New research led by The University of Queensland has found community involvement, culturally safe services and better access may be the key to improving vaccination rates among Aboriginal and Torres Strait Islander children.
The study reviewed more than a decade of data to identify ways to strengthen vaccination coverage for First Nations children in Australia under five years of age.
Study co-author, First Nations midwife and advanced health worker Cindy Tyson, said successful programs shared common features, including strong community involvement, culturally safe services and a visible First Nations health workforce.
"Programs work best when they are responsive to the communities they serve," Ms Tyson said.
"Improving access to healthcare, such as more flexible services and bringing care closer to families, can make a real difference.
"We know that many health services, including our Aboriginal Community Controlled Health Organisations, do great work to provide culturally safe vaccination services."
The review found strong support for immunisation in Aboriginal and Torres Strait Islander communities, but identified practical and cultural barriers that could affect access.
UQ PhD candidate and Southern Queensland Rural Health Principal Project Officer Clara Walker said the findings showed the issue was not vaccine rejection.
"This isn't about people rejecting vaccines - it's about the practical and cultural barriers families face," Ms Walker said.
"Transport, clinic availability, wait times and how culturally safe a service feels all play a major role."
Associate Professor Paul Gardiner, of UQ's School of Public Health, said vaccination rates for Aboriginal and Torres Strait Islander children had declined in recent years, raising concerns about protection against preventable diseases.
National figures from 2024 show coverage for Aboriginal and Torres Strait Islander children is close to the 95 per cent target associated with herd immunity by age five, but falls short at earlier milestones.
The research found 90.13 per cent of Aboriginal and Torres Strait Islander children are fully vaccinated at one year of age and 88.03 per cent at two years of age.
Dr Gardiner said the early gaps needed to be addressed.
"We've seen a downward trend in childhood immunisation coverage since the pandemic," Dr Gardiner said.
"If early gaps aren't addressed, it risks undoing years of positive progress.
"Children are catching up by five years of age, but the goal is for on-time vaccination to provide protection in line with the immunisation schedule."
Ms Tyson said the review could help health services build on existing strengths.
"We hope this review helps health services build on their strengths and implement practical strategies to support vaccination."
The research was published in the Australian Journal of Primary Health.
The paper was developed and written by First Nations and non-Indigenous researchers and used the term "First Nations peoples" to refer to Aboriginal and Torres Strait Islander peoples, while acknowledging the cultural and linguistic diversity of these communities.
