2023 . Volume 47

Communicable Diseases Intelligence
Annual immunisation coverage report 2021
14 October 2022
Brynley Hull, Alexandra Hendry, Aditi Dey, Julia Brotherton, Kristine Macartney, Frank Beard

https://doi.org/10.33321/cdi.2023.47.47
Electronic publication date: 24/8/2023
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Communicable Diseases Intelligence
ISSN: 2209-6051 Online
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Table of contents

List of figures

6

Abstract

128Introduction

9

Results

Figure 1: Recorded coverage of seasonal
influenza vaccine in children aged 6–59
months, by jurisdiction, Australia, 2020
versus 2021

42

Discussion

12

46

Acknowledgments

Figure 2: Recorded coverage of seasonal influenza vaccine by age group,
Australia, 2020 versus 2021

46

Author details

14

47

References

Figure 3: Coverage of seasonal influenza
vaccine in Indigenous children aged
6–59 months, by jurisdiction, Australia,
2020 versus 2021

51

Appendix A

14

Figure 4: Coverage of seasonal influenza
vaccine by age group for Indigenous
persons, Australia, 2020 versus 2021

15

Figure 5: Coverage of meningococcal B
vaccine for Indigenous children, by dose
number and jurisdiction, Australia, 2021

16

Figure 6: Cumulative percentage of
infants vaccinated with the second
dose of DTPa-containing vaccine by
age in months and Indigenous status,
Australia, 2021

16

Figure 7: Cumulative percentage of
infants vaccinated with the second
dose of 13vPCV by age in months andIndigenous status, Australia, 2021

17

Figure 8: Cumulative percentage of
infants vaccinated with the second doseof rotavirus vaccine by age in months
and Indigenous status, Australia, 2021

17

Figure 9: Cumulative percentage ofchildren vaccinated with the first dose ofmeasles-mumps-rubella vaccine (MMR)
by age in months and Indigenous status,
Australia, 2021

18

Figure 10: Cumulative percentage
of children vaccinated with the first

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19

Figure 11: Trends in ‘on-time’ vaccination for the second dose of DTPa, by
Indigenous status, Australia, 2012–2021

19

Figure 12: Trends in ‘on-time’ vaccination for the first dose of MMR, by
Indigenous status, Australia, 2012–2021

20

23

24

Figure 13: On-time vaccination coverageof one dose of measles-mumps-rubella(MMR)-containing vaccine assessed at
13 months of age by Statistical Area 3,
Australia and major capital cities, 2021
Figure 14: Coverage of the second doseof measles-mumps-rubella (MMR)containing vaccine at 24 months of age
by Statistical Area 3, Australia and major
capital cities, 2021
Figure 15: Coverage of the fourth doseof diphtheria-tetanus-acellular pertussis(DTPa)-containing vaccine at 24 monthsof age by Statistical Area 3, Australia andmajor capital cities, 2021

25

Figure 16: Coverage of one dose ofmeningococcal C-containing vaccine at
24 months of age by Statistical Area 3,
Australia and major capital cities, 2021

26

Figure 17: Proportion of vaccinations
given to children aged < 7 years byprovider type and jurisdiction, Australia,
2021

26

Figure 18: Proportion of vaccinations
given to children aged < 7 years by typeof reporting mechanism and jurisdiction, Australia, 2021

34

Figure 19: Coverage (%) of the adolescent booster dose of diphtheria-tetanus-

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acellular pertussis (dTpa) vaccine by 15
years of age, by jurisdiction, Australia,
2020 and 2021.
34

Figure 20: Coverage (%) of the adolescent booster dose of diphtheria-tetanusacellular pertussis (dTpa) vaccine in
Indigenous adolescents by 15 years ofage, by jurisdiction, Australia, 2020 and
2021

35

Figure 21: Coverage (%) of meningococcal ACWY vaccine in adolescents by 17
years of age, by jurisdiction, Australia,
2020 and 2021

35

Figure 22: Coverage (%) of meningococcal ACWY vaccine in Indigenous adolescents by 17 years of age, by jurisdiction,
Australia, 2020 and 2021

36

Figure 23: Number of adolescentsreceiving a meningococcal ACWY
vaccination by age group, Australia, 2020
and 2021

37

Figure 24: Zoster vaccine coverage for
adults turning 71 years of age in the yearof interest, by jurisdiction, Australia,
2019, 2020, and 2021

38

Figure 25: Zoster vaccine coverage for
Indigenous adults turning 71 years ofage in the year of interest, by jurisdiction, Australia, 2019, 2020, and 2021

38

Figure 26: Zoster vaccine coverage
for adults turning 72–79 years of age
in the year of interest, by jurisdiction,
Australia, 2019, 2020, and 2021

39

Figure 27: Zoster vaccine coverage for
Indigenous adults turning 72–79 yearsof age in the year of interest, by jurisdiction, Australia, 2019, 2020,  and 2021

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39

Figure 28: Zoster vaccine coverage bywhether vaccinated at < 71 years or ≥ 71
years of age, by single year of age birthcohort, Australia, 2021

65

Figure A.7: Trends in ‘fully vaccinated’
coverage at 60 months of age by
Indigenous status and quarter, Australia,
2012 to 2021

40

Figure 29: 13vPCV coverage in 70-yearolds by Indigenous status for 2020 versus
2021, Australia

66

41

Figure 30: 13vPCV coverage in 71–79
year olds by Indigenous status for 2020
versus 2021, Australia

Figure A.8: Trends in coverage forhepatitis A vaccine by 30 months of age
for Indigenous children by jurisdiction,
Australia, 2012 to 2021

67

41

Figure 31: Weekly cumulative influenza
vaccine uptake (≥ 1 dose) by age group,
Australia, 2021

Figure A.9: Trends in coverage forpneumococcal vaccine for Indigenous
children by jurisdiction, Australia, 2012
to 2021

68

Figure A.10: Proportion of vaccinations,
including COVID-19 vaccines, given to
all persons by provider type and jurisdiction, Australia, 2021

69

Figure A11: Proportion of all nonCOVID-19 vaccinations given to all
persons by provider type and jurisdiction, Australia, 2021

70

Figure A.13: Coverage (%) of a COVID19 vaccine in all people aged 16 years
and over by Indigenous status,Australia,
2021

70

Figure A.12: Coverage (%) of a COVID19 vaccine in all people by age group,
Australia, 2021

59

Figure A.1: Trends in ‘fully vaccinated’
coverage by quarter, Australia, 2012 to
2021

60

Figure A.2: Trends in vaccination coverage at 12 months of age, by vaccine/
antigen and quarter, Australia, 2012 to
2021

61

Figure A.3: Trends in vaccination coverage at 24 months of age, by vaccine/
antigen and quarter, Australia, 2012 to
2021

62

Figure A.4: Trends in vaccination coverage at 60 months of age, by vaccine/
antigend and quarter, Australia, 2012 to
2021

63

Figure A.5: Trends in ‘fully vaccinated’
coverage at 12 months of age, by
Indigenous status and quarter, Australia,
2012 to 2021

64

Figure A.6: Trends in ‘fully vaccinated’
coverage at 24 months of age, by
Indigenous status and quarter, Australia,
2012 to 2021

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List of tables
7

Vaccine abbreviations

10

Table 1: Vaccination coverage (%) inchildren by age assessment milestone,
vaccine/antigen and Indigenous status,
Australia, 2020 versus 2021

21

Table 2: ‘Fully vaccinated’ coverageassessed at earlier (9, 15, 21, 51 monthsof age) and standard (12, 24, 60
months of age: shaded) milestones, by
Indigenous status and remoteness ofarea of residence, Australia, 2021

22

Table 3: ‘Fully vaccinated’ coverageassessed at earlier (9, 15, 21, 51monthsof age) and standard (12, 24, 60 months:
shaded) age milestones, by socioeconomic status of area of residence,
Australia, 2021

27

Table 4: Human papillomavirus (HPV)
vaccination coverage (dose 1 and course
completion, %) for girls by 15 years ofage, by Indigenous status and jurisdiction, Australia, 2020 and 2021

28

Table 5: Human papillomavirus (HPV)
vaccination coverage (dose 1 and course
completion, %) for boys by 15 years ofage, by Indigenous status and jurisdiction, Australia, 2020 and 2021

29

30

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Table 6: Human papillomavirus (HPV)
vaccination coverage (dose 1 and course
completion, %) for adolescents by 15
years of age, by gender, Indigenous
status, and socio-economic status,
Australia, 2020 and 2021
Table 7: Human papillomavirus (HPV)
vaccination coverage (dose 1 and course
completion, %) for adolescents by 15
years of age, by gender, Indigenous status, and remoteness of area of residence,
Australia, 2020 and 2021

31

Table 8: Number of girls aged 11–14
years who received a first dose ofhuman papillomavirus (HPV) vaccine,
proportion of those who received asecond dose in the same calendar year,
and number who received diphtheria,
tetanus, pertussis (acellular) – adolescent/adult formulation (dTpa) vaccine,by Indigenous status and jurisdiction,
Australia, 2020 and 2021

32

Table 9: Number of boys aged 11–14
years who received a first dose ofhuman papillomavirus (HPV) vaccine,
proportion of those who received asecond dose in the same calendar year,
and number who received diphtheria,
tetanus, pertussis (acellular) – adolescent/adult formulation (dTpa) vaccine,by Indigenous status and jurisdiction,
Australia, 2020 and 2021

51

Table A.1: Australian NIP Schedule in
2021

52

Box A.1: Significant changes in immunisation policy, immunisation incentives
and coverage calculation algorithms,
Australia, 2017 to 2021

55

Table A.2: Vaccinations required to bedeemed ‘fully vaccinated’ by each assessment milestone

71

Table A.3: Recorded coverage of seasonal influenza vaccine by age group,jurisdiction, Indigenous persons and all
persons, 2020 and 2021, Australia

72

Table A.4: ‘Fully vaccinated’ coverageassessed at standard age milestones (12,24 and 60 months) and earlier (9, 15,
21, 51 months) milestones, by Primary
Health Network, 2021

73

Table A.5: Coverage (%) of a COVID-19
vaccine in all people by age group andjurisdiction, 2021

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Table A.6: Coverage (%) of a COVID-19
vaccine in all people aged 16 years andover by jurisdiction and Indigenous
status, 2021

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Annual Report

Annual immunisation coverage report 2021
14 October 2022
Brynley Hull, Alexandra Hendry, Aditi Dey, Julia Brotherton, Kristine Macartney, Frank Beard

Abstract
We analysed Australian Immunisation Register (AIR) data as at 3 April 2022 for children, adolescents and adults for the calendar year 2021, with data on trends from previous years also presented.
Children: ‘Fully vaccinated’ coverage in Australian children in 2021 was 0.6–0.8 of a percentage
point lower than in 2020 at the 12-month (94.2%) and 60-month (94.0%) age assessment milestones,
but stable at the 24-month milestone (92.1%). Due to the lag time involved in assessment at milestoneages, ‘fully vaccinated’ coverage figures for 2020 and 2021 predominantly reflect vaccinations due in2019 and 2020, respectively, and hence show a small impact on childhood coverage in the first year of
the coronavirus disease 2019 (COVID-19) pandemic. ‘Fully vaccinated’ coverage in Aboriginal andTorres Strait Islander (hereafter respectfully referred to as Indigenous) children was 0.7–1.5 percentage points lower in 2021 than 2020 at the 12-month (91.6%), 24-month (90.1%) and 60-month (96.3%)
milestones, although 2.3 percentage points higher than children overall at 60 months. Influenza
vaccination coverage in children aged 6–59 months was approximately 20 percentage points lower in
2021 than 2020, both for children overall (26.5%) and for Indigenous children (22.5%).
‘On time’ vaccination (within 30 days of the recommended age) was up to two percentage points
lower in 2021 than 2020 for vaccines due at 4 and 6 months of age, suggesting possible pandemic
impacts, but was similar or higher for vaccines due at 12 months of age. While on-time vaccinationin Indigenous children has improved progressively since 2012, it remained 6–13 percentage points
lower than in children overall in 2021.
‘Fully vaccinated’ coverage at the earlier milestones (3 months after due date of last scheduled
vaccine) of 9, 15, 21 and 51 months was 1.5–2.8 percentage points lower for children living in theleast advantaged residential area quintile than the most advantaged, a similar disparity as in 2020.
Coverage at the earlier milestones was 2.3–10.0 percentage points lower for Indigenous children living in remote areas than in major cities and regional areas, with disparity at 21 months of age 2.1–2.2
percentage points higher in 2021 than in 2020, and 1.2–2.1 percentage points higher at 51 months.
Adolescents: In 2021, a total of 80.3% of girls and 77.2% of boys (and 73.3% and 66.2% of Indigenous
girls and boys) had completed the human papillomavirus (HPV) vaccination schedule by 15 yearsof age, 0.2–0.4 of a percentage point lower than 2020 (1.7–1.8 percentage points for Indigenous),
reflecting vaccinations due in school programs prior to the pandemic with possible pandemic impact
on catch-up vaccination. However, the proportion of adolescents completing the two-dose HPV vaccination schedule within a calendar year was 15.3 percentage points lower in 2021 than 2020 and26.9 percentage points lower than in 2019, likely due to pandemic-related disruption to school-based
programs. Additionally, 87.3% of adolescents (83.8% for Indigenous) had received the recommended
booster dose of diphtheria-tetanus-acellular pertussis (dTpa) vaccine by 15 years, and 76.1% (66.7%
for Indigenous) the recommended meningococcal ACWY vaccine dose by 17 years of age.
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Adults: Zoster vaccine coverage in 2021 remained relatively low, at just over 30%, in adults aged
70 years, but increased to 47% in those aged 71–79 years, reflecting ongoing catch-up vaccination.
Coverage of 13vPCV was low in 2021, reaching 17.2% in adults aged 70 years and 20.1% in those aged
71–79 years. Influenza vaccination coverage in adults in 2021 was progressively higher with increasing age, reaching 62.1% in the 65–74 years age group (64.6% in Indigenous) and 68.5% in the 75+
years age group (67.7% in Indigenous). Influenza vaccine coverage for other National Immunisation
Program (NIP)-eligible Indigenous adult age groups was only 22.0% for those aged 20–49 years, and43.5% for those aged 50–64 years. By the end of 2021, a total of 91.6% of people in Australia aged 16+
years had received a second dose of a COVID-19 vaccine (71.8% for Indigenous), with over 99% of
those aged 70+ years having received a second dose.
Conclusions: Vaccination coverage in children and adolescents remained relatively high in 2021,
although with some evidence of COVID-19 pandemic impacts, particularly on receipt of two dosesof HPV vaccine within the same calendar year. It will be important to ensure catch-up vaccinationin children and adolescents occurs. A strengthened focus on adult vaccination is needed, as coverageremained suboptimal in 2021. The impact of mandatory reporting of all NIP vaccinations frommid-2021, on completeness of AIR data, has not yet been formally evaluated.
Keywords: vaccination coverage; vaccination timeliness; Aboriginal and Torres Strait Islander
vaccination coverage; influenza vaccination; COVID-19 vaccination
Vaccine abbreviations
Abbreviation

Description

13vPCV

13-valent pneumococcal conjugate vaccine

DTPa

diphtheria-tetanus-acellular pertussis (children aged under 10 years formulation)dTpa

diphtheria-tetanus-acellular pertussis (individuals aged 10 years and over formulation)

23vPPV

23-valent pneumococcal polysaccharide vaccine

Flu

influenza

Hep A

hepatitis A

Hep B

hepatitis B

Hib

Haemophilus influenzae type b

HPVhuman papillomavirus

MenACWY

meningococcal ACWY

MenC

meningococcal C

MMR

measles-mumps-rubella

MMRV

measles-mumps-rubella-varicellahealth.gov.au/cdi

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Introduction
This is the fifteenth annual Australian immunisation coverage report, with reports now covering the years 2007–2021.1–14 This 2021 report isthe second in the series to report ‘whole-of-life’
coverage data, i.e. vaccinations for children,
adolescents and adults, from the Australian
Immunisation Register (AIR), following the
AIR’s expansion in 2016. This report complements high level data on vaccination coverage published by the Australian Government
Department of Health and Aged Care,15 byproviding a comprehensive analysis of trends
and interpretation of their relationship to factors including policy and program changes. The
report includes detailed analyses of coveragedata for the calendar year 2021, with a particular focus on changes from 2020. It also shows
trend data from 2012 onwards. We also aimed
to assess the impact of the coronavirus disease2019 (COVID-19) pandemic and associatedpublic health response measures (see timelineof ‘lockdowns’ in Australia from March 2020 toNovember 2021, available elsewhere)16 on vaccination coverage.
This report uses the longstanding international
practice of reporting at key childhood andadolescent milestone ages to measure coverageagainst national targets and to track trends overtime. National vaccination coverage and timeliness for 2021 was measured using AIR data
as at 3 April 2022. Childhood cohort vaccination status was assessed for ‘fully vaccinated’(as defined by the Australian Government
Department of Health and Aged Care) andindividual vaccines at the standard milestones:
12 months of age (for vaccines due at 6 months),
24 months of age (for vaccines due at 6, 12 and18 months) and 60 months of age (for vaccines
due at 48 months), including by Aboriginal andTorres Strait Islander (hereafter respectfullyreferred to as Indigenous) status and at small
area level (Primary Health Network [PHN]
and Australian Bureau of Statistics StatisticalArea 3 [SA3]). Coverage for vaccines includedin the National Immunisation Program (NIP)
for Indigenous children only was also assessed,

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using appropriate milestones/cohorts and forrelevant jurisdictions, with meningococcal B
vaccine (added to the NIP for Indigenous children in July 2020) included for the first time inthis series of reports. Timeliness of childhood
vaccination was assessed by calculating ‘on-time’vaccination (within 30 days of recommendedage) for selected vaccine doses, by Indigenous
status, and ‘fully vaccinated’ coverage at earlier
age milestones of 9, 15, 21 and 51 months by
Indigenous status, and socio-economic status
and remoteness of area of residence. Coveragefor vaccines included in the NIP for adolescentsand adults was also assessed using appropriate
milestones and cohorts. We assessed HPV, dTpa
and meningococcal ACWY vaccine coverage
for adolescents by jurisdiction, Indigenous
status, age and gender. We assessed zoster vaccine coverage (including for the new inactivatedrecombinant vaccine Shingrix which became
available on private prescription in June 2021)
for adults by jurisdiction and Indigenous status,with expanded assessment by age group compared to previous reports, and 13-valent pneumococcal conjugate vaccine (13vPCV) coverage
for adults by Indigenous status and age (added
to the NIP in July 2020 and included for the firsttime in this series of reports). Influenza vaccination coverage for 2021 compared to 2020 was
assessed across all ages by Indigenous status.
A more detailed description of the methods
used in this report is provided in the Appendix.
The NIP schedule in 2021 is summarised inTable A.1 in the Appendix. Important recentchanges to vaccination policy, the incentive payment system and ‘fully vaccinated’
coverage algorithms are shown in Box A.1 in
the Appendix.

