Vaccine rates are in decline across Australia, leading to record-high infection rates for preventable diseases such as measles, whooping cough, and influenza.

A report by the Australian Medical Association (AMA) called “From Coverage to Concern: A Policy Analysis of Australia’s Immunisation Decline” paints a troubling picture of the state of immunization. Vaccination rates have been steadily falling for people of all ages since 2020, with vaccine coverage in children aged 5 years dropping to 93% this year.

“The report confirmed our suspicions that across all of our immunization programs…we’re seeing a really concerning downturn in participation,” Danielle McMullen, MBBS, president of the AMA and a general practitioner (GP) in Queensland, told Medscape News Australia.

Measles is a very contagious illness that requires a high degree of immunity to reduce the risk for outbreaks and deaths. But vaccination rates in children are falling, and there were 158 cases of measles this year, which is at least 100 more than last year.

“Some areas of Queensland were well below what we need for herd immunity, which means that all it will take is one or two travelers returning home, and we could well have a significant measles outbreak on our hands,” said McMullen. In Queensland’s Gold Coast, for instance, only 76% of 2-year-olds were vaccinated against measles in 2024, which is a significant drop from the 82% coverage recorded in 2021.

“It’s also really disappointing to see…the downturn in HPV [human papillomavirus] vaccination,” said McMullen. “The HPV vaccine was an Australian invention and could turn the tide on cervical cancer and other HPV-related cancers.”

Australia was on track to eliminate HPV-related cervical cancer by 2035. But HPV vaccination rates have dropped 5.5% for girls and 7% for boys since 2020. They are now well below the 90% target rate.

“We are really disappointed by these statistics, and it highlights how urgent the need is for governments and health providers to be working together to combat misinformation, make sure patients have a safe space to discuss their questions, and make sure that we get back to being world leaders in immunization,” said McMullen.

Concerning Statistics

According to the AMA’s report, influenza infection rates have reached their highest level in almost a quarter of a century after the rate of childhood vaccinations fell from 46% to 28% between 2020 and 2024.

There were more than 57,000 cases of whooping cough and almost 176,000 cases of respiratory syncytial virus (RSV) in 2024. These are the highest numbers since 1991 and 2021, respectively. Many cases of RSV are in young children, for whom it is a serious illness.

The COVID vaccine booster is recommended every 6 months for people aged 75 years or older because the disease remains a significant cause of illness and death in this group. But only 32% received a booster in the 6 months before September.

“We’re already seeing hospitals operating beyond their capacity,” said McMullen. “Now is not the time to let more infectious diseases…back into the community.”

Diagnosing the Problem

Australia’s declining vaccination rates result in part from pandemic-related vaccine fatigue. “People are just sick and tired of immunizations and don’t want to think about it anymore,” said McMullen. “With the cost-of-living crisis and the busy world we live in now, people do also find it harder for people to fit in immunizations.

“The COVID pandemic was a once-in-a-lifetime, terrible event…and a lot of people have anger about the pandemic, and this has been taken out on anything to do with public health. That, unfortunately, includes vaccines,” Raina MacIntyre, MBBS, a professor of global biosecurity at the University of New South Wales in Sydney, told Medscape News Australia.

Spreading misinformation about vaccines globally and instantaneously, social media has led to falling immunization rates all over the world, said MacIntyre. “It’s time we started countering that in a more effective way. But unfortunately, that requires tracking of disinformation, and we’re just playing catch-up.”

Finding a Solution

The AMA is calling on the government to boost vaccination rates by giving extra resources to general practices. “GPs have been real stewards of our immunization programs, coordinating the recalls and reminders and chasing up patients who haven’t been immunized,” said McMullen.

Policy changes, including the introduction of pharmacy vaccinations, have made GPs “less sure about whose job is it to be watching who’s been immunized and who hasn’t,” said McMullen. “We would like to see governments support general practice as the core of our national immunization programs and obviously appropriately support them to do that coordinating.”

Australia doesn’t have to reinvent the wheel to lift vaccination rates; the federal government’s Seven-Point Plan, which raised vaccination rates for 1-year-olds from 52% in 1995 to 95% by 2020 by providing financial incentives to GPs and parents, would also be effective today, Rodney Pearce, MBBS, a GP based in South Australia and the chair of the not-for-profit Immunisation Coalition, told Medscape News Australia.

From 1998, GPs received $18.50 for each child who was vaccinated, regardless of whether the vaccines were administered by the GP or another provider. GP clinics also received a bonus payment for hitting vaccine coverage goals across their patient cohorts. This policy provided a financial reward for tracking down and integrating vaccine data and helped fund vaccine fridges and nursing staff, said Pearce.

Between 2008 and 2013, these incentive payments were gradually scrapped. Now, “there’s nothing that rewards everyone to work together and focus on getting vaccination rates up,” said Pearce.

McMullen reported having no relevant financial relationships. Raina MacIntyre reported being on the advisory boards of several vaccine manufacturers, including GSK and Moderna. She recently published a book on vaccine hesitancy called Vaccine Nation. Pearce reported being the chair of the Immunisation Coalition, which receives funding from pharmaceutical companies for its editorially independent podcasts.

Felicity Nelson is a freelance science journalist based in Sydney.