observed declines in coverage. More research is needed to delineate contributory factors, particularly among adolescents and Aboriginal and Torres Strait Islander peoples. This can then be used to inform evidence-based and culturally appropriate strategies to increase vaccine uptake and coverage equity. The National Immunisation Strategy for Australia 2025–2030 provides a comprehensive framework to guide such measures and improve coverage – and hence the protection provided by vaccine programs – against disease.
Brynley Hull, Alexandra Hendry, Aditi Dey et al.
Tambe Elvis Akem, Nnam Immaculate Muhzong
Brynley Hull, Alexandra Hendry, Kristine Macartney et al.
Brynley Hull, Alexandra Hendry, Kristine Macartney et al.