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Results
ChildrenCoverage at 12, 24 and 60 months of age‘Fully vaccinated’‘Fully vaccinated’ coverage for all children(incorporating all vaccines/antigens includedin the relevant assessment algorithm – referto detailed methods section in Appendix)
decreased between 2020 and 2021 at two age
milestones: 12 months (from 94.8% to 94.2%)
and 60 months (from 94.8% to 94.0%). ‘Fully
vaccinated’ coverage at 24 months remained
at 92.1% in 2021 (Table 1). Trends in ‘fully vaccinated’ coverage by quarter from 2012 to 2021
are shown in Figure A.1 in the Appendix. ‘Fully
vaccinated’ coverage at the three age milestones
decreased by 0.5–0.8 of a percentage point
between the March 2021 and December 2021
quarterly data points. ‘Fully vaccinated’ coverage for 2021 at the three age milestones is also
provided by primary health network (PHN) in
Table A.4 in the Appendix. For the 12-month age
milestone, ‘fully vaccinated’ coverage ranged
from a low of 89.2% in the North Coast PHN in
New South Wales (NSW) to a high of 96.4% in
the Western NSW PHN. For the 24-month age
milestone, ‘fully vaccinated’ coverage ranged
from a low of 87.4% in the North Coast PHN
in NSW to a high of 94.7% in the Australian
Capital Territory PHN. For the 60-monthage milestone, ‘fully vaccinated’ coverage
ranged from a low of 90.9% in the Gold Coast(Queensland) and North Coast (NSW) PHNs
to a high of 96.8% in the Western Victoria PHN.
NB: coverage estimates in this report may differ slightly from estimates published elsewherethat are calculated using rolling annualised
quarterly coverage data.
Coverage by individual vaccines/antigens
Coverage for all individual vaccines/antigens at
12 months of age decreased between 2020 and
2021, by 0.5–0.8 of a percentage point (Table1). For vaccines/antigens included in the ‘fully

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vaccinated’ algorithm, coverage was 94.6–94.7%
in 2021 for the third dose of diphtheria-tetanusacellular pertussis (DTPa), hepatitis B, polio,and Hib antigens (usually given together in ahexavalent combination vaccine at 6 months ofage), and 95.9% for 13vPCV. Coverage for thesecond dose of rotavirus vaccine, which is notincluded in the ‘fully vaccinated’ algorithm
due to upper age limits, decreased by 0.8 of apercentage point, from 92.5% to 91.7%. Trends
in individual vaccine/antigen coverage at 12
months of age by quarter from 2012 to 2021 areshown in Figure A.2 in the Appendix. Coveragefor individual vaccines/antigens at 12 monthsof age decreased by 0.9–1.6 percentage points
between the March 2020 and December 2021
quarterly data points.
Coverage for almost all individual vaccines/
antigens included in the ‘fully vaccinated’ algorithm at 24 months of age decreased between
2020 and 2021: by 0.1 of a percentage point for
those due at 6 months of age (third dose of polio
and hepatitis B), reaching 96.5% and 96.3%,
respectively; by 0.0–0.3 percentage points for
those due at 12 months (Men C-containing
and the first dose of measles-mumps-rubella[MMR]), reaching 95.4% and 95.5%, respectively; and by 0.3–0.4 percentage points for
those due at 18 months (fourth dose of DTPa,
reaching 93.2%, and the second dose of MMR[MMR2] and varicella, usually given together as
measles-mumps-rubella-varicella [MMRV] vaccine, reaching 93.6%), whilst the third dose of
13vPCV decreased by 0.2 of a percentage point
to 95.4%. (Table 1).
Coverage in 2021 at 24 months was 95.0% formeningococcal ACWY vaccine and 90.8% for
MMRV vaccine, 0.4 and 2.8 percentage points
lower, respectively, than for the relevant vaccines/antigens included in the ‘fully vaccinated’
algorithm (meningococcal C-containing vaccine and MMR2/varicella, data not shown).
Trends in individual vaccine/antigen coverage
at 24 months of age by quarter from 2012 to
2021 are shown in Figure A.3 in the Appendix.

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Table 1: Vaccination coverage (%) in children by age assessment milestone, vaccine/antigen andIndigenous status, Australia, 2020 versus 2021a
Vaccine/antigen

Milestone age‘Fully vaccinated’

2020

2021

c

93.1

91.6

94.8

94.2

24 months

91.2

90.1

92.1

92.1

e

97.0

96.3

94.8

94.0

12 monthsc (Dose 3)

93.3

91.8

95.3

94.7

d

24 months (Dose 4)

92.5

91.3

93.5

93.2

e

60 months (Dose 4 or 5)

98.5

96.5

96.7

94.2

12 monthsc (Dose 3)

93.3

91.8

95.3

94.7

24 months (Dose 3)d

60 months
Diphtheria-tetanus- acellular pertussis

Polio

Hepatitis B

Measles-mumps-rubella

VaricellaMeningococcal C-containing vaccine

13-valent pneumococcal conjugate
vaccineRotavirus vaccine

97.3

96.9

96.6

96.5

e

60 months (Dose 4)

97.0

96.4

94.9

94.3

12 monthsc (Dose 3)

93.2

91.8

95.2

94.6

d

24 months (Dose 4)

94.6

93.3

94.3

93.9

e

60 months (Dose 4)

98.8

98.6

96.7

96.4

12 monthsc (Dose 3)

93.2

91.8

95.1

94.6

d

24 months (Dose 3)

97.3

96.9

96.4

96.3

e

60 months (Dose 3)

98.8

98.7

96.6

96.6

12 monthsf

N/A

N/A

N/A

N/A

d

24 months (Dose 1)

96.9

96.3

95.8

95.5

d

24 months (Dose 2)

93.9

92.4

94.0

93.6

e

60 months (Dose 2)

98.8

98.6

96.8

96.6

12 monthsf

N/A

N/A

N/A

N/A

d

24 months (Dose 1)

93.6

92.2

94.0

93.6

e

60 months (Dose 1)

98.8

98.6

96.8

96.6

12 monthsf

N/A

N/A

N/A

N/A

24 months (Dose 1)

96.9

96.6

95.7

95.4

d

Haemophilus influenzae type b

All children (%)

2021

12 monthsbaIndigenous (%)
2020

d
e

60 months (Dose 1)

N/A

N/A

N/A

N/A

12 monthsc (Dose 2 or 3)

96.7

96.1

96.5

95.9

24 monthsd (Dose 3)

96.8

96.3

95.6

95.4

e

60 months (Dose 3)

97.4

97.8

95.2

95.4

12 monthsc (Dose 2)

87.6

86.4

92.5

91.7

24 months

f

N/A

N/A

N/A

N/A

60 months

N/A

N/A

N/A

N/A

f

a

Source: Australian Immunisation Register, data as at 31 March 2021 for 2020 coverage and 3 April 2022 for 2021 coverage.

b

Refer to Appendix for details of ‘fully vaccinated’ assessment algorithms. Coverage estimates in this table are calculated using
12-month-wide cohorts and may differ slightly from estimates published elsewhere using rolling annualised cohorts.

c

Cohort born 1 January 2019 – 31 December 2019 (2020 estimate, i.e. vaccines due from mid-2019 to mid-2020) and 1 January 2020 – 31
December 2020 (2021 estimate, i.e. vaccines due from mid-2020 to mid-2021).

d

Cohort born 1 January 2018 – 31 December 2018 (2020 estimate, i.e. vaccines due from mid-2018 [6-month doses] to mid-2020 [18month doses]) and 1 January 2019 – 31 December 2019 (2021 estimate, i.e. vaccines due from mid-2019 [6-month doses] to mid-2021[18 month doses]).

e

Cohort born 1 January 2015 – 31 December 2015 (2020 estimate, i.e. vaccines due in 2019) and 1 January 2016 – 31 December 2016(2021 estimate, i.e. vaccines due in 2020).

f

N/A: Not applicable (vaccine either not given prior to this milestone, or contraindicated after previous milestone).

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Coverage for all individual vaccines/antigens
included in the ‘fully vaccinated’ algorithm
at 24 months of age decreased by 0.3–0.6 of apercentage point between the March 2021 andDecember 2021 quarterly data points.
Coverage for antigens included in the ‘fully
vaccinated’ algorithm at 60 months of age
decreased between 2020 and 2021, from 96.7%
to 94.2% for the fourth (or fifth) dose of DTPa
and from 94.9% to 94.3% for the fourth doseof polio (Table 1). Trends in individual vaccine/
antigen coverage at 60 months of age by quarter
from 2012 to 2021 are shown in Figure A.4 in
the Appendix. Coverage for the individual vaccines/antigens included in the ‘fully vaccinated’
algorithm at 60 months of age decreased by 0.6
of a percentage point between the March 2021
and December 2021 quarterly data points.
Influenza vaccine coverage
Influenza vaccine coverage in children aged 6–59
months decreased from 46.1% in 2020 to 26.5%
in 2021 (Figure 1), and in children aged 5–9
years from 29.9% to 15.6% (Figure 2). Coveragefor children aged 6–59 months decreased inall jurisdictions, with the largest decrease seenin Western Australia (from 50.7% in 2020 to
24.6% in 2021). There was substantial variationin recorded coverage for children aged 6–59
months by jurisdiction in 2021, ranging from
22.4% in Queensland to 49.6% in the Australian
Capital Territory (Figure 1).

Coverage by Indigenous status‘Fully vaccinated’ at 12, 24 and 60 months of age
Between 2020 and 2021, ‘fully vaccinated’ coverage for Indigenous children decreased at all
three age milestones: 12 months (from 93.1% to91.6%), 24 months (from 91.2% to 90.1%) and
60 months (from 97.0% to 96.3%) (Table 1).
The disparity in ‘fully vaccinated’ coverage
between Indigenous and all children increased
at 12 months of age from 1.7 percentage points
in 2020 to 2.6 percentage points in 2021, andat 24 months from 0.9 of a percentage point in2020 to 2.0 percentage points in 2021 (Table1). ‘However, ‘fully vaccinated’ coverage at
60 months of age in 2021 remained higher in
Indigenous than in all children, by 2.3 percentage points.
Trends in ‘fully vaccinated’ coverage by
Indigenous status by quarter from 2012 to 2021
are shown in Figures A.5, A.6 and A.7 in the
Appendix. These show a generally increasing
trend in ‘fully vaccinated’ coverage over time,
but with a decrease of 0.1–1.9 percentage points
between the March 2021 and December 2021
quarterly data points.
Coverage by individual vaccines/antigens at 12, 24 and60 months of age
Coverage at 12 months of age in Indigenous
children decreased for all individual vaccines/
antigens between 2020 and 2021, by 0.6–1.5
percentage points (Table 1).
Coverage at 24 months of age in Indigenous
children decreased for all individual vaccines/
antigens between 2020 and 2021, by 0.3–1.5
percentage points. Coverage in Indigenous children in 2021 was higher than in all children for
the third dose of polio and hepatitis B, the firstdose of MMR, meningococcal C-containing
and the third dose of 13vPCV, but lower for the
fourth dose of DTPa and Hib, the second doseof MMR, and varicella (Table 1).

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Figure 1: Recorded coverage of seasonal influenza vaccine in children aged 6–59 months, byjurisdiction,a,b,c Australia, 2020 versus 2021
100

All children – 2020

90

All children – 2021

80

Coverage (%)

70

64.5

60

59.8
49.6

50

45.5

41.9

40

50.5
41.6

31.2

30

23.3

50.0

44.8
29.5

30.9

22.4

50.7

46.1

24.6

26.5

20
10
0

JurisdictionaSource: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).

b

At least one dose of any influenza vaccine. (Note: 2020 estimates have been revised following a change in methodology and therefore
differ to what was presented in the 2020 report – see detailed methods in Appendix for further detail.)c

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

Figure 2: Recorded coverage of seasonal influenza vaccine by age group,a,b Australia, 2020
versus 2021
100

All persons – 2020

90

All persons – 2021

80
68.5
62.9
61.2 62.1

70

Coverage (%)

60
50
40
30
20
10

46.1
26.5 29.9

35.2 38.2
24.8
15.6

33.8 32.1

23.5 23.9
22.7
15.1
13.3

0

Age groupaSource: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).

b

At least one dose of any influenza vaccine. (Note: 2020 estimates have been revised following a change in methodology and therefore
differ to what was presented in the 2020 report – see detailed methods in Appendix for further detail.)

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Coverage at 60 months of age in Indigenous
children in 2021 remained very high (over 96%)
for all vaccines/antigens, and higher than in all
children (Table 1). However, coverage decreased
marginally for individual vaccines/antigens
from 2020 to 2021, except for 13-vPCV which
increased by 0.4 of a percentage point to 97.8%.
Influenza vaccine coverage
Influenza vaccine coverage in Indigenous children decreased from 43.0% in 2020 to 22.5% in
2021 in those aged 6–59 months (Figure 3) andfrom 33.8% to 15.5% in those aged 5–9 years(Figure 4). Coverage in Indigenous children
aged 6–59 months decreased in all jurisdictions, with the largest decreases seen in Western
Australia (from 44.6% in 2020 to 18.9% in 2021)
and in New South Wales (from 37.8% to 19.9%).
There was substantial variation in coverage forchildren aged 6–59 months by jurisdiction in
2021, ranging from 18.9% in Queensland andWestern Australia to 53.2% in the Northern
Territory (Figure 3).

for Indigenous children (Northern Territory,
Queensland, South Australia and Western
Australia), increased from 73.5% in 2020 to
81.7% in 2021. Longer term trends in 13vPCV
fourth dose coverage (Figure A.9 in the
Appendix) show the highest coverage levels are
consistently achieved in the Northern Territory(91.9% in the September 2021 quarter).
Meningococcal B vaccine coverage for Indigenous children
Meningococcal B vaccine coverage, for the firstcohort of Indigenous children eligible to havereceived 3 doses of meningococcal B vaccine
by 31 December 2021 at the 2, 4 and 12 monthschedule points under the NIP program implemented on 1 July 2020, is shown in Figure 5.
Nationally, 78.7% of Indigenous children had
received their first dose of meningococcal B
vaccine, 75.8% had received their second doseand 63.8% their third. Coverage varied byjurisdiction, highest in South Australia and theNorthern Territory and lowest in Victoria andTasmania (Figure 5).

Hepatitis A vaccine for Indigenous children

Timeliness of vaccination

In July 2020, the scheduled ages for hepatitis
A vaccination for Indigenous children in thefour jurisdictions where it is funded under the
NIP (Northern Territory, Queensland, South
Australia and Western Australia) changed from12 to 18 months for dose 1 and from 18 months
to 4 years for dose 2. Coverage for the first doseof hepatitis A vaccine by 30 months of age, forthe four jurisdictions combined, was 82% in
2021, with coverage for the second dose under
the new schedule not yet able to be assessed.
Longer term trends in hepatitis A vaccine coverage (Figure A.8 in the Appendix) show the highest coverage levels are consistently achieved in
the Northern Territory (95.0% for dose 1 in theJune 2021 quarter).

The proportion of infants with on-time receipt(within 30 days of the recommended age) of thesecond dose of DTPa-containing vaccine in 2021
was lower than in 2020 for both Indigenous andnon-Indigenous children, by 0.6 and 1.8 percentage points respectively. The proportion of
infants with on-time receipt of the second dose of
DTPa in 2021 was 11.2 percentage points lower
in Indigenous than non-Indigenous infants in
2021 (Figure 6). The differential narrowed withincreasing age, reaching 1.4 percentage points
at 9 months of age.

Pneumococcal vaccine for Indigenous children
Coverage for the additional fourth dose of
13vPCV by 30 months of age, for the combined four jurisdictions where it is funded

health.gov.au/cdi

The proportion of infants with on-time receiptof the second dose of 13vPCV in 2021 was lower
than in 2020 for both Indigenous and nonIndigenous children, by 0.4 and 2.0 percentage
points respectively. The on-time vaccination differential for the second dose of 13vPCV between
Indigenous and non-Indigenous infants in 2021
was 11.3 percentage points, narrowing to 1.5
percentage points at 9 months of age (Figure 7).

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Figure 3: Coverage of seasonal influenza vaccine in Indigenous children aged 6–59 months, byjurisdiction,a,b,c Australia, 2020 versus 2021
100

Indigenous – 2020

90
80

72.5

Coverage (%)

70
60
50
40

Indigenous – 2021

53.2

51.2
35.1

43.0

38.5

37.8

30
19.9

20

26.3

21.4

18.9

48.7

44.0

44.6

23.1

43.0

22.5

18.9

10
0

JurisdictionaSource: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).

b

At least one dose of any influenza vaccine. (Note: 2020 estimates have been revised following a change in methodology and therefore
differ to what was presented in the 2020 report – see detailed methods in Appendix for further detail.)c

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

Figure 4: Coverage of seasonal influenza vaccine by age group for Indigenous persons,
Australia,a,b 2020 versus 2021
100

Indigenous – 2020

90

Indigenous – 2021

80

72.5

70

64.6
56.3

Coverage (%)

60
50
40
30
20

70.7 67.7

43.5

43.0
33.8
22.5

15.5

32.3

33.9

30.6
15.4

16.5

22.0

39.7
25.0

10
0

Age groupaSource: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).

b

At least one dose of any influenza vaccine. (Note: 2020 estimates have been revised following a change in methodology and therefore
differ to what was presented in the 2020 report – see detailed methods in Appendix for further detail.)

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Figure 5: Coverage of meningococcal B vaccine for Indigenous children, by dose number andjurisdiction,a,b,c Australia, 2021
100

94.5 93.9

90
80
72.5
70

Coverage (%)

89.1

86.0
78.2
71.3

Dose 1

93.4

Dose 2

85.6

83.4

82.5

73.3

80.0

78.7

73.0

69.2

75.8

63.8

63.7

61.3

60

Dose 356.5
50.4 51.2

50

53.6

50.0

43.5
37.7

40
30
20
10
0

ACT

NSW

NT

Qld

SA

Tas.

Vic.

WA

AUST

Jurisdictionab

Source: Australian Immunisation Register, data as at 3 April 2022.
Coverage assessed for cohort of Indigenous children born 1 May 2020 – 31 Oct 2020. The first eligible cohort to have received 3 dosesof meningococcal B vaccine by 31 Dec 2021 at the 2, 4 and 12 month schedule points under the NIP program implemented 1 July 2020.
Only two doses of meningococcal B vaccine are required if the first dose is administered after 12 months of age.

cNote: Coverage may be underestimated, particularly for dose 1, due to under-reporting to the AIR (e.g. of doses given prior to childbeing registered on Medicare).

The proportion of Indigenous infants with
on-time receipt of the second dose of rotavirus vaccine in 2021 was 1.3 percentage points
lower than in 2020. The on-time vaccinationdifferential for the second dose of rotavirus vaccine between Indigenous and non-Indigenous
infants in 2021 was lower than that for DTPacontaining vaccine and 13vPCV at 5.6 percentage points, narrowing with increasing age to
0.2 of a percentage point at 6 months of age(Figure 8).
The proportion of children with on-time receiptof the first dose of MMR vaccine in 2021 was
0.6 of a percentage point lower than in 2020 for
Indigenous but 0.6 of a percentage point higher
for non-Indigenous children. The on-time

health.gov.au/cdi

vaccination differential for the first dose of
MMR vaccine between Indigenous and nonIndigenous children in 2021 was 13.0 percentage points, narrowing to 2.0 percentage points
at 17 months of age (Figure 9).
The proportion of children with on-time receiptof the first dose of MenACWY vaccine washigher in 2021 than 2020 for both Indigenous
and non-Indigenous children, 1.0 and 0.5 percentage points higher, respectively. The on-time
vaccination differential for the first dose of
MenACWY vaccine between Indigenous andnon-Indigenous children in 2021 was 7.7 percentage points, narrowing to 0.8 of a percentage
point at 17 months of age (Figure 10).

