Winning the public’s trust, better access and good data – especially in some communities – are needed to avert big problems, Mark Butler says.
Federal health minister Mark Butler has launched a new National Immunisation Strategy at what he says is “a really critical time” of falling immunisation rates.
“Australia is going to continue to experience increasing and more severe outbreaks, preventable deaths, significant demand on health services and reduced productivity unless action is taken now to increase vaccination coverage and turn around these disturbing trends,” the health minister said.
“Even though our childhood vaccination rates are still world leading, they are trending in exactly the wrong direction and must be turned around.”
Minister Butler launched the strategy for 2025-2030 at the Public Health Association of Australia’s Communicable Diseases and Immunisation Conference in Adelaide today, saying the government expects to invest around $2.4 billion over the next four years in vaccines, communication campaigns, immunisation registry administration, and research.
“The priority for me is addressing the acceptance and access issues around childhood immunisation,” he told delegates.
“I’m also really determined to look at access. I want to understand why families who would otherwise be willing to get a vaccination are not doing it.
“Those two things are probably my priority against a range of other really worthy work that I think will roll out from this strategy over the coming five years.”
The strategy addresses several key areas:
improving access, with a focus on equity for Aboriginal and Torres Strait Islander peoples and other priority groups;
building trust, understanding and acceptance of immunisation in communities;
using data to target strategies and monitor performance;
strengthening the workforce;
harnessing new technologies; and
reforming vaccine program governance, delivery and accountability.
“The decline in childhood vaccination rates across Australia has been steady since 2020,” said Mr Butler.
“The reasons for decline, essentially, are a mix of acceptance issues, concerns around safety vaccine fatigue and reduced confidence in the vaccination system, on the one hand, and access issues that are reported by families.
“Since the pandemic, we’ve seen 15 consecutive quarters of reduced immunisation coverage of Australians under the age of five.
“Most communities now see a vaccination rate below, and in some cases well below, the 95% rate for herd immunity. In some areas of Australia, as few as 75% of children are fully vaccinated against deadly and preventable diseases like measles, diphtheria and polio, substantially increasing the spread of risk of those diseases, particularly in those isolated communities.”
It’s not just us, the minister pointed out – childhood vaccination rates have been declining in over 100 countries, leading to outbreaks of yellow fever, cholera, diphtheria, polio, measles and other illnesses.
And where it is us, it’s not just in areas like Byron Bay in NSW and Margaret River in WA where rates are too low, Mr Butler told delegates.
“It’s another diverse list of communities as well. We’re in the centre of Adelaide. The five-year-old immunisation rate in Adelaide City is just 81% – one of the lowest in the community,” he said.
“You see similar rates in communities as diverse as Bankstown, the Goldfields in the west, outback South Australia and many others besides.
“So it is not an easy task for us to turn around the particularly disturbing rates of immunisation in what is a very diverse range of communities.”
An important part of the strategy was partnering with communities, delivering services in new and specific ways, addressing misinformation and strengthening the knowledge of vaccination providers in communities, he said.
Public trust in vaccines had to be increased, said the minister. And while existing campaigns were well researched, something different needed to be done.
“We think carefully about who we’re trying to target,” he said.
“We thought carefully, for example, when designing the current round of information campaigns about whether we were targeting the dug-in resistors or the people who are on the fence, if you like, and we deliberately went after the people on the fence.
“But, you know, the rates continue to decline.
“So I think it is important that we have a very deep look at the way in which we’re spending hard-earned taxpayer money on communication campaigns and whether it is doing the job in a new environment.
“You know that this is a new environment. The proliferation of rubbish on social media, as you know better than me, is something we just didn’t have to deal with 10 years ago, let alone all of the legacy issues associated with covid.
“I want to look at this afresh. I don’t just want to do what we’ve been doing over the last several years.”
Mr Butler said workforce was an important component in improving equity of access to vaccination.
“We’ll explore opportunities to enable health professionals to work to their full scope of practice,” he said.
“I’ve seen the degree to which access for basic immunisations has been improved by opening up all NIP vaccines to community pharmacies over the last 18 months or so.
“We’re going to strive to harmonise workforce policies, training and accreditation across all states and territories, which have developed very substantially since the covid pandemic,” said Mr Butler.
The state and territory health ministers, with whom he was meeting this week, all endorsed the new national strategy, said Mr Butler. As a group, they often discussed the complications of consistently rolling out vaccination programs around the country, given the structure of the federation, he said.
“As you all know, I am limited in what I can list or provide as part of the NIP. It’s got to be approved by the Pharmaceutical Benefits Advisory Committee. And sometimes that lags behind community desire, including the medical community.
“And sometimes states leap ahead of where PBAC is, and [have] done so, for example, in some areas in providing free flu vaccines for people aged five to 64.
“Queensland and WA jumped ahead on maternal vaccines for RSV, got some extraordinary outcomes … It produced great results that I think bolstered the case for a national maternal vaccine program around Abrysvo.”
Mr Butler highlighted the need for better data to guide actions, noting that reforms made to the Australian Immunisation Register over the past several years had “significantly improved” understanding of where immunisation was taking place.
“We are in the process of building a better data set about what’s happening, and that will continue over the over the course of the five years and guide some of the responses we make,” said Mr Butler.
“For example, before we listed Abrysvo, it was extraordinary to me as the country’s health minister that I had no line of sight of whooping cough vaccination rates among pregnant women.
“Some states were able to report rates that were 2022 rates. Queensland probably had the most up-to-date rates that showed a 10% reduction.
“But there was nothing in the AIR that told me what was happening in that uptake; where there were particular challenges for us to respond to. So, we’ve got to get better data … to guide our response.”
The minister launched the strategy in a plenary session that included three public health experts – Dr Nadia Charania, an associate professor from Auckland University of Technology, Dr Dawn Casey, deputy CEO of the National Aboriginal Community Controlled Health Organisation and Professor James Ward, director of the Poche Centre For Indigenous Health – who presented their insights into advancing equity and access, working with community partnerships and precision public health.
Read the full strategy here.
Find information about the topics discussed at the conference here.
