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Vaccine fatigue a growing threat to herd immunity

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by Professor Peter Jones

For a couple of weeks each year, I work at hospitals in the Solomon Islands.

It may be confronting to learn that just a three-hour flight from Brisbane, young babies are dying of meningitis, and young women of 40 with cervical cancer are being sent home with a single packet of paracetamol to ease their suffering.

In Australia, vaccines prevent both of these deadly conditions.

Imagine for a moment if we did not have the whooping cough vaccine.

We would lose thousands of otherwise healthy babies to this frightening bacterial infection. As a society, we would pay anything to prevent such grief.

Across 2024, we have had a massive whooping cough epidemic. There have been 45,000 cases of whooping cough in Australia. 

One of the positive outcomes of the COVID-19 pandemic has been our ability to test and identify the actual cause of a greater proportion of respiratory tract infections. 

A downside from the pandemic and perhaps the various vaccine mandates has been the community developing “vaccine fatigue,” and Australia’s ability to achieve high rates of immunisation has been dropping.

Whooping cough is a bacterial infection caused by Bordetella Pertussis.

The vaccine for whooping cough is about 80 percent effective, which is effective enough to cause herd immunity if 95 percent of the community is vaccinated. 

To maintain immunity, there needs to be compliance with both the initial vaccine schedule and the boosters.

A Medical Journal of Australia research paper released in June found that vaccination fatigue after the COVID-19 pandemic was one reason behind the drop in the percentage of vaccinated 12-month-old children in Australia, from 94.31 percent in 2019 to 93.16 percent in 2023.

In the same study, negative parent perceptions about vaccines indicated that the vaccine coverage rate might be as low as 87 percent.

There is evidence that, in addition to a drop in compliance with the primary immunisation schedule, ensuring everyone gets their boosters is the bigger problem. 

Up to 25 percent of high school children are not receiving their whooping cough booster in Year 7.

The main concern is that many of the other conditions we have managed to almost consign to history will re-emerge if we are unable to maintain our vaccination rates.

There is a need to rebuild trust with the broader community so that the community sees the benefits of vaccination and wishes to get their children and family members protected as quickly as possible.

Yet, despite the advantages vaccines have given us over many decades, we are seeing worrying trends. 

peter jones
Professor Peter Jones.

Unfortunately, the concerted drive for us all to get the COVID-19 vaccine has left some people feeling browbeaten.

Sections of the public have switched off and no longer wish to engage with vaccination—and that is a concern because vaccinations drive herd immunity and are important to the health of us all.

The challenge for government and the health community is how we re-engage with these people, many of whom oppose a totalitarian style of vaccination education such as that seen during the pandemic. 

Prior to COVID-19, a balanced carrots-and-stick approach saw Australia’s vaccination rate among children improve from 53 percent in the late 1980s to 95 percent in 2020.

It isn’t just a question of getting the vaccination message out there. The challenge is the sheer volume of information and misinformation across so many channels—some of it questionable or downright wrong.

Trying to get the right public health message to the intended audience is strangely more difficult than ever before. As a result, more of the public believe some of the negative stories written about vaccination.

That attitude is reflected in the MJA research paper, which showed that the percentage of people who thought children got too many vaccines had risen from 17.2 percent in 2017 to 25.2 percent in 2023. 

The number of people who believed “vaccine ingredients cause harm” rose from 14.6 percent in 2017 to 19.4 percent in 2023.

One of the newest vaccines to become mainstream combats the respiratory syncytial virus (RSV)—a particularly nasty illness that is responsible for 160,000 child deaths worldwide. 

If this vaccine succeeds, there will be thousands of infants under the age of one who will no longer need admission for the treatment of bronchiolitis. Let’s hope the RSV vaccine roll-out is a good news story for Australia in 2025.

In Australia, we should be grateful for the great healthcare system we have, and that every child can have access to a magnificent immunisation schedule that makes terrible illnesses like meningitis, polio, tetanus, liver cancer, severe pneumonia, rubella, and cervical cancer rare events.

The messaging around vaccination needs to capture a collective national and state pride for the outcomes that have been achieved in improving the health of the community. Part of this is changing the way health issues are reported in Australia.

Too often, the narrative is one of doom and gloom, such as stories about ramping.

Factual reporting is justified, but to maintain public faith in healthcare, we also need to report all the good that is done, particularly with vaccination.

The lives of some of our youngest and most vulnerable are at stake.

* Dr Peter Jones is a Professor of Paediatric Medicine at Bond University.

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