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Figure 6: Cumulative percentage of infants vaccinated with the second dose of DTPa-containing
vaccine by age in months and Indigenous status,a,b,c Australia, 2021
100
92.3

Percentage of those vaccinated90
80

non-Indigenous
81.1

Indigenous

11.2 percentage points differential

70
60

On-time vaccination

50(within 30 days of the recommended age)

40
30
20
10
0

Age infant received second dose of DTPaa

Source: Australian Immunisation Register, data as at 3 April 2022. Cohort born 1 January 2020 – 31 December 2020.

b

DTPa: diphtheria-tetanus-acellular pertussis-containing vaccine (child formulation).

cShown as cumulative percentage vaccinated (number of infants who received vaccine dose at particular age / total number of infants
who received the vaccine dose, expressed as a percentage).

Figure 7: Cumulative percentage of infants vaccinated with the second dose of 13vPCV by age inmonths and Indigenous status,a,b,c Australia, 2021
100

Percentage of those vaccinated

90
80

92.2

non-Indigenous
80.9

Indigenous

11.3 percentage points differential

70
60
50

On-time vaccination(within 30 days of the recommended age)

40
30
20
10
0

Age infant received second dose of 13vPCVa

Source: Australian Immunisation Register, data as at 3 April 2022. Cohort born 1 January 2020 – 31 December 2020.

b

13vPCV = 13-valent pneumococcal conjugate vaccine.

cShown as cumulative percentage vaccinated (number of infants who received vaccine dose at particular age / total number of infants
who received the vaccine dose, expressed as a percentage).

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Figure 8: Cumulative percentage of infants vaccinated with the second dose of rotavirus vaccine
by age in months and Indigenous status,a,b Australia, 2021
100

95.5

Percentage of those vaccinated

90

89.9

80

non-Indigenous

Indigenous

5.6 percentage points differential

70

On-time vaccination

60(within 30 days of the recommended age)

50
40
30
20
10
0

Age infant received second dose of rotavirusaSource: Australian Immunisation Register, data as at 3 April 2022. Cohort born 1 January 2020 – 31 December 2020.

bShown as cumulative percentage vaccinated (number of children who received vaccine dose at particular age / total number of infants
who received the vaccine dose, expressed as a percentage).

Figure 9: Cumulative percentage of children vaccinated with the first dose of measles-mumpsrubella vaccine (MMR) by age in months and Indigenous status,a,b Australia, 2021
100

Percentage of those vaccinated

90
80
70

non-Indigenous

Indigenous

80.1
13.0 percentage points differential
67.1

60
50
40

On-time vaccination(within 30 days of the recommended age)

30
20
10
0

Age child received first dose of MMR
aSource: Australian Immunisation Register, data as at 3 April 2022. Cohort born 1 January 2019 – 31 December 2019 (i.e. due for theirfirst dose of MMR in 2020).

b

Shown as cumulative percentage vaccinated (number of infants who received vaccine dose at particular age / total number of children
who received the vaccine dose, expressed as a percentage).

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Figure 10: Cumulative percentage of children vaccinated with the first dose of meningococcal
ACWY vaccine (MenACWY) by age in months and Indigenous status,a,b Australia, 2021
100

Percentage of those vaccinated

90
80
70

non-Indigenous
79.5
71.8

Indigenous

7.7 percentage points differential

60

On-time vaccination

50
40(within 30 days of the recommended age)

30
20
10
0

Age child received first dose of MenACWY vaccinea

Source: Australian Immunisation Register, data as at 3 April 2022. Cohort born 1 January 2019 – 31 December 2019 (i.e. due formeningococcal ACWY vaccine in 2020).

aShown as cumulative percentage vaccinated (number of infants who received vaccine dose at particular age / total number of children
who received the vaccine dose, expressed as a percentage).

Trends in on-time vaccination for the second
dose of DTPa-containing vaccine from 2012
to 2021 by Indigenous status are shown in
Figure 11. The proportion of Indigenous infants
vaccinated on time increased from 73.4% in2012 to 82.2% in 2021, with the disparity inon-time vaccination between Indigenous andnon-Indigenous infants in Australia decreasingfrom 16.9 percentage points to 10.3 percentage
points over this period.
Trends in on-time vaccination for the first doseof MMR-containing vaccine from 2012 to 2021
by Indigenous status are shown in Figure 12. The
proportion of Indigenous children vaccinatedon time increased from 60.4% in 2012 to 67% in
2021, with the disparity in on-time vaccination
between Indigenous and non-Indigenous children in Australia remaining stable at around
11–13 percentage points over this period.
On-time vaccination coverage for the first doseof MMR-containing vaccine assessed at 13

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months of age by Statistical Area 3 (presented forthe first time in this series of reports) is shownin Figure 13. On-time MMR vaccination coverage in 2021 varied across Australia, with coverage in many rural and remote areas of Western,
Central and Far North Australia substantiallybelow that in Southeast Australia, with 62.4%
on-time vaccination in Katherine, 63.5% in East
Pilbara and 65.4% in Alice Springs.
Tables 2 and 3 present ‘fully vaccinated’ coverage assessed three months after the last vaccine
dose due—that is, earlier than the standard
assessment milestones—to capture aspects oftimeliness, along with the standard 12-month,24-month and 60-month age milestones. For
all four of the earlier assessment milestones(9-month, 15-month, 21-month and 51-month),‘fully vaccinated’ coverage in 2021 was lower
in Indigenous children residing in remoteareas than in those residing in major cities
and regional areas, with the greatest coverage differential at 21 months of age (Table 2).

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Figure 11: Trends in ‘on-time’ vaccination for the second dose of DTPa, by Indigenous status,a,bAustralia, 2012–2021
100.0
90.0
80.0

90.3 91.0
73.4

74.3

90.8

91.0

91.5

75.6

77.4

78.0

92.3

92.6

92.1

80.2

81.9

81.5

Coverage (%)

70.0

92.0
82.1

Indigenous

non-Indigenous

2017

2019

60.0

92.5
82.2

50.0
40.0
30.0
20.0
10.0
0.0
2012

2013

2014

2015

2016

2018

2020

2021

Year
a

All data points are calculated for a 12-month-wide birth cohort using AIR data.

bWithin 30 days of the recommended age (i.e. by 5 months of age as second dose of DTPa vaccine due at 4 months of age).

Figure 12: Trends in ‘on-time’ vaccination for the first dose of MMR, by Indigenous status,
Australia,a,b 2012–2021
100.0
90.0
80.0

Coverage (%)

70.0
60.0

73.4 73.0
60.4 60.2

75.5

75.8

77.9

78.0

78.5

77.3

79.5

80.0

64.1

64.3

66.3

67.5

67.5

65.9

67.7

67.0

Indigenous

50.0

non-Indigenous

40.0
30.0
20.0
10.0
0.0
2012

2013

2014

2015

2016

2017

2018

2019

2020

2021

Year
a

All data points are calculated for a 12-month-wide birth cohort using AIR data.

bWithin 30 days of the recommended age (i.e. by 13 months of age as first dose of MMR vaccine due at 12 months of age).

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Figure 13: On-time vaccination coverage of one dose of measles-mumps-rubella (MMR)containing vaccine assessed at 13 months of age by Statistical Area 3,a,b,c Australia and major
capital cities, 2021a

Source: Australian Immunisation Register.

b

Receipt of a scheduled vaccine dose within 30 days of the recommended age (i.e. by 13 months of age as first dose of MMR vaccine due
at 12 months of age).

c

Cohort born 1 January 2019 – 31 December 2019 i.e. due for first dose of MMR in 2020.

dNumber in parentheses: number of Statistical Area 3s in each category.

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Table 2: ‘Fully vaccinated’ coverage assessed at earlier (9, 15, 21, 51 months of age) and standard(12, 24, 60 months of age: shaded) milestones, by Indigenous status and remoteness of area ofresidence,a,b Australia, 2021
Indigenous
statusIndigenous

Non-Indigenous

All children

Remotenesscategory c

9 mo (%) d

12 mo
(%) d

15 mo
(%) e

21 mo
(%) e

24 mo
(%) e

51 mo
(%) f

60 mo
(%) f

Major cities

85.7

92.0

87.9

83.4

90.1

87.0

96.2

Inner and outerregional

84.9

92.2

89.0

83.9

91.3

86.9

96.5

Remote and very
remote

75.7

88.7

85.6

74.0

85.7

82.2

96.1

All

83.9

91.6

88.0

82.3

90.1

86.2

96.4

Major cities

91.7

94.4

90.9

88.8

92.1

88.6

94.0

Inner and outerregional

91.4

94.1

91.4

89.1

92.7

88.9

94.6

Remote and very
remote

91.4

94.5

90.1

86.4

91.3

86.2

92.9

All

91.6

94.3

90.8

88.8

92.2

88.6

94.1

Major Cities

91.5

94.3

90.8

88.6

92.1

88.5

94.1

Inner and outerregional

90.6

93.9

91.1

88.5

92.5

88.7

94.8

Remote and very
remote

84.7

92.0

88.3

81.3

89.0

84.5

94.2

All

91.1

94.2

90.8

88.4

92.1

87.6

94.3

a

Source: Australian Immunisation Register, data as at 3 April 2022.

b

Coverage algorithm used for 9/21/51 month milestones same as for 12/24/60 months, respectively; algorithm used for 15 months sameas that for 24 months but excludes doses due at 18 months; for further detail of algorithms, refer to Table A.2 in the Appendix.

c

Accessibility/Remoteness Index of Australia (ARIA++).

d

Cohort born 1 January 2020 – 31 December 2020 (i.e. vaccines due from mid-2020 to mid-2021).

e

Cohort born 1 January 2019 – 31 December 2019 (i.e. vaccines due from mid-2019 [6-month doses] to mid-2021 [18 month doses]).

f

Cohort born 1 January 2016 – 31 December 2016 (i.e. vaccines due in 2020).

In contrast, while ‘fully vaccinated’ coverage for
non-Indigenous children in remote areas was
2.4–2.7 percentage points lower at both 21 and51 months of age than for children in major cities and regional areas, it was similar at 9 monthsof age and slightly higher at 12 months of age.
‘Fully vaccinated’ coverage in 2021 was substantially higher at the standard milestones than theearlier milestones, most markedly for vaccines
due at 48 months when assessed at 60 months
versus 51 months, for both Indigenous and nonIndigenous children, and across all remotenesscategories (Table 2).

health.gov.au/cdi

When stratified by socio-economic status ofarea of residence, children residing in areas
included in the most advantaged (fifth) quintile
in 2021 had 2.4–3.1 percentage points higher‘fully vaccinated’ coverage than children in theleast advantaged (first) quintile at the earlier
assessment milestones (9, 15, 21 and 51 months;
Table 3). The disparity between vaccination
coverage in the most and least advantaged quintiles at the standard milestones ranged from 1.1
percentage points at 60 months of age to 2.2
percentage points at 24 months of age.
‘Fully vaccinated’ coverage assessed at the earlier and standard age milestones in 2021, by
PHN, is shown in Table A.4 in the Appendix.

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Table 3: ‘Fully vaccinated’ coverage assessed at earlier (9, 15, 21, 51months of age) and standard (12, 24,
60 months: shaded) age milestones, by socio-economic status of area of residence,a,b Australia, 2021
SEIFAc quintile

9 mo
(%)d

12 mo
(%)d

15 mo
(%)e

21 mo
(%)e

24 mo
(%)e

51 mo
(%)f

60 mo
(%)f

First (least advantaged)

89.5

93.3

89.3

86.5

90.8

87.0

93.7

Second

90.2

93.6

90.5

87.9

91.8

88.2

94.3

Third

91.5

94.4

90.9

88.7

92.2

88.5

94.1

Fourth

92.0

94.8

91.7

89.5

92.8

89.1

94.5

Fifth (most advantaged)

92.3

94.8

91.8

89.6

93.0

89.4

94.8

All

91.1

94.2

90.8

88.4

92.1

88.5

94.3

a

Source: Australian Immunisation Register, data as at 3 April 2022.

b

Coverage algorithm used for 9/21/51 month milestones same as for 12/24/60 months, respectively; algorithm used for 15 months sameas 24 months but excludes doses due at 18 months.

c

SEIFA Index of Economic Resources.

d

Cohort born 1 January 2020 – 31 December 2020 (i.e. vaccines due from mid-2020 to mid-2021).

e

Cohort born 1 January 2019 – 31 December 2019 (i.e. vaccines due from mid-2019 [6-month doses] to mid-2021 [18 month doses]).

f

Cohort born 1 January 2016 – 31 December 2016 (i.e. vaccines due in 2020).

Small area coverage analysis
Childhood vaccination coverage in Australia in
2021 varied within jurisdictions and major capitalcities, with coverage in some areas substantiallybelow the national average, especially the northcoast region of New South Wales and the Gold
Coast region of Queensland (Figures 14-16).
Coverage of 95% or higher at 24 months of age
was achieved for 28.4% of SA3 areas for the second
dose of MMR-containing vaccine (93/328) (Figure14), 23.8% for the fourth dose of DTPa-containing
vaccine (78/328) (Figure 15) and 66.5% for meningococcal ACWY vaccine (218/328) (Figure 16).
Provider type and reporting to the AIR
In 2021, the large majority (82.2%) of vaccinations given to children aged < 7 years in Australia
were administered in general practice settings,
with the Northern Territory the only jurisdiction
with a minority of vaccinations in young children(19.9%) given in general practice (Figure 17).
Overall, 9.5% of vaccinations were delivered inlocal council clinic settings (with the proportion
highest in Victoria at 22.3%); 6.1% in community
health services (highest in the Northern Territory[52.0%], Australian Capital Territory [28.3%] and

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Western Australia [17.6%]); 1.2% in hospitals; and0.8% in Indigenous health services (highest in the
Northern Territory at 23.5%). A greater proportionof children aged < 7 years were vaccinated in general practice compared to people of all ages (Figure
A.10 in the Appendix), and a lesser proportion in
local council settings, with children in this age
group not eligible for pharmacist vaccination, but
distribution was more similar for non-COVID-19
vaccinations (Figure A11 in the Appendix), notingthat children aged < 7 years were not eligible for
COVID-19 vaccination in 2021.
In 2021, a total of 86.2% of vaccinations given tochildren aged < 7 years on the AIR were reported
using practice management software (jurisdictional range 29.7–92.2%; Figure 18), which was
10.7 percentage points higher than in 2017. Less
common methods of reporting included the AIR
website (10.6%; jurisdictional range 1.6–31.7%)
and internet data interchange (IDI) upload, where
immunisation providers/organisations send vaccination encounter details in bulk to the AIR (3.0%,
jurisdictional range 0.1–68.7%). The proportion of
vaccinations in children aged < 7 years reported to
the AIR using practice management software washigher in 2021 than in people of all ages (77.5%,
jurisdictional range 56.0–89.7%, data not shown).

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Figure 14: Coverage of the second dose of measles-mumps-rubella (MMR)-containing vaccine at
24 months of age by Statistical Area 3,a,b Australia and major capital cities, 2021a

Source: Australian Immunisation Register.

b

Cohort born 1 January 2019 – 31 December 2019 i.e. due for their second dose of MMR from mid-2020 to mid-2021.

c

Number in parentheses: number of Statistical Area 3s in each category.

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Figure 15: Coverage of the fourth dose of diphtheria-tetanus-acellular pertussis (DTPa)-containing
vaccine at 24 months of age by Statistical Area 3,a,b Australia and major capital cities, 2021a

Source: Australian Immunisation Register.

b

Cohort born 1 January 2019 – 31 December 2019 i.e. due for their fourth dose of DTPa from mid-2020 to mid-2021.

c

Number in parentheses: number of Statistical Area 3s in each category.

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Figure 16: Coverage of one dose of meningococcal C-containing vaccine at 24 months of age by
Statistical Area 3,a,b Australia and major capital cities, 2021a

Source: Australian Immunisation Register.

b

Cohort born 1 January 2019 – 31 December 2019 i.e. due for their meningococcal C-containing vaccine in 2020.

c

Number in parentheses: number of Statistical Area 3s in each category.

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Figure 17: Proportion of vaccinations given to children aged < 7 years by provider type andjurisdiction,a,b Australia, 2021

100.0

93.7

89.1

90.0

% of vaccinations by provider type

Local government/council clinic ᶜ
Hospital

General practitioner
Community health service
Indigenous health service
86.1

85.0

80.0

75.9

76.4

82.2

70.0 68.1
60.0

52.0

50.0
40.0
28.3

30.0

23.5

19.9

20.0

22.3

17.6

11.0

10.0
0.0

ACT

NSW

NT

Qld

9.5
6.1

SA

Tas.

Vic.

WA

AUST

JurisdictionaSource: Australian Immunisation Register, data as at 3 April 2022.

b

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

cIncludes public health units and jurisdictional health departments.

Figure 18: Proportion of vaccinations given to children aged < 7 years by type of reporting
mechanism and jurisdiction,a,b Australia, 2021
PMS -online claiming ᶜ

AIR website

100% of vaccinations reported

90

90.3

87.5

85.9

IDI upload ᵈ
92.2

Other ᵉ

88.4

86.1

86.2

80
70

68.7

68

60
50
40

31.7

30
20

29.7
13.7

9.3

10
0

ACT

NSW

NT

Qld

SA

10.6

9.3

Tas.

Vic.

WA

AUST

JurisdictionaSource: Australian Immunisation Register, data as at 3 April 2022.

b

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

cdPractice management software.
IDI = internet data interchange (approved immunisation providers/organisations can send vaccination encounter details in bulk to the
AIR using the IDI upload facility).

e

Manual and history forms.

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HPV vaccine course completion in Indigenous
girls was 73.3% in 2021, lower than in 2020
(75.0%) and seven percentage points lower thanin all girls. Course completion in Indigenous
girls in 2021 ranged from 49.6% in South
Australia to 81.0% in New South Wales (Table 4).

Adolescents
Human papillomavirus vaccine coverage
HPV vaccination coverage in girls, for receipt offirst dose and course completion by 15 years ofage, is shown in Table 4, by Indigenous status
and jurisdiction for 2020 and 2021. In 2021,
80.3% of Australian girls had completed a fullcourse of HPV vaccine by 15 years of age, downfrom 80.5% in 2020. Course completion in 2021
varied from 76.4% in Queensland to 84.9% in
the Australian Capital Territory (Table 4).

In 2021, 77.2% of Australian boys had completed
a full course of HPV vaccine by 15 years of age,
down from 77.6% in 2020. Course completion
varied from 65.7% in the Northern Territory
to 81.2% in the Australian Capital Territory(Table 5).

