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The latest drop in childhood immunisation rates has raised concerns among medical authorities that some communities are losing herd immunity to diseases such as measles. By Kristina Kukolja.
The rising risks of vaccine reluctance
Australian medical authorities say disturbing evidence is emerging of a possible return of previously eliminated diseases, as childhood immunisation rates continue to fall. In many parts of the country, they are now below “herd immunity” levels.
The federal government says families are increasingly choosing to forgo thousands of dollars a year under the Family Tax Benefit rather than have their children immunised.
The proportion of children covered by this payment who did not meet immunisation requirements has increased from about 3.8 per cent in 2019 to 4.4 per cent in 2025.
The Australian Medical Association cites ongoing measles outbreaks in Queensland – some with community transmission confirmed – as a warning that this highly contagious and potentially fatal disease could become endemic in certain regions; that is, regularly returning and spreading.
“If you get down below about the 95 per cent coverage rate, the cracks of herd immunity begin to show,” warns AMA president Dr Danielle McMullen.
Minister for Health, Disability and Ageing Mark Butler has described the fall in childhood immunisation rates as “alarming”. Last month, he said the government is concerned they “are starting to drop below herd immunity levels, particularly for very serious conditions like measles”. At about 120, he said, the number of measles cases recorded in Australia this year is “larger … than any time since the [Covid] pandemic”.
More than a decade ago, the World Health Organization (WHO) declared Australia free of endemic measles. While cases would occur every year, usually brought in by travellers, “immunisation got us to the point where measles wasn’t able to spread”, McMullen says. The scale of the Queensland outbreak, she says, “is making us worried about whether that’s still the case in all communities”. McMullen notes that cases have also been recorded in Western Australia, New South Wales and Victoria.
If childhood immunisation rates continue to fall, she adds, herd immunity against other serious diseases, such as mumps, rubella, whooping cough and meningitis, could be lost.
If that were to occur, cases would likely show up in pockets first, “certainly in areas with low immunisation rates”, McMullen says. “If more of those combined, suddenly we are in a situation where some of these illnesses are not prevented across the country.
“Our focus needs to be on how we turn the tide.”
Australia’s childhood immunisation rates also worry 72-year-old Gary Newton. He has lived with permanent paralysis in his legs since contracting polio as a 15-month-old baby in 1954, decades before vaccines eradicated the disease here.
“I’ve had polio all my life. I know the struggles that have come with growing up with polio,” Newton says. “It’s horrendous.”
He says the risks of an anti-vaccination trend must be taken seriously.
“The door is open – how far we want to push it open remains in the hands of the public and whether they want to see that level of bad health again.”
Much of the public loss in confidence in immunisation is blamed on “vaccine fatigue”, reflecting global reactions to pandemic-era public health measures.
This year’s Australian Immunisation Register data shows that less than 92 per cent of children in Australia are “fully immunised” by the age of one, down three percentage points from 2020. For two-year-olds the rate has dropped below 90 per cent. Both groups saw the largest drops in coverage.
Last year, according to data from the National Centre for Immunisation Research and Surveillance (NCIRS), one in three children received the first dose of the measles-mumps-rubella vaccine late. One in five were late getting the second dose of the whooping cough vaccine.
“Prior to 2020, immunisation coverage at all of our standard milestones for young children were steadily increasing for about eight years, getting up close to our target of 95 per cent,” recalls Associate Professor Frank Beard, the associate director of coverage, evaluation and surveillance at the NCIRS.
“The Covid-19 pandemic was very disruptive,” say Beard. “Even though a lot of that disruption is gone, it’s concerning that, four years on, coverage is heading in the wrong direction.”
The NSW North Coast, South Western Sydney, Central Queensland, the Sunshine Coast and Gold Coast and regional Western Australia are among areas with the lowest coverage – well below the recommended herd immunity threshold.
