Australia's childhood vaccination rates are declining, sparking fears about risk to herd immunity

By Alison Branley, ABC

Vaccination rates among children and teens have reached "critical" levels, according to experts, who are warning deaths are inevitable if Australia does not do more to turn around a steady decline in immunisation rates.

Figures from the National Centre for Immunisation Research and Surveillance (NCIRS), released on Thursday, show a widespread decline in immunisations for a range of illnesses over the past five years.

In some cases, rates are now below the threshold required to ensure herd immunity.

The data includes vaccines for a wide range of diseases, including whooping cough, diphtheria, tetanus, rotavirus, pneumococcal, polio, hepatitis B, four types of meningococcal, measles, mumps and rubella, as well as the human papillomavirus (HPV) vaccine for teens.

Gary Grohmann, director of the Immunisation Coalition and former consultant to the World Health Organisation, described the figures as "absolutely alarming".

The figures show the proportion of children up-to-date with their immunisations by the age of 12 months had fallen from 94.8 percent to 91.6 percent since 2020.

The percentage of those fully vaccinated by age two was down from 92.1 percent to 89.4 percent in the same time frame, and those who had received all required immunisations for age five fell from 94.8 percent to 92.7 percent.

The most concerning falls were among teens where uptake of the HPV vaccine - which helps protect against cervical cancer in girls and other genital cancers in boys - has dropped from 84.9 percent to 77.9 percent among boys and from 86.6 percent to 81.1 percent among girls in five years.

"When you look at the adolescent data where it's dropping well below 80 percent that is really concerning," Dr Grohmann said.

"If you're starting to get into the 80 percent [range], then it really is getting critical. We know as virologists, microbiologists, that we do need about 95 percent of the whole population vaccinated."

Dr Grohmann was most concerned about parts of Australia where recent data revealed as few as 75 percent of two-year-olds have had their required vaccinations.

"We will see further spread of disease, particularly measles," he said.

"It is a numbers game. There will be more hospitalisations. And although we have really good medical care in Australia, it could be that children will die of measles or get serious disease.

"It means basically that disease spread will increase and unfortunately hospitalisations and possibly deaths to viruses like measles might also occur."

The numbers have put Australia's vaccination program back to levels not seen since 2014, said Frank Beard, an associate director at the NCIRS which collated the figures.

He told the ABC the drop in vaccinations undid work to boost rates that saw measles almost eliminated nationally prior to the pandemic.

"It is definitely a concern that there's a decreasing trend since the pandemic," Dr Beard said.

"Herd protection is always a concern, and particularly for diseases like measles."

'This is Ash's legacy'

Bruce and Ashley Langoulant have firsthand experience of the impacts of a vaccine-preventable disease.

Ashley, now 35, was just six months old when she came down with meningitis brought on by pneumococcal infection.

Langoulant said even though it happened in 1989, he still vividly remembers rushing his baby daughter to the emergency room with seizures, a fever and a raised fontanelle.

"She was almost lifeless," he said.

His little girl rapidly declined over the next 24 hours.

She survived but with profound intellectual and physical disability.

She has cerebral palsy, epilepsy and she is deaf, non-verbal and uses a wheelchair.

"I don't even know if she knows we're her parents," Langoulant said.

When Ashley was born, there was no vaccine yet for pneumococcal.

In the early 2000s when one was developed, Langoulant, as chair of the Meningitis Centre Australia, was crucial to getting it listed on the National Immunisation Program.

He's at a loss as to why parents would not take up a free vaccine.

"Ash was the unvaccinated child. We didn't have a choice and we're still living it 35 years later," he said.

"Ash is in a wheelchair because she got a bacterial infection which is vaccine-preventable.

"This is what happens if you don't vaccinate."

For the Langoulant family, Ash's experience is her legacy to the world.

"She has this natural presence which is a gift," Langoulant said.

Call for catch-up pop-up clinics

Dr Grohman and Dr Beard both said more widespread public health measures seen during the pandemic, such as vaccine clinics, mobile and pop-up clinics and after-hours clinics, were needed to help increase vaccine uptake.

The National Vaccination Insights project run in collaboration with NCIRS found that for about one in 10 patients, the cost of medical appointments was a barrier to getting vaccines, and just getting an appointment on time was a barrier for a similar number.

A survey of 2000 people found about six in 10 people said a hurdle for them was "feeling distressed" when thinking about vaccinating their child.

General distrust of vaccines and health information continued to be barriers, as well.

Of those parents with unvaccinated children, 46.7 percent would "not feel guilty" if their child got sick with a vaccine-preventable disease and 47.9 percent do not believe vaccines are safe for a child.

"Vaccination coverage is heading in the wrong direction, and so to turn it around, we need to have a range of strategies to improve it," Dr Beard said.

Dr Grohmann said medical professionals had a key role to play in educating patients, particularly as more people got more medical information online and the misinformation became widespread.

"It's really important that they get the message that vaccination is really important and protects the whole community. And most importantly, they're effective and safe," he said.

Dr Beard said the decrease in teens getting vaccinated for HPV was also driven by a rise in school avoidance after the pandemic.

"Adolescent vaccination is predominantly conducted in school settings and we know that school attendance has still been lower than it was before the pandemic," he said.

- This story was first published by the ABC.