Table 4: Human papillomavirus (HPV) vaccination coverage (dose 1 and course completion, %)for girls by 15 years of age, by Indigenous status and jurisdiction,a,b,c Australia, 2020 and 2021
Jurisdictiond
ACT
Dose 1
Course completion
NSW
Dose 1
Course completion
NT
Dose 1
Course completion
Qld
Dose 1
Course completion
SA
Dose 1
Course completion
Tas.
Dose 1
Course completion
Vic.
Dose 1
Course completion
WA
Dose 1
Course completion
AUST
Dose 1
Course completion

All girls

Indigenous girls

2020

2021

2020

2021

9.8
83.6

90.3
84.9

86.4
75.8

89.7
72.1

87.7
83.4

87.7
83.5

92.1
83.5

90.8
81.0

87.7
76.9

86.4
75.5

89.1
76.2

87.2
72.9

83.6
76.7

83.0
76.4

85.6
71.5

83.7
69.9

86.8
78.2

86.1
76.7

82.2
58.8

74.7
49.6

88.3
78.3

88.0
78.4

91.5
80.3

88.8
76.8

88.2
82.0

87.5
81.2

88.2
77.0

87.1
75.2

84.9
78.7

84.2
79.1

82.4
65.4

81.0
67.8

86.6
80.5

86.2
80.3

87.8
75.0

86.1
73.3

a

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).

b

HPV vaccinations received after eleventh birthday and before fifteenth birthday in cohort born 1 January 2005 – 31 December 2005 for2020 coverage estimates (i.e. vaccines due from early 2017 to late 2018) and cohort born 1 January 2006 – 31 December 2006 for 2021
coverage estimates (i.e. vaccines due from early 2018 to late 2019).

c

Course completion defined as receipt of two doses if dose 2 given ≥ 5 months after dose 1, or receipt of three doses if dose 2 given < 5months after dose 1.

d

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

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Table 5: Human papillomavirus (HPV) vaccination coverage (dose 1 and course completion, %)for boys by 15 years of age, by Indigenous status and jurisdiction, Australia,a,b,c 2020 and 2021
Jurisdictiond

All boys

Indigenous boys

2020

2021

2020

2021

87.6
80.4

89.3
81.2

79.6
55.6

82.7
62.2

85.8
80.6

85.3
80.1

88.1
77.3

86.6
75.0

83.9
70.0

80.8
65.7

82.5
63.7

79.5
57.1

82.0
73.8

81.5
73.3

80.9
64.8

76.8
63.9

85.5
75.3

84.3
72.7

69.3
47.5

72.0
50.3

85.6
73.3

83.5
72.1

86.4
69.1

82.1
68.1

86.2
78.4

85.9
78.4

85.6
73.1

79.6
63.3

84.3
77.6

84.1
78.4

78.7
60.4

77.6
62.7

84.9
77.6

84.4
77.2

83.0
68.0

80.6
66.2

ACT
Dose 1
Course completion
NSW
Dose 1
Course completion
NT
Dose 1
Course completion
Qld
Dose 1
Course completion
SA
Dose 1
Course completion
Tas.
Dose 1
Course completion
Vic.
Dose 1
Course completion
WA
Dose 1
Course completion
AUST
Dose 1
Course completionab

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).
HPV vaccinations received after eleventh birthday and before fifteenth birthday in cohort born 1 January 2005 – 31 December 2005 for2020 coverage estimates and cohort born 1 January 2006 – 31 December 2006 for 2021 coverage estimates.

c

Course completion defined as receipt of two doses if dose 2 given ≥ 5 months after dose 1, or receipt of three doses if dose 2 given < 5months after dose 1.

d

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

HPV vaccine course completion in Indigenous
boys was 66.2% in 2021, lower than in 2020
(68.0%) and eleven percentage points lower thanin all boys nationally (77.2%). Course completion in Indigenous boys ranged from 50.3% in
South Australia to 75.0% in New South Wales(Table 5).
HPV vaccination coverage of first dose andcourse completion, by 15 years of age, is shownin Table 6 by gender, Indigenous status, andsocio-economic status of area of residence in2020 and 2021. Girls residing in areas in themost advantaged (fifth) quintile in 2021 had
5.1 percentage points higher course completion

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overall than girls residing in the least advantaged (first) quintile (82.3% versus 77.2%), and
8.0 percentage points higher for Indigenous girls(77.3% versus 69.3%) (Table 6). Boys residing inareas in the most advantaged quintile in 2021
had 8.3 percentage points higher course completion overall than boys residing in the least
advantaged quintile (80.4% versus 72.1%) and13.2 percentage points higher for Indigenous
boys (74.1% versus 60.9%) (Table 6). The disparity between course completion in the mostand least advantaged quintiles was greater in
2021 than 2020 across all categories, by 0.9–2.9percentage points (Table 6).

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Table 6: Human papillomavirus (HPV) vaccination coverage (dose 1 and course completion, %)for adolescents by 15 years of age, by gender, Indigenous status, and socio-economic status,a,b,c
Australia, 2020 and 2021
All girls
SEIFA quintile

Indigenous girls

2020

2021

2020

2021

Dose 1
Course completion

86.1
78.2

84.8
77.2

86.9
72.1

83.8
69.3

Dose 1
Course completion

86.7
80.1

86.3
80.0

89.8
77.7

88.4
76.8

Dose 1
Course completion

86.2
80.3

86.0
80.2

86.9
74.5

87.5
74.7

Dose 1
Course completion

86.7
81.1

86.4
80.7

88.3
77.9

87.5
75.4

87.3
82.4

87.1
82.3

89.8
78.9

86.3
77.3

d

First (least advantaged)

SecondThird

FourthFifth (most advantaged)
Dose 1
Course completion

All boys

Indigenous boys

2020

2021

2020

2021

Dose 1
Course completion

83.1
73.7

81.8
72.1

80.1
64.3

78.1
60.9

Dose 1
Course completion

84.6
77.0

83.8
76.2

84.3
70.7

80.2
67.1

Dose 1
Course completion

84.8
77.8

84.3
77.4

83.6
68.0

81.4
67.9

Dose 1
Course completion

85.4
78.7

85.1
78.5

85.3
70.5

83.4
72.4

86.0
80.2

86.1
80.4

86.5
74.6

85.5
74.1

First (least advantaged)

SecondThird

FourthFifth (most advantaged)
Dose 1
Course completionab

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).
HPV vaccinations received after eleventh birthday and before fifteenth birthday in cohort born 1 January – 31 December 2005 for 2020
coverage estimates and cohort born 1 January – 31 December 2006 for 2021 coverage estimates.

c

Course completion defined as receipt of two doses if dose 2 given ≥ 5 months after dose 1 or receipt of three doses if dose 2 given < 5months after dose 1.

d

SEIFA Index of Economic Resources.

HPV vaccination coverage, of first dose andcourse completion by 15 years of age, is shownin Table 7 by gender, Indigenous status, andremoteness category of area of residence in 2020
and 2021. In 2021, HPV course completion waslowest in adolescents residing in remote areas,
with the disparity compared to those residing
in major cities greater in boys than in girls (8.5

health.gov.au/cdi

and 10.9 percentage points lower for all boys
and Indigenous boys, respectively, compared to
4.8 and 4.7 percentage points lower for all girls
and Indigenous girls, respectively) (Table 7).
The disparity between course completion inremote areas and major cities was lower in 2021
than 2020 for girls, by 1.0–2.0 percentage points,
but higher in boys, by 0.8–1.6 percentage points.

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Table 7: Human papillomavirus (HPV) vaccination coverage (dose 1 and course completion,%) for adolescents by 15 years of age, by gender, Indigenous status, and remoteness of area ofresidence,a,b,c Australia, 2020 and 2021
All girls
Remoteness categorydIndigenous girls

2020

2021

2020

2021

86.3
80.7

85.9
80.4

88.3
76.2

86.9
74.6

87.5
80.8

87.0
80.3

88.1
76.2

86.4
73.9

86.1
74.9

85.4
75.6

86.0
69.5

84.4
69.9

Major cities
Dose 1
Course completion
Inner & outer regional
Dose 1
Course completion
Remote & very remote
Dose 1
Course completion

All boys
Remoteness categorydIndigenous boys

2020

2021

2020

2021

84.7
77.9

84.3
77.7

84.2
70.6

82.4
69.7

85.6
77.6

84.9
76.7

83.1
68.4

79.9
66.1

82.9
70.2

82.2
69.2

80.0
61.3

78.2
58.8

Major cities
Dose 1
Course completion
Inner & outer regional
Dose 1
Course completion
Remote & very remote
Dose 1
Course completionab

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).
HPV vaccinations received after eleventh birthday and before 15th birthday in cohort born 1 January – 31 December 2005 for 2020
coverage estimates and cohort born 1 January – 31 December 2006 for 2021 coverage estimates.

c

Course completion defined as receipt of two doses if dose 2 given ≥ 5 months after dose 1 or receipt of three doses if dose 2 given < 5months after dose 1.

dAccessibility/Remoteness Index of Australia (ARIA++).

Table 8 shows the number of girls aged 11–14
years who received a first dose of HPV vaccine
in 2020 or 2021 and the proportion who went
on to receive a second dose in the same calendar
year, by jurisdiction and Indigenous status. This
proportion was 15.5 percentage points lower in
2021 than in 2020 (59.2% versus 74.7%), ranging from 82.7 percentage points lower in theAustralian Capital Territory to 4.2 percentage
points higher in Victoria. For Indigenous girls,
the proportion was 14.0 percentage points lower
in 2021 than in 2020 (47.3% versus 61.3%), andranged from 60.9 percentage points lower in theAustralian Capital Territory to 0.5 of a percentage point higher in Queensland (Table 8).

on to receive a second dose in the same calendar
year, by jurisdiction and Indigenous status. This
proportion was 15.1 percentage points lower in
2021 than in 2020 (57.5% versus 72.6%), ranging from 79.8 percentage points lower in theAustralian Capital Territory to 3.3 percentage
points higher in Victoria. The proportion for
Indigenous boys was 12.1 percentage points
lower in 2021 than in 2020 (46.2% versus
58.3%) and ranged from 52.1 percentage points
lower in the Australian Capital Territory to 4.4
percentage points higher in Victoria (Table 9).

Table 9 shows the number of boys aged 11–14
years who received a first dose of HPV vaccine
in 2020 or 2021 and the proportion who went
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Table 8: Number of girls aged 11–14 years who received a first dose of human papillomavirus(HPV) vaccine, proportion of those who received a second dose in the same calendar year, andnumber who received diphtheria, tetanus, pertussis (acellular) – adolescent/adult formulation(dTpa) vaccine, by Indigenous status and jurisdiction,a Australia, 2020 and 2021
All girls aged 11–4 years
2020

2021

Jurisdictionb

HPV
dose 1(n)% received
HPV
dose 2c

dTpa
(n)

HPV
dose 1(n)% received
HPV
dose 2c

dTpa
(n)

ACT

2,499

86.4

2,382

2,423

3.7

326

NSW

41,10071.6

41,421

43,40432.0

42,446

NT

1,411

60.8

1,426

1,206

59.1

1,211

Qld

29,14379.0

29,52729,43977.7

30,063

SA

9,001

83.1

9,211

9,231

80.0

9,490

Tas.

2,618

65.0

2,616

2,838

67.9

2,787

Vic.

33,85971.3

33,71934,25075.5

34,761

WA

15,23878.3

15,491

14,281

59.2

14,671

AUST

134,869

74.7

135,793137,07259.2

135,755

Indigenous girls aged 11–14 years
2020

2021

HPV
dose 1(n)% received
HPV
dose 2c

dTpa
(n)

HPV
dose 1(n)% received
HPV
dose 2c

dTpa
(n)

ACT

48

66.7

43

52

5.8

15

NSW

2,346

67.2

2,344

2,548

34.5

2,519

NT

524

35.3

518

445

32.8

442

Qld

2,224

62.4

2,247

2,164

62.9

2,201

SA

276

63.0

284

275

58.9

282

Tas.

265

63.4

260

256

60.9

248

Vic.

543

57.1

543

425

56.2

426

WA

971

59.7

958

773

43.5

795

AUST

7,197

61.3

7,197

6,938

47.3

6,928

a

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 counts) and as at 3 April 2022 (for 2021 counts).

b

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

c

Percentage of those who received first dose of HPV vaccine in 2020 or 2021 who then went on to receive the second dose in the same
calendar year.

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Table 9: Number of boys aged 11–14 years who received a first dose of human papillomavirus(HPV) vaccine, proportion of those who received a second dose in the same calendar year, andnumber who received diphtheria, tetanus, pertussis (acellular) – adolescent/adult formulation(dTpa) vaccine, by Indigenous status and jurisdiction,a Australia, 2020 and 2021
All boys aged 11–14 years
2020

2021

Jurisdictionb

HPV
dose 1(n)% received
HPV
dose 2c

dTpa
(n)

HPV
dose 1(n)% received
HPV
dose 2c

dTpa
(n)

ACT

2,508

84.1

2,378

2,519

4.3

356

NSW

41,87069.1

42,173

43,46430.5

43,108

NT

1,370

60.1

1,356

1,275

53.2

1,315

Qld

29,83875.7

30,081

30,34675.5

30,985

SA

8,932

81.2

9,120

9,493

78.4

9,718

Tas.

2,545

67.5

2,532

2,852

64.9

2,821

Vic.

35,02969.5

34,83435,44072.8

36,102

WA

15,84677.6

16,097

14,96057.4

15,404

AUST

137,93872.6

138,571

140,34957.5

139,809

Indigenous boys aged 11–14 years
2020

2021

HPV
dose 1(n)% received
HPV
dose 2c

dTpa
(n)

HPV
dose 1(n)% received
HPV
dose 2c

dTpa
(n)

ACT

58

63.8

53

60

11.7

17

NSW

2,186

64.8

2,161

2,341

32.6

2,362

NT

531

35.2

512

439

28.7

474

Qld

2,198

60.1

2,203

2,111

60.3

2,152

SA

298

58.4

290

286

55.9

286

Tas.

236

63.1

229

282

55.7

273

Vic.

523

53.7

525

420

58.1

425

WA

952

53.2

931

770

47.9

784

AUST

6982

58.3

6904

6709

46.2

6773

a

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 counts) and as at 3 April 2022 (for 2021 counts).

b

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

c

Percentage of those who received first dose of HPV vaccine in 2020 or 2021 who then went on to receive the second dose in the same
calendar year.

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Diphtheria-tetanus-acellular pertussis (dTpa) booster
vaccine coverage
Figure 19 shows coverage, by 15 years of age,of the adolescent booster dose of diphtheriatetanus-acellular pertussis (dTpa) vaccine in2020 and 2021, by jurisdiction. Nationally, dTpa
coverage was 0.5 of a percentage point higher in
2021 than 2020 (87.3% versus 86.8%). Coveragein 2021 ranged from 82.9% in the Northern
Territory to 89.4% in the Australian Capital
Territory.
In 2021, 78.0% of adolescents had received theadolescent booster dose of dTpa vaccine andhad also completed the HPV vaccination schedule by 15 years of age; only 3.3% had received
the dTpa adolescent booster dose but no dose/sof HPV vaccine (data not shown).
Figure 20 shows coverage, by 15 years of age, ofthe booster dose of dTpa vaccine in 2020 and
2021 in Indigenous adolescents, by jurisdiction. Nationally, dTpa coverage for Indigenous
adolescents was 0.4 of a percentage point lower
in 2021 than 2020 (83.8% versus 84.2%), and3.5 percentage points lower than coverage inall adolescents. Coverage in 2021 ranged from
75.1% in South Australia to 89.3% in New
South Wales.
In 2021, 68.8% of Indigenous adolescents hadreceived the adolescent booster dose of dTpa
vaccine and had also completed the HPV vaccination schedule by 15 years of age; only 2.6%
had received the dTpa adolescent booster dose
but no dose/s of HPV vaccine (data not shown).
In 2021, the number of dTpa vaccinations
recorded nationally in girls aged 11–14 years
was similar to the number recorded in 2020;
however, in the Australian Capital Territory,
the number of administered doses in 2021 was
86.3% lower than in 2020 (326 versus 2,382
doses) (Table 8).
The number of dTpa vaccinations recorded inboys aged 11–14 years was 0.9% higher nationallyin 2021 than in 2020; however, in the Australian

health.gov.au/cdi

Capital Territory, the number of administereddoses in 2021 was 85.0% lower than in 2020(356 doses versus 2,378 doses) (Table 9).
Meningococcal ACWY vaccine coverage
Figure 21 shows coverage, by 17 years of age,of meningococcal ACWY vaccine in 2020 and
2021, by jurisdiction. Nationally, coverage
was 1.8 percentage points higher in 2021 than2020 (76.1% versus 74.3%). Coverage in 2021
ranged from 73.7% in Queensland to 83.0% in
Tasmania.
Figure 22 shows coverage, by 17 years of age,of meningococcal ACWY vaccine in 2020 and
2021 in Indigenous adolescents, by jurisdiction.
Nationally, coverage for Indigenous adolescentswas 1.4 percentage points lower in 2021 than2020 (66.7% versus 68.1%), and 9.4 percentage
points lower than coverage in all adolescents.
Coverage in Indigenous adolescents in 2021
ranged from 58.9% in Victoria to 85.6% in
Tasmania.
Figure 23 shows the number of adolescents who
received a meningococcal ACWY vaccinationin 2020 and 2021 by age group. Overall, thenumber of doses administered was 5.0% lower
in 2021 than 2020, and lower in all age groups
except 14 and 15 years (13.3% and 5.0% higher,
respectively) (Figure 23).
Influenza vaccine coverage
Influenza vaccine coverage in adolescents aged
10–14 years and 15–19 years decreased by
11.5 and 7.6 percentage points between 2020
and 2021, to 13.3% and 15.1%, respectively(Figure 2) with decreases seen in all jurisdictions (Appendix, Table A.3). In 2021, coverage
for adolescents aged 10–14 years ranged from
11.8% in New South Wales to 17.6% in South
Australia, and for adolescents aged 15–19 years
from 13.2% in New South Wales to 20.0% in
South Australia (Appendix, Table A.3).

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Figure 19: Coverage (%) of the adolescent booster dose of diphtheria-tetanus-acellular pertussis(dTpa) vaccinea by 15 years of age, by jurisdiction,b,c,d Australia, 2020 and 2021.
100
90

89.4
88.5
87.0
88.0

2020
84.4 82.9 84.2

2021

84.5 88.5 87.9

87.3
86.3 87.088.1 87.5
87.4 86.8
83.9

80
70

Coverage (%)

60
50
40
30
20
10
0

ACT

NSW

NT

Qld

SA

Tas.

Vic.

WA

AUST

JurisdictionadTpa: diphtheria, tetanus, pertussis (acellular) – adolescent/adult formulation.

b

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 counts) and as at 3 April 2022 (for 2021 counts).

c

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

ddTpa vaccinations received after 11th birthday and before 15th birthday in cohort born 1 January – 31 December 2005 for 2020
coverage estimates and cohort born 1 January – 31 December 2006 for 2021 coverage estimates.

Figure 20: Coverage (%) of the adolescent booster dose of diphtheria-tetanus-acellular pertussis(dTpa) vaccinea in Indigenous adolescents by 15 years of age, by jurisdiction,b,c,d Australia, 2020
and 2021
100.0
90.0
80.0

2020
2021
88.9 89.3
88.0 85.8
84.2 83.8
84.1
82.8
82.5
82.3
80.6 80.4
81.0 78.5
80.8 80.7
75.1
73.3

Coverage (%)

70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0

ACT

NSW

NT

Qld

SA

Tas.

Vic.

WA

AUST

JurisdictionadTpa: diphtheria, tetanus, pertussis (acellular) – adolescent/adult formulation.

b

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 counts) and as at 3 April 2022 (for 2021 counts).

c

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

ddTpa vaccinations received after 11th birthday and before 15th birthday in cohort born 1 January – 31 December 2005 for 2020
coverage estimates and cohort born 1 January – 31 December 2006 for 2021 coverage estimates.

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Figure 21: Coverage (%) of meningococcal ACWY vaccine in adolescents by 17 years of age, by
jurisdiction,a,b,c Australia, 2020 and 2021
100
90
80

Coverage (%)

70

2020

2021
83.0
80.0 79.1

80.9 84.3
79.4
75.0 75.9
73.3 73.7
73.0

79.4 79.1
76.1
75.7 74.6
74.3

58.1

60
50
40
30
20
10
0

ACT

NSW

NT

Qld

SA

Jurisdiction

Tas.

Vic.

