Updated vaccines, falling coverage and rising mistrust put primary care at the centre of Australia’s 2026 respiratory response.
General practitioners have been called on to help actively drive vaccine uptake as Australia heads into a winter season that experts say remains inherently unpredictable despite currently subdued case numbers.
At a national respiratory briefing, Dr Masha Somi, Professor Patrick Reading and Professor Kristine Macartney outlined a cautiously optimistic start to 2026 but stressed that low early-season case numbers should not be mistaken for reduced risk.
Dr Somi, acting deputy director-general of the Australian Centre for Disease Control, said surveillance systems did not pick up untested cases and relied on multiple data streams to build a national picture.
She said the ACDC’s National Notifiable Disease Surveillance System’s numbers were “unlikely representation of the level of infection in the community”.
“These are the numbers that are reported to us into the system,” she said.
“They don’t include people who might have an infection but don’t get tested, or those who test themselves with rapid antigen tests.
“So that’s why we use a number of respiratory infection surveillance systems, including community symptom surveys, to provide a comprehensive analysis through our respiratory surveillance report.
As of 4 May more than 31,000 covid cases have been reported to the NNDSS – about half of the number seen at the same time in 2025.
The highest notification rates have been in children aged four years and under and older people aged 75 years and over, and notifications were currently gradually decreasing nationally, Ms Somi said.
More than 29,300 influenza cases have been reported to the NNDSS for the same period – about half of the numbers seen at the same time in 2025.
“In 2025 there was a high rate of influenza, and actually we had the highest number of recorded notifications into the NNDSS since keeping records began in 1991,” Dr Somi told the briefing.
The highest notification rates for influenza in 2026 so far have been in children aged nine years and under and in adults aged 75 years and over.
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For RSV close to 34,600 cases have been reported to the NNDSS so far in 2026 – about 16% lower than the numbers seen at the same time in 2025. Notification rates are highest in children aged four years and under, followed by adults aged 75 years and older.
“Notifications are currently decreasing slightly, after a steady increase through February and March nationally,” Dr Somi said.
“RSV notifications in recent times are interesting, and we’ve been watching closely, and that’s because the RSV vaccine was added to the national immunisation program early last year, and this is to protect babies before they can be vaccinated themselves.
“Also, states and territories funded monoclonal antibodies for these infants. At the same time, we’ve seen a marked drop in RSV cases among infants. For example, reported RSV numbers for kids under eight months halved between 2024 and 2025.
“There is an evaluation underway on the impact of the mother and infant programs, and that will give us a good understanding of the role that the two programs have played.
“We do know, however, that maternal immunisation reduces the risk of severe RSV disease in infants by around 70% so it’s likely that the addition of the vaccine to the national program and the monoclonal antibodies to state programs have had something to do with the reductions that we’re seeing.”
For clinicians, the message was to act early rather than react when winter sets in and cases start to rise.
Professor Macartney, director of the Australian National Centre for Immunisation Research and Surveillance and Professor of Paediatrics and Child Health at the University of Sydney said vaccination should be framed clearly to patients as an annual booster that maintains protection against evolving strains.
She emphasised that protection was meaningful even in years of imperfect strain matching, with vaccines typically reducing hospitalisation risk by around half.
“You can halve your chance of being hospitalised for influenza by having a vaccine,” she said.
Despite this, uptake remains suboptimal. Coverage among older adults has plateaued at just over 60%, while only one in four young children are vaccinated against influenza.
“We would like to see it higher,” Professor Macartney said.
The introduction of a nasal influenza vaccine for children is expected to improve uptake in younger cohorts.
Professor Macartney noted the nasal spray was registered in Australia for use from ages two years and above up to 18 years.
“It’s the first time that this vaccine has been available in Australia, but the vaccine has been used for decades in the US, in Canada, in the UK, and in fact, it is the backbone of a very comprehensive all child influenza program in the UK,” she said.
“So there’s been tremendous learning about its effectiveness, its impact on transmission, and indeed, safety, very safe vaccine from decades of use.
“It’s just that it took a long time to get a southern hemisphere formulation manufacturers.”
From a virology standpoint, Professor Reading, director of the WHO Collaborating Centre for Reference and Research on Influenza, Doherty Institute, said this year’s vaccine had been updated to better match circulating strains, with changes to both H1N1 and H3N2 components following a prolonged and atypical 2025 season.
“We had a long, extended 2025 season, the highest number of deaths, the highest number of cases,” he said.
He said that while early global data showed moderate vaccine effectiveness even against emerging variants, the 2026 formulation was now “a better match for the circulating viruses that we’re expecting this winter”.
Still, he cautioned against overconfidence in forecasting.
“We cannot predict the severity, or which virus or viruses will predominate in the upcoming influenza season,” Professor Reading said.
“We kind of have to wait and watch. Influenza vaccines are the best way to reduce the likelihood of hospitalisation.”
Within that uncertainty, the emphasis returns to prevention, particularly for high-risk groups including older adults, young children, pregnant women and those with chronic conditions.
The concept of boosters extends beyond influenza alone, but Professor Macartney clarified that for flu, the annual vaccine is itself the booster, with additional doses recommended only in specific situations such as pregnancy or travel to the Northern Hemisphere.
Across all speakers, the role of general practice was framed as both clinical and communicative, delivering vaccines while also shaping patient perceptions.
“Vaccination is the most effective way to reduce the impact of respiratory infections,” Dr Somi said.
With influenza activity expected to rise in the coming weeks, the consensus message to GPs is to act now: identify eligible patients, initiate recalls, and reinforce booster messaging before the seasonal peak arrives.
“GPs are a critical part of our health system,” Professor Macartney said.
“They’re incredibly across their patients and their communities.”
