Around 92% of children in Australia are fully vaccinated. Of the remaining 8% that are not up to date, around half are behind schedule because they find it difficult to access services, while the final 4% of children are not immunised because their parents do not accept vaccine recommendations.
So how has Australia managed to maintain such high vaccine uptake?
Julie Leask, University of Sydney, says Australia made a major commitment to increasing vaccination rates in the mid-1990s. A seven-point plan was designed to make it easier to vaccinate and encourage parents to follow medical advice on immunisation.
The plan did more than raise awareness of disease or immunisation programmes. “There is a misconception that all we need to do is stop groups that promote opting out of vaccination,” says Dr Leask. “It’s not that simple.”
Australia’s strategy included establishing a national register to allowhealth authorities to keep track of what vaccines children have had, and incentives for immunisation providers and for parents.
“Right now there are quite strong financial incentives for parents to fully vaccinate their children,” Dr Leask told Vaccines Today, noting the strong emphasis on the role of parents whose access to certain government payments is dependent on keeping up with the national vaccine schedule.
For some remote and socially disadvantaged groups, including Aboriginal and Torres Strait islander communities, poverty, transport issues, and access to health services can be a bigger barrier than acceptance.
However, thanks to measures to overcome these challenges, Australia has increased uptake even in remote areas. By the age of two, most aboriginal children have immunisation rates similar to the national average.
“That’s a success story we often don’t hear,” says Dr Leask. In fact, hepatitis B vaccination rates are even higher in Aboriginal children than in the wider population. “Not only are we closing the gap but we’re creating a new gap which means we’re finally redressing some of the inequalities that they’ve lived under for so long.”
The bottom line from the Australian experience is that a more sophisticated and multifaceted approach is required to sustain high childhood immunisation rates. Sometimes posters and reminders are not enough.
“Campaigns are really important for getting the message out there. But if you don’t have a car or if you’re homebound it’s really hard to get your child immunised on time,” says Dr Leask.
“It’s important to acknowledge that barriers to access are really important and no amount of campaigning alone will address that problem.”