WA

AUST

a

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 counts) and as at 3 April 2022 (for 2021 counts).

b

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

cMeningococcal ACWY vaccinations received after thirteenth birthday and before seventeenth birthday in cohort born 1 January – 31
December 2003 for 2020 coverage estimates and cohort born 1 January – 31 December 2004 for 2021 coverage estimates.

Figure 22: Coverage (%) of meningococcal ACWY vaccine in Indigenous adolescents by 17 yearsof age,a,b,c by jurisdiction, Australia, 2020 and 2021
100

2020

90

Coverage (%)

70

84.0

79.4

80
68.3
67.0
66.6

60

2021
79.7

67.3 66.8

62.2

85.6
70.6

65.3

63.6

58.9

68.1
66.7
64.6

50.3

50
40
30
20
10
0

ACT

NSW

NT

Qld

SA

Jurisdiction

Tas.

Vic.

WA

AUST

a

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 counts) and as at 3 April 2022 (for 2021 counts).

b

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

cMeningococcal ACWY vaccinations received after thirteenth birthday and before seventeenth birthday in cohort born 1 January – 31
December 2003 for 2020 coverage estimates and cohort born 1 January – 31 December 2004 for 2021 coverage estimates.

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2021

242,9352020

12,987
7,068

9,654

50,00011,312100,000

11,794150,000

58,86145,884

149,305

200,000

156,791

250,000

9,988

Number of adolescents receiving a dose

300,000

230,709

Figure 23: Number of adolescents receiving a meningococcal ACWY vaccination by age group,a,bAustralia, 2020 and 2021

0

Age groupaSource: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).

b

Aged 14–19 years as at date of vaccination.

Influenza vaccine coverage in Indigenous
adolescents aged 10–14 years and 15–19 years
decreased by 16.8 and 14.1 percentage points
between 2020 and 2021, to 15.4% and 16.5%,
respectively (Figure 4), with decreases seen in all
jurisdictions (Appendix, Table A.3). Coveragefor Indigenous adolescents aged 10–14 years in
2021 ranged from 12.8% in Western Australia to
25.1% in the Northern Territory and for adolescents aged 15–19 years from 14.0% in Western
Australia to 24.5% in the Northern Territory(Appendix, Table A.3).

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COVID-19 vaccine coverage
By the end of 2021, a total of 79.5% of Australianadolescents aged 12–15 years had received afirst dose of a COVID-19 vaccine and 73.4%
had received a second dose (Appendix, FigureA.12). Coverage of the first dose of COVID-19
vaccine in adolescents aged 12–15 years ranged
from 68.1% in Western Australia to above 99%
in the Australian Capital Territory (Appendix,
Table A.5).

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than for adults overall in both years (Figure 27),
with coverage in 2021 ranging from 35.7% in
Western Australia to 60.6% in Tasmania.

AdultsZoster vaccine coverage
Zoster vaccine coverage for Australian adults
aged 70 years decreased from 30.9% in 2020
to 30.6% in 2021, with coverage in 2021 ranging from 14.5% in the Northern Territory to
40.9% in Queensland (Figure 24). Coverage in
Indigenous adults aged 70 years decreased from
28.7% in 2020 to 26.5% in 2021 (Figure 25), withcoverage in 2021 ranging from 13.0% in the
Northern Territory to 41.7% in the Australian
Capital Territory.

Zoster vaccine coverage for adults by whether
vaccinated at < 71 years or ≥ 71 years, by single
year of age birth cohort, is shown in Figure 28.
Coverage is greater than 40% for all cohorts
aged 72–79 years, highest in those aged 74 years
at 49.7%, with the older cohorts predominantly
vaccinated at ≥ 71 years i.e. as part of the catchup vaccination program initiated in late 2016.
Of 6,460,914 adults in Australia who were in theage cohort who turned 50–69 years of age during 2021, a total of 68,276 (1.1%) had received
a dose of zoster vaccine during 2021 (up to 31
December 2021; data not shown).

Zoster vaccine coverage for Australian adults
aged 71–79 years increased from 43.7% in 2020
to 46.7% in 2021, with coverage in 2021 ranging from 31.3% in the Northern Territory to
55.3 in Queensland (Figure 26). Coverage in
Indigenous adults aged 71–79 years increased
from 44.9% in 2020 to 47.3% in 2021, higher

Of the 197,968 doses of zoster vaccine recordedon the AIR as administered in 2021, only 12,890
doses (6.5%) were recorded as Shingrix vaccine(data not shown).

Figure 24: Zoster vaccine coverage for adults turning 71 years of age in the year of interest, by
jurisdiction,a,b,c Australia, 2019, 2020, and 2021
100
90

2019

80

2020

2021

Coverage (%)

70
60
50
40

40.4

40.9
27.2

30
20

33.4

31.5

27.1

26.0

30.6

14.5

10
0

ACT

NSW

NT

Qld

SA

Tas.

Vic.

WA

AUST

Jurisdictionab

Source: Australian Immunisation Register, data as at 3 April 2022.
ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

c

Cohorts: 1 January – 31 December 1948 for 2019 coverage; 1 January – 31 December 1949 for 2020 coverage; 1 January – 31 December
1950 for 2021 coverage. Coverage: receipt of one dose of Zostavax or two doses of Shingrix before turning 71 years of age and includes
doses given at less than 70 years of age.

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Figure 25: Zoster vaccine coverage for Indigenous adults turning 71 years of age in the year ofinterest, by jurisdiction,a,b,c Australia, 2019,d 2020,d and 2021
100
90

2019

80

2020

2021

Coverage (%)

70
60
50
40

41.7

37.4

30

29.5

24.8

30.6

26.5
22.0

20

13.0

16.8

10
0

a
b

ACT

NSW

NT

Qld

SA

Jurisdiction

Tas.

Vic.

WA

AUST

Source: Australian Immunisation Register, data as at 3 April 2022.
ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

c

Cohorts: 1 January – 31 December 1948 for 2019 coverage; 1 January – 31 December 1949 for 2020 coverage; 1 January – 31 December
1950 for 2021 coverage. Coverage: receipt of one dose of Zostavax or two doses of Shingrix before turning 71 years of age and includes
doses given at less than 70 years of age.

d2019 and 2020 estimates have been revised due to an issue with the recording of Indigenous status on the AIR and are therefore
different to what was presented in the 2020 report.

Figure 26: Zoster vaccine coverage for adults turning 72–79 years of age in the year of interest,by jurisdiction,a,b,c Australia, 2019, 2020, and 2021
100

2019

90

2020

2021

80

Coverage (%)

70
60

55.3

54.9

50

51.6

51.2
44.1

42.0

40

45.7

46.7

31.3

30
20
10
0

ACT

NSW

NT

Qld

SA

Tas.

Vic.

WA

AUST

JurisdictionaSource: Australian Immunisation Register, data as at 3 April 2022.

b

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

c

Cohorts: 1 January 1940 – 31 December 1947 for 2019 coverage; 1 January 1941 – 31 December 1948 for 2020 coverage; 1 January
1942 – 31 December 1949 for 2021 coverage. Coverage: receipt of one dose of Zostavax or two doses of Shingrix before turning 80
years of age and includes doses given at less than 71 years of age.

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Figure 27: Zoster vaccine coverage for Indigenous adults turning 72–79 years of age in the yearof interest, by jurisdiction,a,b,c Australia, 2019,d 2020,d and 2021
100

2019

90

2020

2021

80

Coverage (%)

70
60

60.6

56.1

53.7

50

44.0

51.6

40

47.3

44.5

39.4

35.7

30
20
10
0

ACT

NSW

NT

Qld

SA

Tas.

Vic.

WA

AUST

JurisdictionaSource: Australian Immunisation Register, data as at 3 April 2022.

b

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

c

Cohorts: 1 January 1940 – 31 December 1947 for 2019 coverage; 1 January 1941 – 31 December 1948 for 2020 coverage; 1 January 1942
– 31 December 1949 for 2021 coverage. Coverage: receipt of one dose of Zostavax or two doses of Shingrix before turning 80 years ofage and includes doses given at less than 71 years of age.

d2019 and 2020 estimates have been revised due to an issue with the recording of Indigenous status on the AIR and are therefore
different to what was presented in the 2020 report.

Figure 28: Zoster vaccine coverage by whether vaccinated at < 71 years or ≥ 71 years of age, bysingle year of age birth cohort,a,b Australia, 2021
100
90

Vaccinated at < 71 years of age

80

Vaccinated at ≥ 71 years of age

Zoster coverage (%)

70
60
50
40
30
20
10
0

8.1

13.9

17.1

21.4
29.8
45.2

30.6

30.9

31.6

28.3

45.8

46.2

45.8

16.3
0.4

0.1

0.0

0.0

71 yr

72 yr

73 yr

74 yr

75 yr

76 yr

77 yr

78 yr

79 yr

(1950)(1949)(1948)(1947)(1946)(1945)(1944)(1943)(1942)

Age at end of 2021
(Year born)aSource: Australian Immunisation Register, data as at 3 April 2022.

b

Coverage: receipt of one dose of Zostavax or two doses of Shingrix before turning 80 years of age and includes doses given at less than
70 years of age.

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13vPCV coverage

Influenza vaccine coverage

Recorded 13vPCV coverage in adults aged 70
years increased by 15 percentage points overall
between 2020 and 2021, reaching 17.2%, andby 16.8 percentage points in Indigenous adults,
reaching 18.8% (Figure 29).

Influenza vaccine coverage in adults aged 20–49
years and 65–74 years increased by 0.4 and 0.9
of a percentage point between 2020 and 2021,
reaching 23.9% and 62.1%, respectively; coverage in adults aged 50–64 years and 75+ years
increased more substantially, by 3.0 and 5.6
percentage points, reaching 38.2% and 68.5%,
respectively (Figure 2). Coverage by jurisdiction
is shown in Table A.3 in the Appendix.

Recorded 13vPCV coverage in adults aged 71–79
years increased by 12 percentage points overall
between 2020 and 2021, reaching 20.1%, andby 10.9 percentage points in Indigenous adults,
reaching 20.7% (Figure 30).
Of 6,460,914 adults in Australia who were in theage cohort who turned 50–69 years of age during 2021, a total of 63,481 (1.0%) were recorded
as having received a dose of 13vPCV during2021 (up to 31 December 2021; data not shown).
Of 105,847 Indigenous adults in Australia who
were in the age cohort who turned 50–69 yearsof age during 2021, a total of 11,470 (10.8%)
were recorded as having received a dose of
13vPCV during 2021 (up to 31 December 2021;
data not shown).

Influenza vaccine coverage in all Indigenous
adult age groups decreased between 2020 and
2021, with the largest decrease in those aged
50–64 years (12.8 percentage points to 43.5%)
and the smallest decrease in Indigenous adults
aged 75+ years (3.0 percentage points to 67.7%)(Figure 4). Coverage by jurisdiction is shown in
Table A.3 in the Appendix.

Figure 29: 13vPCV coverage in 70-year-olds by Indigenous status for 2020 versus 2021,a Australia
50
45

All

Indigenous

40

Coverage (%)

35
30
25
20

18.8

17.2

15
10
5
0

a

2.2

2.0
70 years

70 years

2020

2021

Source: Australian Immunisation Register, data as at 3 April 2022.

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Figure 30: 13vPCV coverage in 71–79 year olds by Indigenous status for 2020 versus 2021,a Australia
50

All

45

Indigenous

40

Coverage (%)

35
30
25

15
10

20.7

20.1

20
9.8

8.1

5
0

a

71–79 years

71–79 years

2020

2021

Source: Australian Immunisation Register, data as at 3 April 2022.

Cumulative proportion vaccinated (%)

Figure 31: Weekly cumulative influenza vaccine uptake (≥ 1 dose) by age group,a Australia, 2021
100
90
80

6–59 mo

5–9 yr

10–14 yr

15–19 yr

20–49 yr

50–64 yr

65–74 yr

75+ yr

70

68.5
62.1

60
50
40

38.2

30

26.5
23.9
15.6
15.1
13.3

20
10
0

Week/month of vaccinationaSource: Australian Immunisation Register, data as at 3 April 2022.

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Figure 31 shows weekly cumulative influenza
vaccine uptake in the AIR in 2021, by age group.
Uptake was highest for all age groups between
the first week of April and the last week of May,
with the steepest trajectories in adults aged
65–74 years and in those aged 75+ years. Uptake
was slowest in children aged 5–9 years, and inadolescents aged 10–14 years and 15–19 years.
Uptake commenced later in 2021 than in 2020,
where it was highest for all age groups between
the last week of March and the first week of May(data not shown).
COVID-19 vaccine coverage
By the end of 2021, a total of 94.5% of Australians
aged 16 years and over had received a first doseof a COVID-19 vaccine; 91.6% had received asecond dose (Appendix, Figure A.13). Coveragein people aged 16 years and over for the firstdose ranged from 89.3% in the Northern
Territory to above 99% in the Australian Capital
Territory, and for the second dose from 84.6%
in the Northern Territory to above 99% in theAustralian Capital Territory (Appendix, Table
A.6).
Adult coverage of both first and second dose
increased with increasing age (Appendix, FigureA.12), ranging from 91.4% first dose and 87.8%
second dose coverage in those aged 16–49 years
to above 99% for both doses in those aged 70
years and over. Coverage by jurisdiction and age
group is shown in Table A.5 in the Appendix.
COVID-19 vaccine coverage was lower in
Indigenous people aged ≥ 16 years for both firstand second dose, at 79.2% and 71.8%, respectively (Appendix, Figure A.13), ranging from
67.5% and 52.7% in Western Australia to 90.8%
and 88.0% in the Australian Capital Territory(Appendix, Table A6).

Discussion
Overall findings
Vaccination coverage in children‘Fully vaccinated’ coverage in Australian children in this 2021 report was 0.6–0.8 of a percentage point lower than in our 2020 report at
the 12-month (94.2%) and 60-month (94.0%)
age assessment milestones, but stable at the
24-month milestone (92.1%).14 Due to the lagtime involved in ‘fully vaccinated’ coverageassessment, ‘fully vaccinated’ coverage figuresin the 2020 and 2021 reports predominantly
reflect vaccinations due in 2019 and 2020,
respectively, and hence show a small impact
on overall childhood coverage in the first yearof the COVID-19 pandemic, lower than thatseen in many other countries.17–19 However,pandemic impacts on coverage were greater insome areas, particularly remote areas with ahigh proportion of Indigenous people such as
the East Pilbara SA3 area in Western Australia
and Katherine and Alice Springs SA3 areas in
the Northern Territory, with coverage for thesecond dose of MMR and fourth dose of DTPa
decreasing from above 90% in the 2020 report14
to below 90% in this report. True coveragein children was likely somewhat higher thanpresented here, given previously documented
under-reporting to the AIR.20,21‘Fully vaccinated’ coverage in 2021 was around
two percentage points lower at the 24-month
milestone than at 12 and 60 months of age,likely due to the greater number of antigens
required in order to be classified as ‘fully vaccinated’ at 24 months.9 In contrast, only one
vaccine (DTPa-polio, scheduled at 48 months)
is included in ‘fully vaccinated’ assessment at 60
months. Expansion of the 60-month assessment
algorithm, to include a more comprehensive
range of the vaccines/antigens that should havebeen received by that age, would be useful tobetter monitor uptake under the NIP.
Coverage was lower in 2021 than in 2020 for
almost all individual vaccines/antigens included

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in the ‘fully vaccinated’ assessment algorithms.
The largest decrease was for DTPa-containing
vaccine at 60 months of age (a 2.5 percentage
point decrease); all other decreases were lessthan one percentage point. In the context ofAustralia’s 95% coverage targets, which are particularly critical to measles control, coverage at
24 months of age in 2021 was 95.5% for the firstdose of measles-containing vaccine; and while
coverage was lower for the second dose of MMR
at 24 months (93.6%), it was 96.6% at 60 monthsof age.
Influenza vaccine coverage in 2021 in children
aged 6 months to 4 years, at 26.5%, was 19.6
percentage points lower than in 2020 (46.1%),
in the context of historically low levels of circulating influenza due to COVID-19 pandemicrelated public health measures.22
Vaccination coverage in adolescents
In 2021, a total of 80.3% of girls in Australia hadcompleted a full course of HPV vaccine by age
15 years, down slightly from 80.5% in 2020, and77.2% of boys, down from 77.6%. Completion of
HPV vaccination in 2021 was lower in adolescents residing in socio-economically disadvantaged and remote areas, around five percentage
points lower for girls and eight for boys. While
HPV coverage by 15 years of age for both 2020
and 2021 predominantly represents vaccinations due in school-based programs prior to the
COVID-19 pandemic, the slight decreases could
be due to pandemic-related effects on catch-up
vaccination. Pandemic-related impacts can beseen more clearly in the decrease in proportionof adolescents aged 11–14 years who received afirst dose of HPV vaccine and then went on toreceive their second dose in the same calendar
year. This proportion was around 15 percentage
points lower in 2021 than in 2020, and 27 percentage points lower than in 2019.14 This likely
reflects the impact of public health measures,
particularly school closures, in the context ofthe minimum 6-month interval recommended
between doses.23 Re-deployment of school-based
immunisation providers into COVID-19 vaccination clinics in 2021 may have also impacted

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completion rates. However, with modelling ofboth-sex HPV vaccination programs suggestingthat sustained population vaccination coverageof over 80% will be sufficient for elimination oftargeted HPV types, Australia still looks wellplaced to achieve this.24
Coverage of the adolescent booster dose of dTpa
vaccine by 15 years in 2021 was 87.3%, half apercentage point higher than 2020, and coverage of meningococcal ACWY vaccine by 17
years of age was 76.1%, almost two percentage
points higher. While these figures predominantly represent vaccinations due in schoolbased programs prior to the pandemic, thenumber of meningococcal ACWY vaccinations
recorded as given in 2021 was five percentage
points lower than in 2020, and 9 percentage
points lower than in 2019,14 indicating likely
pandemic impacts on uptake. A particularlymarked drop in dTpa and in second dose HPV
vaccinations was seen in the Australian Capital
Territory in 2021: due to a territory-wide lockdown from August to September, with adolescent COVID-19 vaccination prioritised upon
school reopening, a decision was made to defer
the dTpa and second-dose HPV vaccinations forYear 8 students to 2022.25
Vaccination coverage in adults
Zoster vaccine coverage in 2021 remained
relatively low, at just over 30%, in adults aged
70 years, the primary NIP target group, but
increased to 47% in those aged 71–79 years,
reflecting substantial levels of ongoing catch-up
vaccination. Greater focus on promoting timely
vaccination at 70 years is required, particularly
if the NIP-funded catch-up zoster vaccination
program for adults aged 71–79 years is notextended further (currently scheduled to finish on 31 October 2023)26. True zoster vaccine
coverage is likely higher, as under-reporting to
the AIR has previously been documented.27, 28
Mandatory reporting of all NIP vaccines wasintroduced in July 2021.29
Coverage of 13vPCV vaccine, introduced onto
the NIP in July 2020 for all adults aged 70 years

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and over, was low in 2021, reaching 17.2% in
adults aged 70 years and 20.1% in those aged
71–79 years. Influenza vaccination coverage inadults in 2021 was progressively higher withincreasing age, reaching 62.1% and 68.5% in
the 65–69 year 75+ year age groups respectively.
Coverage was also higher in 2021 than 2020
across all adult age groups, which could be due
in part to increased completeness of reporting,as mandatory reporting for influenza vaccine
was introduced in March 2021.29, 30 By the endof 2021, a total of 91.6% of Australians aged ≥16 years (and over 99% of those aged ≥ 70 years)
had received a second dose of a COVID-19
vaccine.

with no further doses required at 18 months(MenACWY, polio and hepatitis B vaccines) was
96.6% or greater overall at 24 months in 2021.
Similarly, although coverage in 2021 for the second dose of MMR and varicella (usually given
as MMRV vaccine at 18 months) in Indigenous
children was 92.4% at 24 months, it was over six
percentage points higher (98.6%) at 60 months.
Likely related to these issues, in remote areas
with a high proportion of Indigenous people,
less pandemic-related impact was observed on
coverage at 24 months for MenC-containing
vaccine (due at 12 months) than for the fourth
dose of DTPa and second dose of MMR (bothdue at 18 months).

