1 May 2024

‘Sluggish’ flu vaccine uptake has experts worried

Public health Vaccination

Some of the groups most at risk have the lowest vaccination rates, including children and older Australians.


A“sluggish” uptake of flu vaccination, particularly in children under five years and adults aged over 65 years has Australia’s peak immunisation body “very concerned”.

Latest data from the Australian Immunisation Register showed 1,291,211 flu vaccines were administered across the country between 1 March and 14 April.

Of these, only 19,268 vaccines went into the arms of children under five years, and 613,687 to adults aged 65 years and over. In the Northern Territory and Tasmania, less than 170 children under five years received a flu vaccine in that period. Also in the Northern Territory, just 1545 over 65s received a vaccine.

Both age groups are among the highest risk groups for serious illness and complications from the flu virus.

By comparison, 1,572,384 vaccines were reported for the same period in 2023, the register showed.

Queensland – one of only two states in the country to offer free vaccination to all residents – led the charge for vaccination numbers, notching up 416,398 vaccines. Western Australia, which will offer free vaccination during May and June, has recorded 68,166 vaccines. NSW has delivered 349,373 vaccines, followed by Victoria (257,816), South Australia (145,185), ACT (28,496), Tasmania (18,402), and the Northern Territory (7238).

The Immunisation Coalition held the first of three webinars on influenza, covid and RSV last week, with both attendees and panelists raising concerns about barriers to flu vaccination.

“Vaccine fatigue” was a major problem, said panelist Dr Kirsten Baulch, GP and founder of national workplace vaccine provider Medimobile.

“Vaccine fatigue is very real and I think it’s going to take a while to work through,” she said.

She later told Dermatology Republic it was a phenomenon from the covid pandemic and there was no easy fix.

“It is a real problem, vaccine fatigue or vaccine burnout,” she said.

Mandatory vaccination during the covid pandemic had played a major role in this burnout, Dr Baulch said.

“I think that’s, that’s something that the public will feel for a long time,” she said.

“There’s also a lot of vaccines available to people [including those for other conditions such as shingles and RSV], which is exciting, but I’m absolutely sure that it’s confusing for people.”

Dr Baulch said she believed many GPs would be unaware of how “sluggish” the flu vaccine uptake was across Australia so far this year.

“That’s very concerning to the Immunisation Coalition for good reason,” she told DR.

“We just know it’s going to mean people hospitalised and dying. And it’s hard to have that knowledge with those immunisation rates if that’s going to happen.”

Professor Ian Barr, deputy director of the WHO Collaborating Centre for Reference and Research on Influenza, based at the Doherty Institute in Melbourne, was another panelist on the Coalition’s webinar.

He said a major barrier for immunisation was a lack of community awareness about who was most at risk from the virus.

“People think they’re bulletproof – even their kids are bulletproof,” he said.

Professor Barr said the number of reported cases – now nudging 40,000 nationally as of 23 April – was just a fraction of the number of actual cases circulating in the community. He estimated it could be at least 10 times that figure.

He later told DR that while vaccine fatigue was a definite barrier, cost (for those who are not eligible for free vaccination through the National Immunisation Program) and access were also major contributors to low vaccination rates.

The high vaccination numbers in Queensland supported this.

“Queensland’s leading the pack by a mile and that’s through free vaccination they have rolled out already,” he said.

“They’ve [delivered] about a third of the vaccines given out in the whole of Australia. A well-orchestrated, free campaign is going to beat the pants off any other bits and pieces, which is what the other states have where it’s free for some and not for others.”

Professor Barr said not offering free vaccination to all residents could be a false economy for those states and territories that had not followed the lead of Queensland and Western Australia.

“I suspect it’s all down to the almighty dollar and that’s all they are concerned about,” he said.

“But it comes back to bite them as well because more cases mean more hospitalisations, means more deaths. You might be saving on one hand, but you’re probably not going to save on the other hand.”

The next Immunisation Coalition webinars will be held on 22 May and 19 June. For more information see here.