Feature Article

Strategies to increase vaccination rates in older people


Australian Immunisation Register

The AIR was extended to all age groups from November 2016, replacing the Australian Childhood Immunisation Register.12 The AIR can record vaccinations given through general practice and community clinics, including vaccines funded under the NIP and privately funded vaccinations. It provides an opportunity to record vaccinations of older people and to make this information available to other GPs and healthcare practitioners, for example if the patient moves to a new general practice. 

The data could also be used, when sufficiently complete and reliable, to identify and target regions achieving lower vaccination rates, and to identify high vaccination regions that can be further interrogated to demonstrate best practices.



Despite official recommendations on vaccination in older people and inclusion of many vaccines on the NIP, coverage levels in older adults are well below those in children. Strategies that might increase uptake of recommended vaccines among older people include government actions, such as listing all recommended vaccines on the NIP and improving national surveillance of vaccination coverage levels and disease rates in the older population to inform funding discussions. However, GPs also have the opportunity to help increase vaccination rates among their older patients. Suggested strategies include informing their older patients about the risks and potential severity of vaccine-preventable diseases and the safety and effectiveness of vaccines, co-administration of vaccines where this is safe, and adopting systematic practice strategies to support opportunistic vaccination and patient notification and recall systems.     MT



1.    Damm O, Witte J, Greiner W. A systematic review of herpes zoster vaccine acceptance. Value Health 2015; 18: A592.
2.    Task Force on Community Preventive Services. Recommendations to improve targeted vaccination coverage among high-risk adults. Am J Prev Med 2005; 28(5 Suppl): 231-237.
3.    Mieczkowski T, Wilson S. Adult pneumococcal vaccination: a review of physician and patient barriers. Vaccine 2002; 20: 1383-1392.
4.    Litt J, Rigby K, Duffy J. Australian National Influenza and Pneumococcal Survey in the elderly. Report No. 1. 12/2003 to Commonwealth  Department of Health and Ageing. Adelaide: Discipline of General Practice, Flinders University; 2003. p. 199.
5.    Litt J, Kim S, Woodman R, MacIntyre R, Cunningham A. Australian zoster study: GP and patient views about herpes zoster (shingles), its complications, and the likely acceptance of a zoster vaccine (Zostavax). Int J Infect Dis 2014; 21(Suppl): 436-437.
6.    Australian Technical Advisory Group on Immunisation (ATAGI). Australian immunisation handbook. Canberra: Australian Government Department of Health; 2018. Available online at: (accessed February 2019). 
7.    National Centre for Immunisation Research and Surveillance (NCIRS). NCIRS factsheets & FAQs. Sydney: NCIRS; 2018. Available online at: (accessed February 2019).
8.    Australian and New Zealand Society for Geriatric Medicine (ANZSGM). Position statement no. 7. Immunisation of older people - revision number 3, 2018. Sydney: ANZSGM; 2018. Available online at: (accessed February 2019). 
9.    Britt H, Miller GC, Charles J, et al. General practice activity in Australia 1990-00 to 2008-09: 10 year data tables. Canberra: Australian Institute of Health and Welfare; 2009. 
10.    Royal Australian College of General Practitioners. Putting prevention into practice. Guidelines for  the implementation of prevention in the general practice setting. Melbourne: RACGP; 2018.
11.    Thomas RE, Lorenzetti DL. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst Rev 2014; (7): CD005188.
12.    Australian Government Department of Human Services. Australian Immunisation Register. Available online at: (accessed February 2019).



COMPETING INTERESTS: Professor Woodward has received funds for sitting on advisory boards and participating in educational events, for Seqirus, Sanofi, MSD and GlaxoSmithKline.  Associate Professor Litt has received funds for sitting on advisory boards for Seqirus and GlaxoSmithKline and speaker’s fees from Seqirus when providing educational updates on zoster vaccination for a range of healthcare providers.  Professor Van Buynder has conducted clinical research on vaccine effectiveness of adjuvanted vaccines via an unrestricted grant from Novartis.  He has also received support for research, education and marketing, travel and/or advisory board activities from Seqirus, Sanofi, GlaxoSmithKline, Roche, Pfizer and Novartis. 


Associate Professor Woodward is Director of Aged Care Research and a Senior Geriatrician at Heidelberg Repatriation Hospital, Melbourne, Vic. Associate Professor Litt is a Public Health Physician and Associate Professor in the Discipline of General Practice, Flinders University, Adelaide, SA. Professor Van Buynder is a Public Health Physician and Professor at the School of Medicine, Griffith University, Brisbane, Qld.