Vaccination coverage in Indigenous people

As seen in children overall, influenza vaccination coverage in Indigenous children in 2021
was considerably lower than 2020: totals of
22.5% in 2021 versus 43.0% in 2020 for those
aged 6 months to 4 years, and 15.5% versus
33.8% for those aged 5 to 9 years. Coverage in
Indigenous children aged 6 months to 4 years
in 2021 was highest in the Northern Territory
at 53.2%.

Children‘Fully vaccinated’ coverage for Indigenous children decreased between 2020 and 2021 at all
three age milestones: 12 months (from 93.1% to91.6%); 24 months (from 91.2% to 90.1%); and60 months (from 97.0% to 96.3%). The 2021
coverage figures predominantly reflect vaccinations due in 2020, showing a small impact (butone slightly higher than in children overall) on
Indigenous childhood coverage in the first yearof the COVID-19 pandemic.
‘Fully vaccinated’ coverage in Indigenous children in 2021 was 2.6 percentage points lower
than in all children at 12 months of age (compared to 1.7 percentage points in 2020), and 2.0
percentage points lower at 24 months (compared
to 0.9 of a percentage point in 2020). ‘Fully vaccinated’ coverage at 60 months of age remained
higher in Indigenous than in all children, by 2.3
percentage points in 2021. The lower coverageat the 12- and 24-month milestones in 2021,
compared to overall, highlights longstanding
timeliness issues among Indigenous children,1,9
with some exacerbation due to the pandemic
apparent, particularly in remote areas. This isparticularly an issue in relation to vaccines/
antigens due 6 months before the assessment
milestone, whereas coverage of individual vaccines/antigens due at 6 or 12 months of age

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Coverage for hepatitis A vaccine and the fourth
dose of 13vPCV, which are funded under the
NIP for Indigenous children in four jurisdictions only (South Australia, Northern Territory,
Queensland and Western Australia), remained
suboptimal in 2021, at 82.0% for the first doseof hepatitis A (second dose coverage unable tobe assessed due to schedule change) and 81.7%
for 13vPCV dose 4, although coverage in the
Northern Territory continued to be substantially higher.
Adolescents
HPV vaccination coverage (both first dose andcourse completion) for Indigenous girls andboys by 15 years of age was 1.7–2.4 percentage
points lower in 2021 than 2020. Coverage waslower than in adolescents overall, particularly
for course completion, seven percentage points
lower for girls and 11 for boys. Further efforts
to address these disparities are required, given
the much higher rates of cervical cancer in

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Indigenous women,31 whilst noting that there isincreasing evidence that a single dose of HPV
vaccine is highly effective in preventing infection and subsequent disease.32-34
AdultsZoster vaccination coverage in 2021 was 26.5%
in Indigenous adults aged 70 years, 2.2 percentage points lower than 2020 and 3.5 points
lower than 2019, suggesting greater COVID-19
pandemic impacts on uptake in Indigenous
than other adults. However coverage in 2021 in
Indigenous adults aged 71–79 years increased
to 47.3%, 0.6 of a percentage point higher thanadults overall, again reflecting substantial ongoing catch-up vaccination.
Coverage of 13vPCV in Indigenous adults was
also low in 2021, reaching 18.8% in those aged
70 years and 20.7% in those aged 71–79 years.
Only 10.8% of Indigenous adults aged 50–69
years were recorded as having received 13vPCV,
despite it being funded under the NIP for all
Indigenous adults in this age group since July
2020. While influenza vaccine coverage wasrelatively high in older Indigenous adults, at
64.6% for those aged 65–74 years and 67.7%
for those aged 75 years and over, coverage inyounger Indigenous adults was considerably
lower, ranging from 22.0% for those aged 20–49
years to 43.5% for those aged 50–64 years.
Further efforts to increase uptake are required
given that annual influenza vaccination isfunded on the NIP for all Indigenous adults,
due to their increased risk of severe disease.
Coverage of the second dose of COVID-19
vaccine in Indigenous people aged ≥ 16 years,
at 71.8%, was 20 percentage points lower thanoverall coverage for this dose.
A focus on timelinessWe examined a broad range of timeliness indicators in this report. The traditional measure of‘on time’ vaccination (within 30 days of the age
recommended on the NIP schedule) was up to
two percentage points lower in infants in 2021
than 2020 for the second dose of DTPa, 13vPCV

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and rotavirus vaccine, suggesting possible pandemic impacts (2021 figures predominantly
reflect vaccinations due during the pandemic
while 2020 figures predominantly reflect vaccinations due prior to pandemic restrictions).
However, there appeared to be little impact on
on-time vaccination for the first dose of MMR
and meningococcal ACWY vaccine, both due at
12 months of age, with timely coverage in 2021
(for vaccinations due in 2020) up to one percentage point higher than in 2020 (for vaccinations
due in 2019). While on-time vaccination in
Indigenous children has improved progressively
since 2012, on-time coverage in 2021 remained
substantially lower than in non-Indigenous
children, ranging from six to 13 percentage
points lower for the vaccines/antigens assessed.
We also examined ‘fully vaccinated’ coverage
at four earlier milestones, three months after
the due date of the last scheduled vaccine, byremoteness and socio-economic status of areaof residence. ‘Fully vaccinated’ coverage at theearlier milestones was consistently lower inchildren living in remote areas than those living
in major cities and regional areas, likely due togreater logistic issues in providing and accessing vaccination in remote areas. The disparity
was substantially higher in Indigenous children, most marked at the 9-month milestonewhere coverage in remote areas in 2021 was
10 percentage points lower than in major cities
and eight percentage points lower than in the2020 report (for which figures predominantly
reflect vaccinations due prior to the COVID-19
pandemic),12 suggesting differential impacts ofthe pandemic. ‘Fully vaccinated’ coverage at theearlier assessment time points in 2021 was twoto three percentage points lower for children
living in areas in the most socio-economicallydisadvantaged quintile than in the least disadvantaged quintile, generally similar to findings
in our 2020 report.14

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45 of 73.

Conclusions

Acknowledgments

We found that, despite the major disruptions associated with the COVID-19 pandemic, vaccine coverage in children in Australia remained relatively
high overall in 2021. Due to assessment lag times,
the small overall decrease observed predominantly
reflects impacts on coverage in the first year of thepandemic (2020). However, impacts on coverage
were greater in some areas and populations, andoverall influenza vaccine coverage almost halved
in children aged 6 months to 4 years, although inthe context of historically low levels of circulating
influenza. While coverage in Indigenous children
was also relatively high overall, timeliness of vaccination remains a persistent issue, with impactsof the pandemic on timeliness particularly seen
in remote areas. Adolescent coverage was also
relatively high in 2021, although with continuinglower course completion rates in Indigenous adolescents and with evidence of pandemic impact,
particularly on receipt of two doses of HPV
vaccine within the same calendar year. It will be
important to ensure that catch-up vaccination inchildren and adolescents occurs, and to monitor
coverage to establish that all pandemic-related
dips in coverage and equity gaps are reversed.

The National Centre for Immunisation
Research and Surveillance is supported by theAustralian Government Department of Healthand Aged Care, the NSW Ministry of Healthand The Sydney Children’s Hospitals Network.
The opinions expressed in this report are thoseof the authors, and do not necessarily represent
the views of these agencies.

A strengthened focus on adult vaccination isneeded, as coverage remained suboptimal in 2021.
Zoster vaccine coverage was approximately 30% in
the primary target group aged 70 years; nonetheless, with ongoing catch-up vaccination, coveragereached 47% in those aged 71–79 years. Coverageof 13vPCV in 2021, the first full year it was available on the NIP, was around 20% for adults aged
70–79 years. Of NIP-eligible groups, around twothirds of adults aged ≥ 65 years were recorded ashaving received influenza vaccine in 2021, but
only one-fifth of Indigenous adults aged 20–49
years, and two-fifths of Indigenous adults aged
50–64 years, were recorded as having received thevaccine. These figures may underestimate true
coverage, as underreporting of adult vaccinations
to the AIR has previously been documented,30,35
with the impact of mandatory reporting of all NIP
vaccinations from mid-2021 on completeness ofreporting not yet formally evaluated.

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Author details
Brynley Hull
Alexandra Hendry
Aditi Dey
Julia Brotherton
Kristine Macartney
Frank Beard

Corresponding author
Brynley Hull
National Centre for Immunisation Researchand Surveillance
The Children’s Hospital at Westmead and The
University of Sydney
Locked Bag 4001, Westmead NSW 2145.
Telephone: +61 2 9845 1435.
Facsimile: +61 2 9845 1418.
Email: brynley.hull@health.nsw.gov.au

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Appendix A
Table A.1: Australian NIP Schedule in 2021
Age

VaccineChildren

Birth

Hep B

2 months

Hep B

DTPa

Hib

Polio

13vPCV

Rotavirus

MenBb

4 months

Hep B

DTPa

Hib

Polio

13vPCV

Rotavirus

MenB b6 months

Hep B

DTPa

Hib

Polio

13vPCVc

MenB b13vPCV

MenB b

12 months
18 months

MMR
DTPa

Hib

Men ACWY
MMRVHep Ad24 months
48 months

DTPa

Polio

Hep Ad23vPPVe

6 months – 9 years

Fluf
Adolescents

9–14 years
12–15 years

23vPPVe
dTpa

HPV

14–19 years

Men ACWY

10–19 years

Fluf
Adults

20–49 years

Fluf≥ 50 years

Fluf≥ 65 years

Fluf

Pregnant women (any age)
70 years
a

b
c
d
e
f
g
h
i
j
k

dTpah

13vPCV,
23vPPVg

Flui
HZj

13vPCVkHep B: hepatitis B; DTPa: diphtheria–tetanus–pertussis (acellular) – paediatric formulation; Hib: Haemophilus influenzae type b; IPV:
inactivated polio vaccine; 13vPCV: 13-valent pneumococcal conjugate vaccine; Flu: influenza; MMR: measles-mumps-rubella; Men
ACWY: meningococcal ACWY conjugate vaccine; MenB: meningococcal B vaccine; MMR: measles-mumps-rubella-varicella; dTpa:
diphtheria–tetanus–pertussis (acellular) – adolescent/adult formulation; HPV: human papilloma virus; 23vPPV: Pneumovax 23 vaccine;
HZ: herpes zoster.
Aboriginal and Torres Strait Islander children only (since July 2020) receive a dose of Meningococcal B vaccine at 2, 4 and 12 months ofage, with an additional dose at 6 months of age for those with specific medical risk conditions.
Aboriginal and Torres Strait Islander children living in the Northern Territory, Western Australia, Queensland and South Australia, andchildren with specified underlying medical conditions that predispose them to invasive pneumococcal disease.
Aboriginal and Torres Strait Islander children – doses at 18 months and 4 years of age in the Northern Territory, Western Australia,
Queensland and South Australia.
Medically at-risk children and Aboriginal and Torres Strait Islander children living in the Northern Territory, Western Australia,
Queensland and South Australia.
Annual vaccination - all Aboriginal and Torres Strait Islander persons aged over 6 months, non-Indigenous adults aged ≥ 65 years.
Aboriginal and Torres Strait Islander adults aged ≥ 50 years and all adults aged ≥ 65 years. 13vPCV vaccine replaced 23vPPV vaccine in
mid-2020.
During the third trimester of pregnancy.
At any stage of pregnancy.
A single dose of HZ vaccine is funded for adults aged 70 years (with catch up for 71–79 year olds to 2021) who have not previously
received a dose of HZ vaccine.
A 13vPCV vaccine for non-Indigenous elderly adults from mid-2020.

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51 of 73Box A.1: Significant changes in immunisation policy, immunisation incentives and coveragecalculation algorithms,a Australia, 2017 to 2021
June 2021: First inactivated recombinant zoster vaccine (Shingrix) available on privateprescription.
May 2021: First recombinant quadrivalent influenza vaccine registered for use in people aged
≥ 18 years.
July 2020: Funded schedule expanded for Aboriginal and Torres Strait Islander children livingin the Northern Territory, Queensland, South Australia and Western Australia from 13vPCV
at 2, 4, 6 and 12 months (3+1) to include an additional dose of 23vPPV at 4 years of age and asecond dose 5–10 years later.
A single dose of 13vPCV is recommended and funded for Indigenous adults at 50 years of age,followed by a dose of 23vPPV 12 months later and a second dose of 23vPPV 5–10 years after that.
A single dose of 13vPCV is recommended and funded for non-Indigenous adults at 70 years ofage, replacing the previously funded dose of 23vPPV at 65 years of age.
Meningococcal B vaccine funded for all Aboriginal and Torres Strait Islander children (age <12 months) and individuals of any age with specified high risk medical conditions. Catch-up
available for all Aboriginal and Torres Strait Islander children < 2 years of age (up to 23 months)
for three years, until 30 June 2023.
Scheduled ages for funded hepatitis A vaccination (two doses) for Aboriginal and Torres Strait
Islander children in the Northern Territory, Queensland, South Australia and Western Australia
changed to 18 months and 4 years.
March 2020: All children aged 6 months to < 5 years funded for influenza vaccine under NIP.
First enhanced quadrivalent influenza vaccine (adjuvanted) funded nationally for adults aged
65 years and over.
April 2019: Meningococcal ACWY conjugate vaccine funded under NIP for adolescents aged
14–16 years delivered through school-based vaccination programs and for adolescents aged
15–19 years delivered through primary care providers as part of an ongoing catch-up program.
March 2019: Annual seasonal influenza vaccination funded by the Northern Territory for all
children aged 6 months to < 5 years.
February 2019: Aboriginal and Torres Strait Islander children and adolescents aged 5–14 yearsof age funded for influenza vaccine under NIP (all Aboriginal and Torres Strait Islander people
aged 6 months and older now eligible for a funded annual influenza vaccine).
July 2018: Schedule for routine childhood vaccination with 13vPCV changed from 2, 4 and 6
months of age to 2, 4 and 12 months of age. Vaccination coverage assessment algorithm for ‘fully

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vaccinated’ at the 12-month milestone amended to require either two or three doses of 13vPCV.
Vaccination coverage assessment algorithm for ‘fully vaccinated’ at the 24-month milestoneamended to require 3 doses of 13vPCV.
Meningococcal ACWY conjugate vaccine funded for all children at 12 months of age, replacing
combined Hib and MenC- containing, with the Hib dose moved to 18 months and given as
monovalent Hib vaccine.
May 2018: Australian Capital Territory, New South Wales, Queensland, South Australia,
Tasmania, Victoria: annual seasonal influenza vaccination program funded for all children
aged 6 months to < 5 years (in place in Western Australia since 2008).
April 2018: Enhanced trivalent influenza vaccines (high-dose and adjuvanted) funded nationally for all adults aged 65 years and over.
February 2018: A two-dose schedule of 9vHPV vaccine recommended and funded under NIP
for female and male adolescents aged 12–14 years, delivered through a school-based program(changed from a three-dose schedule of 4vHPV vaccine in place since 2007 for females and 2013
for males).
July 2017: Queensland, South Australia, Victoria and Western Australia changed from threedose RotaTeq® rotavirus vaccine schedule to two-dose Rotarix® schedule.
Coverage for the second dose of MMR-containing vaccine no longer assessed at 60 monthsof age.
All individuals aged 10 to 19 years and refugees and humanitarian entrants aged 20 years andover are eligible to receive free catch-up vaccinations through an expansion to the National
Immunisation Program (NIP).
a

Source: NCIRS History of Vaccination.36

Detailed methods
The Australian Immunisation Register
The Australian Childhood Immunisation
Register (ACIR) was established on 1 January
1996 by incorporating demographic datafrom Medicare on all enrolled children
aged < 7 years.37 On 30 September 2016, theACIR expanded to become the Australian
Immunisation Register (AIR), to collect dataon vaccinations given from birth to death.38 All
people registered with Medicare are automatically added to the AIR and assigned a unique
Personal Identification Number (PIN) thatthen travels with that person for life, across all
relevant Medicare card numbers (e.g. where

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multiple due to family circumstances or maturity). Participation in the AIR is ‘opt-out’ andso constitutes a nearly complete population
register for Australian residents.37 Individuals
who are not Medicare-registered, but for whoma vaccination encounter is reported to the AIR,
are assigned a Supplementary Identification
Number (SIN),39 with subsequent assignmentof a PIN where the individual is identified to be
Medicare-registered. Data are transferred to the
AIR when a recognised immunisation provider
supplies details of an eligible vaccination. Thisoccurs predominantly via medical practicemanagement software or through direct data
entry on the AIR website, or less commonly bysubmitting paper encounter or history forms.

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Data source

Coverage – children

The AIR contains limited information for eachindividual (PIN/SIN, date of birth, gender,
Indigenous status, postcode) and vaccinations
received (brand/type, dose number, date,immunisation provider). Individuals with a
SIN (i.e. not Medicare-registered) are excluded
from all coverage analyses in this report, alongwith those with an ‘end date’ (applied to an AIR
record when Medicare is notified that the person has died or has left Australia permanently).
Prior to analysis, NCIRS removes duplicate AIR
records i.e. where the PIN is identical, with themost up-to-date record kept based on Medicare
registration date, and duplicate vaccination
records i.e. where the PIN, vaccine type, vaccine
dose and encounter date are identical. To allow
for data entry errors, NCIRS uses statisticalprograms that look for vaccine dose numbers
greater than the nominal last dose e.g. for second MMR dose coverage, programs look fordose 2, 3 or 4 of MMR.

This report uses AIR data as at 3 April 2022. The
cohort method has been used for calculating coverage at the population level (national and state/
territory) since the ACIR’s inception.40 Vaccine/
antigen doses included in the algorithms toassess whether a child is ‘fully vaccinated’ areset by the Australian Government Department
of Health and Aged Care (the Department).
The standard methodology used by Services
Australia/the Department and NCIRS assesses
coverage at 6–12 months after vaccines aredue, to allow time for delayed vaccination.
Cohort vaccination status is assessed at 12
months of age (for vaccines due at 6 months),
24 months of age (for vaccines due at 6, 12 and18 months), and 60 months of age (for vaccines
due at 48 months). A minimum three-month lag
period is allowed for late notification of vaccinations to the AIR, but only vaccines given on or
before a child’s first, second or fifth birthday,
respectively, are included in coverage calculations.40 If a child’s records indicate receipt of thelast dose of a vaccine that required more than
one dose to complete the series, it is assumed
that earlier vaccines in the sequence were given.
This assumption has been shown to be valid in
the past.41,42

Indigenous status
Aboriginal and Torres Strait Islander statuson the AIR is recorded as ‘Indigenous’, ‘nonIndigenous’ or ‘unknown’. For this report,
individuals whose Indigenous status was not
specified (0.7% of persons on the AIR) wereclassified as non-Indigenous for the purposes ofanalysis. While Indigenous status is available in
AIR, other parameters such as country of birth,
ethnicity and medical conditions (including
pregnancy) are not.
Provider type and reporting mechanism to
AIR
The proportion of vaccinations in 2021 in the
AIR was calculated by provider type, reporting
mechanism and by jurisdiction, for children
aged < 7 years and people of all ages. Analysis ofprovider type for all ages assessed all vaccinesand non-COVID-19 vaccines separately.