“Evidence suggests that nearly 43 per cent of Australian parents have mild or serious concerns,” says Sukriti Gera, the lead author of a 2024 study into parental attitudes to childhood vaccinations conducted by Melbourne University and the Royal Children’s Hospital Murdoch Children’s Research Institute. “They delay, selectively vaccinate, or refuse all vaccines for the children – a majority of this relates to vaccine safety.”
The study, which examined immunisation data and surveys between 2020 and 2021, found “vaccine concerns were double in low-coverage areas” and “higher in participants from low socioeconomic areas”.
“Vaccine hesitancy was higher among Aboriginal and Torres Strait Islander communities and those who speak languages other than English at home,” adds Gera.
Out-of-pocket costs, limited appointment availability and eroding trust in information from immunisation providers has affected immunisation rates in children, according to the NCIRS. Its data shows vaccination rates among Aboriginal and Torres Strait Islander people are falling faster than in the general population.
Even before the pandemic, the WHO identified vaccine hesitancy as a threat to global health. Today it warns that misinformation threatens decades of progress that has led to an estimated “154 million lives saved by vaccines in the past 50 years”. Health experts in Australia warn of an “explosion of misinformation” on social media affecting public trust in vaccines.
The AMA’s Danielle McMullen, who also works as a GP, hears it in patients’ questions, such as why there are multiple shots at once, along with “the link between vaccines and autism, which has been well refuted – questions about preservatives and how vaccines are made”.
Her industry is also concerned, she says, about the “emerging risk of AI-generated content” and the impact of “more harmful information about immunisation” from the Trump administration.
“That doesn’t directly impact vaccination policies in Australia, but we know that people listen to that global information, and it raises that level of question and concern here.”
Professor Raina MacIntyre, who heads the biosecurity program at the Kirby Institute at UNSW Sydney, says “massive pushback” against pandemic-era public health policies has seen a “rise in disinformation about everything: masks, governments and vaccines”.
She says the response from public health officials has been inadequate.
“We’ve seen this flood of disinformation to the extent that even doctors and medical professionals are finding it hard to separate what’s true and what’s not. I have had doctors sending around articles from junk science journals,” MacIntyre says.
“If governments are not actively out there detecting and combating it, and sending out strong, positive messaging supporting vaccination, all you’ve got is a stage full of disinformation.”
Health Minister Butler says governments around the world are grappling with declining vaccination rates. Australia has pledged to help fill global aid funding gaps, including through programs addressing HIV/AIDS, dengue fever and polio in the Pacific.
At home, the Australian Technical Advisory Group on Immunisation (ATAGI) plans to review the current two-dose primary immunisation schedule for children aged 12 months and 18 months “to ensure its effectiveness”.
A statement from Butler’s office says the government is “engaging immunisation experts about reinforcing the message to parents and improving access and affordability to increase vaccination rates”. Among the priorities for the new five-year National Immunisation Strategy that was released in June, the Department of Health is working with state and territory governments “to rebuild community trust”.
The medical community hopes improving childhood vaccination rates will be on the agenda of the new Australian Centre for Disease Control.
The NCIRS’s Frank Beard sees better access to vaccines as a priority, and the avenues to improvement are “opening immunisation clinics in the evenings and on the weekends; expanding access through nurse-led clinics and general practice, or in pop-up clinics and public places; and considering whether pharmacists could help vaccinate younger children”.
“We need to lift the health and science literacy of the community and mainstream media,” says McMullen, which also involves “working with regulators, platforms and government about how to temper the availability of misinformation”.
Raina MacIntyre believes the government should urgently address public concerns about Covid and the crucial technology behind related vaccines.
“Governments do not use the C-word. They don’t talk about it. We need to start talking about mRNA vaccines. There’s so much data and evidence that they are safe. We know what the side effects are – they’re quite rare. We need to be brave enough to talk about them. Otherwise, this is just going to keep spiralling.”
This article was first published in the print edition of The Saturday Paper on October 11, 2025 as "Running against the herd".
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