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Australia has a successful adolescent immunisation program, routinely achieving high vaccine coverage for teenagers.

±á´Ç·É±ð±¹±ð°ù,Ìý shows the number of Australian teens receiving the recommended vaccines for their age group has fallen  during the COVID pandemic.

So how much have adolescent vaccination rates dropped, and why might this be? And how can we get back on track?

°Õ³ó±ðÌý provides a series of free vaccinations for Australian teenagers. These are:

• a booster vaccine for diphtheria, tetanus and pertussis (dTpa), usually offered in year 7
• the human papillomavirus (HPV) vaccine, also usually offered in year 7
• a meningococcal ACWY vaccine, offered in year 10.

These vaccines are primarily delivered through school-based immunisation programs and health services such as general practices.

They protect teenagers themselves from diseases, but also help reduce the spread of these diseases in the community.

For example, 2024 has seen a  (pertussis) cases nationally. Although adolescents won’t necessarily get very sick with whooping cough, they can spread the disease. So the dTpa vaccine helps to protect vulnerable populations, including .

HPV is a leading cause of genital warts and cervical cancer. Giving the HPV shot to young teenagers, before they might be exposed to the virus through sexual activity, provides the best protection against .

And older teenagers and young adults are among those at highest risk of , which can be fatal. They’re also most likely to carry meningococcal bacteria in their nose and throat, and to spread it to others.

The most recent  from the National Centre for Immunisation Research and Surveillance (NCIRS) shows a drop in vaccination coverage among teenagers between 2022 and 2023, while the  shows a drop from 2021 to 2022.

For example, the proportion of teens who had received  of dTpa in the year they turned 15 decreased from 87.3% in 2021, to 86.9% in 2022, to 85.5% in 2023.

Meanwhile, the proportion who had received one dose of meningococcal ACWY vaccine by age 17 fell , to 75.9% in 2022, to 72.8% in 2023.

Vaccination coverage among Indigenous teenagers dropped by similar amounts. For example, the proportion of Indigenous teens who had received one dose of meningococcal ACWY vaccine by age 17 fell from Ìý³Ù´ÇÌý.

Overall, in 2023, around  hadn’t received all three of the nationally recommended adolescent vaccines.

These figures show a decline in vaccination coverage among teenagers over three years. This comes after several years of  before the COVID pandemic.

While the decline has been modest, the downward trend is concerning. It leaves more teenagers – and members of the wider community – vulnerable to serious infectious diseases.

There are likely to be many contributing factors.

Although extended school closures and consequent disruption to school vaccination programs at the height of the pandemic likely played a role, these occurred almost exclusively in . So they can’t fully explain the ongoing drop in adolescent vaccination coverage across the country.

We don’t have good published data on what influences vaccine acceptance among teenagers. But given parents or guardians need to complete  for their child to get vaccinated at school, we may be able to extrapolate from some of the challenges relating to childhood vaccination uptake.

The trends among teenagers have been consistent with a fall in the rates of  who are fully vaccinated. In 2023, 92.8% of one-year-olds were fully vaccinated, down from 94.8% in 2020. At five years old, the coverage rate in 2023 was 93.3%, down also from 94.8% in 2020.

A recent survey into barriers to  indicates a high proportion of parents who choose not to vaccinate young children have concerns about vaccine safety (48%) and effectiveness (40%). It’s possible the COVID pandemic has hindered vaccine acceptance.

Practical access barriers may also be hampering adolescent immunisation coverage. These might include  among parents  or immunisation schedules, complicated parental consent processes, , and lack of awareness of immunisation services outside school-based programs.

°Õ³ó±ðÌý for 2023 showed low HPV coverage for adolescents living in socioeconomically disadvantaged and remote locations. This suggests logistics such as transport may also play a role, especially for teens who miss vaccination during the school-based program.

We need research to better understand the factors influencing vaccine uptake among adolescents. This can help us design and implement strategies to improve vaccination coverage in this age group.

For example, understanding the factors influencing HPV vaccination uptake among Indigenous adolescents and ensuring equitable access to targeted and culturally appropriate  has significantly improved vaccination coverage for this group. HPV vaccine coverage for Indigenous women  is now higher than for the general population.

Parents can support their teenagers by talking to them about the importance of immunisation, listening to their concerns and answering any questions they may have. Consent forms will generally include information about the vaccine and the disease it protects against.

If your child misses out on receiving their vaccinations at school or doesn’t attend school, families can access free National Immunisation Program vaccines from their GP, pharmacy, local council or other health services.

 are also available in most states and territories. These services are for children and adolescents who are in high-risk groups or for families who are concerned about vaccinating their children.

Teenagers are the next generation of parents, and their attitudes towards immunisation will influence coverage rates of their children in the future. This is yet another reason we need to successfully address any concerns or barriers for this group around vaccination.

Dr Archana Koirala is a paediatrician and infectious diseases specialist. She works as an infectious diseases clinician and is part of the NSW Immunisation Specialist Service team. The other contributors to the article include Bianca Middleton, Fiona Russell, Katrina Clark, and Sophie Wen. This article first appeared in .