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For most analyses in this report 12-month-wide
cohorts were used: children born between
1 January 2020 and 31 December 2020 for
the 12-month milestone; between 1 January
2019 and 31 December 2019 for the 24-month
milestone; and between 1 January 2016 and 31
December 2016 for the 60-month milestone.
However, to assess ‘fully vaccinated’ trends overtime we used three-month-wide birth cohorts,
with children aged 12–14 months for the
12-month assessment age, children aged 24–26
months for the 24-month assessment age andchildren aged 60–62 months for the 60-monthassessment age.
The proportion of children ‘fully vaccinated’
was calculated using the number of Medicareregistered children completely vaccinatedwith the vaccines of interest by the designatedCommun Dis Intell (2018) 2023;47 (https://doi.org/10.33321/cdi.2023.47.47) Epub 24/8/2023

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age as the numerator and the total number ofMedicare-registered children in the relevant
age cohort as the denominator. Definitionsof ‘fully vaccinated’ coverage are provided inTable A.2 – the definitions for the 12-, 24- and60-month milestones have been developed by
the Department for the purpose of standardised reporting. However, vaccination coverage
estimates in this report may differ slightly
from estimates published elsewhere that arecalculated using rolling annualised quarterly
coverage data.

B vaccine in Indigenous children for the firstIndigenous cohort eligible for meningococcal B vaccination under the NIP, following
implementation on 1 July 2020 of a three-doseschedule at 2, 4 and 12 months of age. The proportion of children vaccinated with the relevant
vaccine/antigen and dose was calculated using
the number of Medicare-registered children
vaccinated with the relevant vaccine/dose by
the designated age as the numerator and thetotal number of Medicare-registered children
in the relevant age cohort as the denominator.

Vaccination coverage was also calculated forindividual NIP vaccines/antigens, including
those given in early childhood but not routinely
reported on and not part of ‘fully vaccinated’
calculations at 12, 24 and 60 months of age.
This additional coverage assessment included
the second dose of rotavirus vaccine by 12months of age, first dose of hepatitis A vaccine
in Indigenous children by 30 months of age, andfourth dose of 13vPCV in Indigenous children by
30 months of age. Coverage was also calculated
for the first time for dose 1–3 of meningococcal

Influenza vaccine coverage for children aged
6–59 months and 5–9 years was calculated by
dividing the number of Medicare-registeredchildren in the relevant age group with at least
one dose of influenza vaccine recorded on the
AIR in the calendar year of interest (i.e. 2020
or 2021) by the total number of Medicareregistered children in the relevant age group(based on birth cohorts where age was assessed
at 30 June in the year of interest), by Indigenous
status and jurisdiction. This differs from

Table A.2: Vaccinations required to be deemed ‘fully vaccinated’ by each assessment milestone
Milestone

Vaccinationsa

9 months/12 months(Cohort born 1 January 2020 – 31 December 2020)

3rd dose DTPa (given at 6 months)
3rd dose polio (given at 6 months)
3rd dose HepB (given at 6 months)
3rd dose Hib (given at 6 months)
2nd or 3rd dose 13vPCV (given at 4 or 6 months)

15 months(Cohort born 1 January 2019 – 31 December 2019)

3rd dose DTPa (given at 6 months)
3rd dose polio (given at 6 months)
3rd dose HepB (given at 6 months)
3rd dose 13vPCV (given at 6 or 12 months)
1st dose meningococcal C-containing vaccine (given at 12 months)
1st dose MMR (given at 12 months)

21 months/24 months(Cohort born 1 January 2019 – 31 December 2019)

4th dose DTPa (given at 18 months)
3rd dose polio (given at 6 months)
3rd dose HepB (given at 6 months)
4th dose Hib (given at 18 months)
1st dose meningococcal C-containing vaccine (given at 12 months)
1st dose varicella (given at 18 months)
2nd dose MMR (given at 18 months)
3rd dose 13vPCV (given at 6 or 12 months)

51 months/60 months(Cohort born 1 January 2016 – 31 December 2016)

4th or 5th dose DTPa (given at 48 months)
4th dose polio (given at 48 months)aDTPa: diphtheria-tetanus-pertussis (acellular) paediatric formulation; Hep B: hepatitis B; Hib: Haemophilus influenzae type b; 13vPCV:
13-valent pneumococcal conjugate vaccine; MMR: measles-mumps-rubella.

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previous reports where denominators were thenumber of Medicare-registered children in therelevant age group based on calculated age atstart of the calendar year of interest.
Timeliness of vaccination
On-time vaccination was defined as receipt ofa scheduled vaccine dose within 30 days of therecommended age. For example, a child who
received the first dose of DTPa vaccine (due by
60 days of age under the NIP but recommended
from as early as 6 weeks of age) when they weremore than 90 days of age was classified as late forthat dose. On-time vaccination was measured in
12-month birth cohorts, with children includedin the analysis assessed at up to three years
after doses were due, to allow time for very latevaccinations to be assessed. Therefore, cohorts
assessed for timeliness are not the same as those
assessed for coverage milestones. The interval
between doses was not evaluated. Timelinessof different vaccines and doses was comparedby plotting the cumulative percentage receiving
each vaccine dose by age in months.
‘Fully vaccinated’ coverage was also assessed atthree months after last vaccine dose due, that is,earlier than the standard assessment milestones
to capture aspects of timeliness, by remotenessand socio-economic status of area of residence.
The definitions of ‘fully vaccinated’ coverage
used are provided in Table A.2 in the Appendix.
Remoteness status
The area of residence of children was definedas ‘major cities’, ‘inner regional’, ‘outerregional’, ‘remote’ and ‘very remote’ using theAccessibility/Remoteness Index of Australia(ARIA++).43 ARIA++ is a continuous varying
index with values ranging from 0 (high accessibility) to 15 (high remoteness), and is based onroad distance measurements from over 12,000
populated localities to the nearest Service
Centres in five categories based on population
size. For analysis in this report, we combined
the two ‘regional’ categories (‘inner regional’and ‘outer regional’) into one category and

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the two ‘remote’ categories (‘remote’ and ‘very
remote’) into one category. ARIA Accessibility/
Remoteness categories were assigned to eachchild using their current recorded postcode on
the AIR.
Socio-economic status
Vaccination coverage and timeliness wereassessed by socio-economic status using the
ABS Socio Economic Indexes for Areas (SEIFA)
Index of Economic Resources.44 The SEIFA
index category was assigned for each individual
using their recorded postcode of residence on
the AIR. For this analysis, we compared vaccination coverage for children living in postcodesclassified as being in the top quintile of all
postcodes with regard to economic resources
with vaccination coverage for children living
in postcodes classified as being in the bottom
quintile of postcodes with regard to economic
resources.
Small area analysis
SA3
Analysis of coverage was undertaken at small
area level using the ABS-defined Statistical Area
3 (SA3),45 chosen because each is small enoughto show differences within jurisdictions but
not too small to render maps unreadable. For
both privacy and precision reasons, SA3s withdenominators of less than 26 children were notincluded in any small area analysis. Maps werecreated using version 15 of the MapInfo mapping software46 and the ABS Census Boundary
Information. As postcode is the only geographical indicator available from the AIR, the ABS
Postal Area to SA3 Concordance 2016 was used
to match AIR postcodes to SA3s.47
PHN
Analysis of coverage was also undertaken at
PHN level. PHNs are organisations that work
to improve coordination of healthcare in theirarea. There are 31 PHNs in Australia.

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Coverage – adolescents
The World Health Organization recommends
assessing HPV vaccine coverage at 15 yearsof age for the purpose of comparison internationally and over time. As HPV vaccination inAustralia is delivered routinely in early highschool, usually around the age of 12–13 years,
all adolescents should have had the opportunity
to complete the vaccination course by age 15
years. Similar to childhood vaccination coverage, HPV vaccine coverage by 15 years of age
was calculated using the cohort method. In thecohorts of Medicare-registered adolescents whoturned 15 years of age during 2021 or 2020 (i.e.
cohorts born in 2006 or 2005, respectively), theproportion who had received dose 1, dose 2 and/or dose 3 of HPV vaccine before their fifteenthbirthday was calculated. The outcome of interest in this cohort is completion of a clinicallyvalid course (either two or three doses). As alladolescents in the 2006 and 2005 birth cohorts
were under 15 years of age at first dose, course
completion was defined as receipt of two doses
if dose 2 was given following a minimum interval of 5 months after dose 1 or receipt of threedoses if dose 2 was given less than 5 months
after dose 1. The proportion of eligible adolescents in the population completing the vaccination course (course completion) is therefore adifferent measure to population coverage witheither dose 2 or dose 3. HPV vaccine coverageand course completion analysis was undertakenby year, gender, Indigenous status, jurisdiction,socio-economic status and remoteness categoryof area of residence.
Adolescent dTpa vaccination coverage by 15
years of age was also calculated using the cohort
method. Using the same 2006 and 2005 birthcohorts as above, the proportion of adolescents
who had received a booster dose of dTpa vaccine
before their fifteenth birthday was calculated.
Analysis was undertaken by Indigenous status,
year and jurisdiction.
Completion of adolescent vaccination by 15
years of age was assessed by calculating the
proportion of Medicare-registered adolescentshealth.gov.au/cdi

in the cohort aged 15 years in 2021 who hadreceived two doses of the HPV vaccine as well
as a dose of dTpa vaccine by 15 years of age. The
proportion of this cohort who had only received
a dose of dTpa vaccine, without a dose of HPV
vaccine (and vice versa) was also calculated.
Analysis was undertaken by Indigenous status.
Adolescent meningococcal ACWY vaccination
coverage by 17 years of age was also calculatedusing the cohort method. In the cohorts ofMedicare-registered adolescents who turned 17
years of age during 2021 or 2020 (i.e. cohorts
born in 2004 or 2003, respectively), the proportion who had received a booster dose ofmeningococcal ACWY vaccine before theirseventeenth birthday was calculated. Analysis
was undertaken by Indigenous status, year andjurisdiction.
In addition to adolescent coverage of HPV,
dTpa and meningococcal ACWY vaccines,
the number of these vaccinations given during 2021 to adolescents aged 11–14 years (for
HPV and dTpa) and 14–18 years (for meningococcal ACWY) was determined by gender(HPV and dTpa only), Indigenous status, agegroup (meningococcal ACWY only), jurisdiction (HPV and dTpa only) and provider type(meningococcal ACWY only). The number ofthese vaccinations given during 2021 was thencompared to the number of vaccinations given
in 2020. Additionally, for adolescents aged < 15years who received a first dose of HPV in 2020
or 2021, the proportion who also received theirsecond dose in the same calendar year was calculated and compared.
Influenza vaccination coverage, for adolescents
aged 10–14 years and 15–19 years, was calculated by dividing the number of adolescents in
the relevant age group with at least one dose of
influenza vaccine recorded on the AIR in thecalendar year of interest (i.e. 2020 or 2021) by
the total number of adolescents registered on
the AIR in the 10–14 years and 15–19 years
age groups (based on birth cohorts where age
assessed at 30 June in the year of interest), by
Indigenous status and jurisdiction. This differs

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from previous reports where denominators were
the number of Medicare-registered adolescentsin the relevant age group based on calculated
age at start of the calendar year of interest.
COVID-19 vaccination coverage estimates foradolescents aged 12–15 years were obtained fromavailable data published by the Department.48
These estimates used the number of first andsecond doses of a COVID-19 vaccine recordedon the AIR for adolescents aged 12–15 years as
at 4 January 2022 as numerator and Australian
Bureau of Statistics Estimated Resident
Population for the 12–15 year age group as at 30
June 2020 as denominator.
Coverage – adults
Adult zoster vaccination coverage was calculated using the cohort method. In the cohorts ofMedicare-registered adults who turned 71 yearsof age during 2021, 2020 or 2019 (i.e. cohorts
born in 1950, 1949 or 1948, respectively), theproportion who had received either one doseof Zostavax vaccine, or two doses of Shingrix®
vaccine, before their seventy-first birthday
was calculated. Similarly, zoster vaccination
coverage was also calculated for the cohortsof adults eligible for catch-up vaccination (i.e.
those turning 72–80 years of age in 2021, 2020
or 2019). Analysis for each year was undertaken
by Indigenous status, single year of age, andjurisdiction.
Adult 13vPCV vaccination coverage wasalso calculated using the cohort method for
Medicare-registered adults who turned 71 yearsof age during 2021 or 2020 (i.e. cohorts bornin 1950 or 1949, respectively). The proportionof these cohorts who had received a dose of
13vPCV before their seventy-first birthday wascalculated. 13vPCV coverage was also calculated
for the cohorts of adults turning 72–80 years ofage in 2021 or 2020. Analysis for each year wasundertaken by Indigenous status at the national
level only.

years was calculated by dividing the number ofMedicare-registered adults in the relevant age
group with at least one dose of influenza vaccine recorded on the AIR in the calendar year ofinterest (i.e. 2020 or 2021) by the total numberof Medicare-registered adults in the AIR in therelevant age group (based on birth cohorts withage assessed at 30 June in the year of interest), by
Indigenous status and jurisdiction. This differsfrom previous reports where denominators were
the number of Medicare-registered children in
the relevant age group based on calculated age
at start of the calendar year of interest.
COVID-19 vaccine coverage estimates for all
Australians aged ≥ 16 years, ≥ 50 years, and ≥70 years were obtained from available data published by the Department.48 Using these publicly
available data, coverage for all Australians aged
16–49 and 50–69 years was also calculated.
First and second dose coverage was calculatedusing the number of first and second doses ofa COVID-19 vaccine recorded on the AIR for
people in each age group as at 4 January 2022 asnumerator and Australian Bureau of Statistics
Estimated Resident Population for the relevant
age group as at 30 June 2020 as denominator.
COVID-19 vaccine coverage estimates for
Indigenous people aged 16 years and over werealso obtained from available data.48 These estimates used the number of first and second dosesof a COVID-19 vaccine recorded on the AIR for
Indigenous people aged 16 years and over as at
4 January 2022 as numerator and the total number of Indigenous people aged 16 years and overin the AIR as at 4 January 2022 as denominator.

Influenza vaccine coverage for adults aged
20–49 years, 50–64 years, 65–74 years and ≥ 75

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Figure A.1: Trends in ‘fully vaccinated’ coverage by quarter,a,b,c Australia, 2012 to 2021
100

60-month coverage algorithm
changed to no longer include MMR2

95
90

Coverage (%)

85
80
75

24-month coveragealgorithm changed to include
four doses of DTPa

12-month coverage algorithm
changed to include
pneumococcal conjugate
24-month coverage algorithm changed
vaccineto include MMR2, Men C and varicella70'Fully vaccinated' by 12 months ᵈ

65'Fully vaccinated' by 12 months ᵉ'Fully vaccinated' by 24 months ᶠ

60'Fully vaccinated' by 24 months ᵍ

55'Fully vaccinated' by 60 months

30 Sep 21

31 Mar 21

30 Sep 20

31 Mar 20

30 Sep 19

31 Mar 19

30 Sep 18

31 Mar 18

30 Sep 17

31 Mar 17

30 Sep 16

31 Mar 16

30 Sep 15

31 Mar 15

30 Sep 14

31 Mar 14

30 Sep 13

31 Mar 13

30 Sep 12

31 Mar 12

50

Coverage assessment date for each cohortaSource: Australian Immunisation Register, data as at 3 April 2022.

b

By 3-month birth cohorts born between 1 January 2011 and 31 December 2020. Coverage assessment date was 12, 24 or 60 months
after the last birth date of each cohort. Vaccination coverage estimates are calculated by quarter and may differ slightly from estimatespublished elsewhere using rolling annualised data.

c

MMR2: second dose of MMR vaccine; MenC: meningococcal C-containing; DTPa: diphtheria-tetanus-acellular pertussis.

dCoverage algorithm before 1 July 2013.

e

Coverage algorithm from 1 July 2013.

f

Coverage algorithm before 1 July 2014.

g

Coverage algorithm from 1 July 2014.

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Figure A.2: Trends in vaccination coverage at 12 months of age,a,b,c by vaccine/antigend andquarter, Australia, 2012 to 2021
100
Pneumococcal dose 2 or 3
assessed from here

Coverage (%)

95
90

Rotavirus 2-dose schedule
for all jurisdictions from here
DTPa

85

Polio
Hib

80

Hep B
PCV

75

Rotavirus

30 Sep 21

31 Mar 21

30 Sep 20

31 Mar 20

30 Sep 19

31 Mar 19

30 Sep 18

31 Mar 18

30 Sep 17

31 Mar 17

30 Sep 16

31 Mar 16

30 Sep 15

31 Mar 15

30 Sep 14

31 Mar 14

30 Sep 13

31 Mar 13

30 Sep 12

31 Mar 12

70

Coverage assessment date for each cohortaSource: Australian Immunisation Register, data as at 3 April 2022.

b

By 3-month birth cohorts born between 1 January 2011 and 31 December 2020. Coverage assessment date was 12 months after
the last birth date of each cohort. Vaccination coverage estimates are calculated by quarter and may differ slightly from estimatespublished elsewhere using rolling annualised data.

c

DTPa: diphtheria-tetanus-acellular pertussis; Hib: Haemophilus influenzae type b; Hep B: hepatitis B; 13vPCV: pneumococcal conjugate
vaccine.

dThird dose of DTPa vaccine, polio vaccine and 13vPCV, second or third dose of Hib and rotavirus vaccines, and third dose of hepatitis B
vaccine.

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Figure A.3: Trends in vaccination coverage at 24 months of age,a,b,c by vaccine/antigend andquarter, Australia, 2012 to 2021
100
95

Dose 3 PCV added
to algorithm

30 Sep 1985

18-month DTPa booster
dose added to NIP

31 Mar 17

Coverage (%)

90

18-month MMRV
vaccine added to NIP

80
75

DTPa

Polio

Hib

Hep B

MMR

MMRV

MenC

Varicella

PCV

30 Sep 21

31 Mar 21

30 Sep 20

31 Mar 20

31 Mar 19

30 Sep 18

31 Mar 18

30 Sep 17

30 Sep 16

31 Mar 16

30 Sep 15

31 Mar 15

30 Sep 14

31 Mar 14

30 Sep 13

31 Mar 13

30 Sep 12

31 Mar 12

70

Coverage assessment date for each cohortaSource: Australian Immunisation Register, data as at 3 April 2022.

b

By 3-month birth cohorts born between 1 January 2010 and 31 December 2019. Coverage assessment date was 24 months after
the last birth date of each cohort. Vaccination coverage estimates are calculated by quarter and may differ slightly from estimatespublished elsewhere using rolling annualised data.

c

DTPa: diphtheria-tetanus-acellular pertussis; Hib: Haemophilus influenzae type b; Hep B: hepatitis B; MMR: measles-mumps-rubella;
MenC: meningococcal C-containing; MMRV: measles-mumps-rubella-varicella; 13vPCV: pneumococcal conjugate vaccine.

dFourth dose of DTPa, third dose of polio, third or fourth dose of Hib, third dose of hepatitis B, second dose of MMR, dose 2 of MMRV,
first dose of MenC one dose of varicella, and a third or fourth dose of 13vPCV.

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Figure A.4: Trends in vaccination coverage at 60 months of age,a,b,c by vaccine/antigend andquarter, Australia, 2012 to 2021
100

Coverage (%)

95
90
85
80

DTPa at 60 mo

75Polio at 60 mo

MMR at 60 mo

30 Sep 21

31 Mar 21

30 Sep 20

31 Mar 20

30 Sep 19

31 Mar 19

30 Sep 18

31 Mar 18

30 Sep 17

31 Mar 17

30 Sep 16

31 Mar 16

30 Sep 15

31 Mar 15

30 Sep 14

31 Mar 14

30 Sep 13

31 Mar 13

30 Sep 12

31 Mar 12

70

Coverage assessment date for each cohortaSource: Australian Immunisation Register, data as at 3 April 2022.

b

By 3-month birth cohorts born between 1 January 2007 and 31 December 2016. Coverage assessment date was 60 months after
the last birth date of each cohort. Vaccination coverage estimates are calculated by quarter and may differ slightly from estimatespublished elsewhere using rolling annualised data.

c

DTPa: diphtheria-tetanus-acellular pertussis; MMR: measles-mumps-rubella.

dFourth or fifth dose of DTPa and fourth dose of polio, second dose of MMR (up until June 2017).

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Figure A.5: Trends in ‘fully vaccinated’ coverage at 12 months of age,a,b by Indigenous status andquarter, Australia, 2012 to 2021
100

non-Indigenous 'fully vaccinated' by 12 months ᶜ
non-Indigenous 'fully vaccinated' by 12 months ᵈ
Indigenous 'fully vaccinated' by 12 months ᶜ
Indigenous 'fully vaccinated' by 12 months ᵈ

94.2

91.3

90

85

30 Sep 21

31 Mar 21

30 Sep 20

31 Mar 20

30 Sep 19

31 Mar 19

30 Sep 18

31 Mar 18

30 Sep 17

31 Mar 17

30 Sep 16

31 Mar 16

30 Sep 15

31 Mar 14

30 Sep 13

31 Mar 13

30 Sep 12

31 Mar 1280

31 Mar 15

12-month coveragealgorithm changed toinclude pneumococcal
conjugate vaccine

30 Sep 14

Coverage (%)

95

Coverage assessment date for each cohortabSource: Australian Immunisation Register, data as at 3 April 2022.
Vaccination coverage estimates are calculated using 3-month wide birth cohorts by quarter and may differ slightly from estimatespublished elsewhere using rolling annualised data.

c

Coverage algorithm before 1 July 2013.

dCoverage algorithm from 1 July 2013.

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Figure A.6: Trends in ‘fully vaccinated’ coverage at 24 months of age,a,b by Indigenous status andquarter, Australia, 2012 to 2021
100

non-Indigenous 'fully vaccinated' by 24 months ᶜ
non-Indigenous 'fully vaccinated' by 24 months ᵈ
Indigenous 'fully vaccinated' by 24 months ᶜ
Indigenous 'fully vaccinated' by 24 months ᵈ95

Coverage (%)

92.7

90

90.1

24-month coverage algorithm
changed to include MMR2,
Men C and varicella85
24-month coveragealgorithm changed toinclude 4 doses of DTPa

30 Sep 21

31 Mar 21

30 Sep 20

31 Mar 20

30 Sep 19

31 Mar 19

30 Sep 18

31 Mar 18

30 Sep 17

31 Mar 17

30 Sep 16

31 Mar 16

30 Sep 15

31 Mar 15

30 Sep 14

31 Mar 14

30 Sep 13

31 Mar 13

30 Sep 12

31 Mar 12

80

Coverage assessment date for each cohortabSource: Australian Immunisation Register, data as at 3 April 2022.
Vaccination coverage estimates are calculated using 3-month wide birth cohorts by quarter and may differ slightly from estimatespublished elsewhere using rolling annualised data.

c

Coverage algorithm before 1 July 2014.

d

Coverage algorithm from 1 July 2014.

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Figure A.7: Trends in ‘fully vaccinated’ coverage at 60 months of age by Indigenous status andquarter,a,b Australia, 2012 to 2021
100

non-Indigenous 'fully vaccinated' by 60 months
Indigenous 'fully vaccinated' by 60 months

96.7

Coverage (%)

95

94.1

60-month coverage algorithm
changed to no longer include
second dose of MMR

90

85

30 Sep 21

31 Mar 21

30 Sep 20

31 Mar 20

30 Sep 19

31 Mar 19

30 Sep 18

31 Mar 18

30 Sep 17

31 Mar 17

30 Sep 16

31 Mar 16

30 Sep 15

31 Mar 15

30 Sep 14

31 Mar 14

30 Sep 13

31 Mar 13

30 Sep 12

31 Mar 12

80

Coverage assessment date for each cohortabSource: Australian Immunisation Register, data as at 3 April 2022.
Vaccination coverage estimates are calculated using 3-month wide birth cohorts by quarter and may differ slightly from estimatespublished elsewhere using rolling annualised data.

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Figure A.8: Trends in coverage for hepatitis A vaccine by 30 months of age for Indigenous
children by jurisdiction,a,b,c,d Australia, 2012 to 2021
100
91.6

90
80

78.1

Coverage (%)

70
60
50
40
NT – dose 2
Qld – dose 2
SA – dose 2
WA – dose 2
AUST – dose 2

30
20
10

NT – dose 1
Qld – dose 1
SA – dose 1
WA – dose 1
AUST – dose 1
Sep-21

Mar-21

Sep-20Mar-20

Sep-19Mar-19Sep-18Mar-18

Sep-17Mar-17

Sep-16

Mar-16

Sep-15Mar-15

Sep-14Mar-14

Sep-13Mar-13

Sep-12Mar-120Month/year of assessmentaSource: Australian Immunisation Register, data as at 3 April 2022.

b

Vaccination coverage estimates are calculated using 3-month wide birth cohorts by quarter.

c

18-month dose assessed: scheduled ages for hepatitis A vaccination changed from 12 to 18 months (dose 1) and 18 months to 4 years(dose 2) from July 2020.

d

Northern Territory (NT), Queensland (Qld), South Australia (SA) and Western Australia (WA) only. AUST: Australia.

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Figure A.9: Trends in coverage for pneumococcal vaccine for Indigenous children by
jurisdiction,a,b,c,d Australia, 2012 to 2021
100
90

90.2
81.7
81.6
79.7
77.5

80

Coverage (%)

70
60
50
40
30
20
10

NT

Qld

SA

WA

AUST
Sep-21

Mar-21

Sep-20Mar-20

Sep-19Mar-19Sep-18Mar-18

Sep-17Mar-17

Sep-16

Mar-16

Sep-15Mar-15

Sep-14Mar-14

Sep-13Mar-13

Sep-12Mar-120Month/year of assessmentaSource: Australian Immunisation Register, data as at 3 April 2022.

b

Vaccination coverage estimates are calculated using 3-month wide birth cohorts by quarter.

c

13vPCV: 13-valent pneumococcal conjugate vaccine. 12-month booster dose (fourth dose) assessed at 30 months of age in all four
jurisdictions.

dNorthern Territory (NT), Queensland (Qld), South Australia (SA) and Western Australia (WA) only. AUST: Australia.

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Figure A.10: Proportion of vaccinations, including COVID-19 vaccines, given to all persons byprovider type and jurisdiction,a,b Australia, 2021
100

% of vaccinations by provider type

90
80

General practitioner

Local government/council clinic ᶜ

Community health service

Pharmacy

Hospital

Indigenous health service

70
58.3

60
50

51.5
45.2

47.3

40
26.6

35.3

28.2 29.9

27.2
21.1

20

0

40.1

52.7

49.3

46.3

35.6

30

10

51.5

7.0

7.2

ACT

NSW

10.5

13.4

NT

14.7
9.6

7.9

8.8

Qld

SA

Tas.

6.4

Vic.

8.8

WA

7.3

AUST

Jurisdictionab

Source: Australian Immunisation Register, data as at 3 April 2022.
ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

cIncludes public health units and jurisdictional health departments.

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Figure A11: Proportion of all non-COVID-19 vaccinations given to all persons by provider typeand jurisdiction,a,b Australia, 2021
100

% of vaccinations by provider type

90
80

74.6

71.7

71.4

70
60

Local government/council clinic ᶜ
Pharmacy
Indigenous health service

General practitioner
Community health service
Hospital

66.4

69.6

66.9

70.4

60.0

50
40
29.7

30
20

15.0

10
0

ACT

25.5
20.7

11.9
6.1
NSW

NT

18.9

19.8

10.4

8.9

13.6
9.2

Qld

SA

Tas.

6.2
Vic.

11.3

WA

13.9
7.1

AUST

Jurisdictionab

Source: Australian Immunisation Register, data as at 3 April 2022.
ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia; AUST: Australia.

cIncludes public health units and jurisdictional health departments.

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Figure A.12: Coverage (%) of a COVID-19 vaccine in all people by age group,a Australia, 2021
Dose 1
100
90

Coverage (%)

80

91.4
79.5

Dose 287.8>9996.8 95.0

>99

73.4

70
60
50
40
30
20
10
0

12–15 yr

16–49 yr

50–69 yr

70+ yrAge groupaSource: Australian Government Department of Health and Aged Care, as at 4 January 2022.49

Figure A.13: Coverage (%) of a COVID-19 vaccine in all people aged 16 years and over by
Indigenous status,a Australia, 2021
Dose 1

100

Dose 294.5

90
80

Coverage (%)

70

91.6

79.2
71.8

60
50
40
30
20
10
0

Indigenousa

All people

Source: Australian Government Department of Health and Aged Care, as at 4 January 2022.49

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64.6

66.5

35.4

65–74 yr

75+ yrTotal (6+ mo)

72.0

39.2

75+ yrTotal (6+ mo)

c
d

d

30.2

74.3

70.3

46.7

28.9

17.7

16.6

20.1

35.1

Indigenousd

ACT

38.8

73.6

69.6

53.9

30.8

33.0

33.6

38.2

51.2

Indigenous

ACT

30.0

64.7

58.8

35.6

21.8

13.2

11.8

14.4

23.3

All

32.1

59.6

58.2

33.8

22.3

20.7

22.6

27.3

41.9

All

24.9

72.3

67.1

44.9

21.2

15.5

15.1

15.6

19.9

Indigenous

NSW

36.8

75.3

72.6

56.0

30.7

26.9

29.6

31.6

37.8

Indigenous

NSW

25.9

35.3

38.6

28.4

23.7

17.1

15.2

15.3

45.5

All

30.5

38.4

42.9

29.2

26.1

27.5

26.1

28.7

59.8

All

34.3

46.0

55.2

45.8

31.5

24.5

25.1

26.3

53.2

Indigenous

NT

54.5

61.7

72.1

64.6

53.5

44.3

42.7

46.3

72.5

Indigenous

NT

31.2

69.9

63.1

38.6

23.0

14.9

12.1

13.3

22.4

All

31.9

66.4

63.7

33.4

21.2

20.5

21.9

26.1

41.6

All

22.6

67.6

64.5

42.0

19.9

15.6

13.6

13.1

18.9

Indigenous

Qld

2021

37.6

65.6

64.3

37.9

26.2

25.3

27.8

32.7

50.5

All

41.2

76.1

70.9

48.2

32.5

20.0

17.6

19.2

31.2

All

Jurisdictionc

35.7

71.2

73.8

54.8

30.2

28.3

29.8

29.9

38.5

Indigenous

Qld

Jurisdictionc

27.2

74.0

67.1

48.6

24.3

19.1

16.9

17.3

21.4

Indigenous

SA

37.6

66.4

67.6

54.5

31.5

29.9

32.4

34.5

43.0

Indigenous

SA

37.9

74.8

68.0

44.8

27.5

15.6

13.6

14.8

29.5

All

39.6

71.4

68.4

43.2

27.3

24.1

25.3

27.0

44.8

All

31.3

84.3

75.0

55.1

28.0

19.1

17.2

18.1

26.3

Indigenous

Tas.

42.3

81.5

80.0

63.1

35.7

33.3

31.1

34.1

44.0

Indigenous

Tas.

33.0

69.1

63.3

38.6

24.7

15.9

14.5

17.4

30.9

All

34.6

61.2

60.4

35.9

24.8

24.0

26.3

31.8

50.0

All

25.4

72.8

67.6

42.6

21.0

14.5

15.4

14.0

23.1

Indigenous

Vic.

46.6

69.4

72.0

56.4

34.8

34.2

37.8

37.5

48.7

Indigenous

Vic.

30.4

70.2

61.0

35.9

22.3

15.3

13.9

16.2

24.6

All

37.1

68.4

64.6

38.5

25.9

26.5

31.4

38.3

50.7

All

20.6

57.1

57.0

36.2

18.1

14.0

12.8

13.4

18.9

Indigenous

WA

38.2

65.6

71.2

52.5

32.4

31.4

34.4

37.3

44.6

Indigenous

WA

Source: Australian Immunisation Register, data as at 31 March 2021 (for 2020 data) and as at 3 April 2022 (for 2021 data).
At least one dose of any influenza vaccine. (Note: 2020 estimates have been revised following a change in methodology and therefore differ to what was presented in the 2020 report – see detailed
methods in Appendix for further detail.)
ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania; Vic.: Victoria; WA: Western Australia.
Indigenous persons.

66.6

65–74 yr

a
b

33.6

18.0

15–19 yr

45.6

17.3

10–14 yr

50–64 yr

23.7

5–9 yr20–49 yr

49.6

6–59 moAll

35.3

50–64 yrAge group(years)

27.4

24.0

29.8

10–14 yr

20–49 yr

37.4

5–9 yr

15–19 yr

64.5

All

6–59 moAge group(years)2020

Table A.3: Recorded coverage of seasonal influenza vaccine by age group, jurisdiction, Indigenous persons and all persons,a,b 2020 and 2021, Australia

Table A.4: ‘Fully vaccinated’ coverage assessed at standard age milestones (12, 24 and 60
months) and earlier (9, 15, 21, 51 months) milestones,a,b by Primary Health Network, 2021
Primary Health Networka

9 mo (%)c 12 mo (%)c 15 mo (%)d21 mo (%)d24 mo (%)d51 mo (%)e60 mo (%)eWestern Victoria

92.9

95.7

93.0

91.2

94.3

91.6

96.8

Western NSW

93.4

96.4

92.9

90.5

94.3

90.6

96.7

Murray

91.2

94.8

92.5

90.6

94.2

90.9

96.7

Murrumbidgee

92.8

95.4

93.3

91.3

94.3

91.5

96.2

Gippsland

90.3

94.5

92.8

90.3

94.0

91.2

96.0

Hunter New England and Central Coast

92.4

94.9

93.1

90.8

94.2

89.9

95.8

South Eastern NSW

92.8

94.9

93.1

91.0

93.9

90.7

95.8

Country SA

89.4

93.5

90.5

87.4

91.5

89.1

95.7

Australian Capital Territory

95.0

96.3

94.1

92.9

94.7

92.3

95.6

Adelaide

92.0

94.7

91.3

89.8

92.9

90.6

95.6

Nepean Blue Mountains

91.9

94.5

93.1

91.0

94.0

90.1

95.3

Eastern Melbourne

92.2

95.0

91.7

89.7

92.8

90.0

95.2

South Eastern Melbourne

91.3

94.4

90.8

88.6

91.9

90.0

94.8

Northern Queensland

89.1

93.6

90.8

87.2

92.7

87.2

94.7

South Western Sydney

90.3

93.3

89.8

87.1

91.1

88.3

94.7

Western Queensland

87.4

93.3

90.5

84.1

92.1

86.9

94.6

Brisbane North

92.9

95.3

92.3

90.0

93.7

89.5

94.5

North Western Melbourne

90.7

94.0

90.0

88.1

91.3

88.7

94.4

Tasmania

92.4

94.7

90.2

87.5

91.2

88.5

94.3

Darling Downs and West Moreton

90.8

94.2

91.2

88.6

92.7

88.1

94.3

Western Sydney

90.8

93.7

89.5

87.5

90.7

88.0

94.0

Brisbane South

91.1

94.2

90.7

88.0

92.2

87.9

93.7

Northern Sydney

94.0

95.5

91.1

89.5

92.2

89.0

93.4

Perth South

90.2

93.8

90.1

87.3

91.6

86.6

93.3

Perth North

91.3

94.6

90.4

87.9

91.8

86.2

93.2

Country WA

85.3

91.4

87.5

82.9

88.9

84.2

92.8

Northern Territory
Central Queensland, Wide Bay, Sunshine
Coast
Central and Eastern Sydney

88.7

93.3

90.6

83.9

90.8

83.6

92.7

88.2

91.9

89.8

86.8

91.4

86.1

92.7

92.6

94.7

90.9

88.5

91.6

86.2

91.6

Gold Coast

87.0

90.7

87.3

84.5

89.1

84.7

90.9

North Coast

86.1

89.2

85.9

83.7

87.4

84.5

90.9

Coverage algorithm used for 9/21/51 month milestones same as for 12/24/60 months, respectively; algorithm used for 15 months sameas 24 months but excludes doses due at 18 months; for further detail of algorithms, refer to Table A.2.

b

Data sorted by the ‘60 months’ column (highest to lowest).

c

Cohort born 1 January 2020 – 31 December 2020d

Cohort born 1 January 2019 – 31 December 2019e

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Table A.5: Coverage (%) of a COVID-19 vaccine in all people by age group and jurisdiction,a 2021
Jurisdictionb

Age group(years)

ACT

NSW

NT

Qld

SA

Tas.

Vic.

WA

12 to 15
Dose 1 (%)
Dose 2 (%)

> 99
96.8

81.4
78.0

76.5
66.4

70.4
63.0

75.4
67.0

78.9
70.8

87.7
83.5

68.1
54.2

16 to 49
Dose 1 (%)
Dose 2 (%)

98.4
96.9

92.0
90.3

88.4
82.7

86.8
81.8

88.4
83.2

97.6
91.1

90.5
88.9

88.6
79.0

50 to 69
Dose 1 (%)
Dose 2 (%)

> 99
> 99

97.4
96.5

90.2
87.6

94.2
91.9

94.4
91.9

95.6
93.3

97.3
96.3

95.2
91.0

70 and over
Dose 1 (%)
Dose 2 (%)

> 99
> 99

> 99
> 99

95.0
92.0

> 99
98.2

> 99
98.9

> 99
> 99

> 99
> 99

> 99
97.2

a

Source: Australian Government Department of Health and Aged Care, as at 4 January 2022.49b

ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia.

Table A.6: Coverage (%) of a COVID-19 vaccine in all people aged 16 years and over by
jurisdiction and Indigenous status,a 2021
Jurisdictionb

Age group(years)

ACT

NSW

NT

Qld

SA

Tas.

Vic.

WA

Indigenous
Dose 1 (%)
Dose 2 (%)

90.8
88.0

86.2
83.7

84.5
74.1

76.0
66.9

73.9
64.6

85.2
79.1

88.6
85.7

67.5
52.7

All people
Dose 1 (%)
Dose 2 (%)

> 99
> 99

95.0
93.6

89.3
84.6

90.9
87.0

92.5
88.4

97.9
93.4

93.9
92.5

92.1
84.8

a
b

Source: Australian Government Department of Health and Aged Care, as at 4 January 2022.49
ACT: Australian Capital Territory; NSW: New South Wales; NT: Northern Territory; Qld: Queensland; SA: South Australia; Tas.: Tasmania;
Vic.: Victoria; WA: Western Australia.

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