The years January 2003 to December 2005 were marked in the main by continuing gains in the control of vaccine preventable diseases and further expansion in routine vaccination programs to cover meningococcal C disease, chickenpox and pneumococcal disease. A particular challenge of the period was that, for the first time, recommendations for the routine use of some new childhood vaccines preceded their provision free of charge to parents (varicella-zoster, inactivated poliomyelitis and 7-valent conjugate pneumococcal vaccine).302 In December 2000, the Australian Childhood Immunisation Register (ACIR) documented that the 90% coverage target for immunisation of 12 month olds had been achieved for the first time. This has been maintained and exceeded through to the end of 2005. This target has now also been met for immunisation of two year olds. Such coverage is likely to have been facilitated by the now routine use of combination vaccines.
These vaccine policy and program changes represent a large investment in public health, which is set to further increase in coming years, with increasingly expensive new vaccines (e.g. against rotavirus, human papillomavirus and shingles) and the incremental increasing cost of all the supporting pillars of immunisation in Australia. Like other industrialised countries, Australia faces the dual challenges of maintaining both high immunisation coverage and public confidence in immunisation, while implementing increasingly complex decisions about the introduction of new vaccines for both children and adults. Although the full evaluation of the impact of current programs, and prioritisation and planning for future programs, require more detailed and precise data, the multiple data sources (notifications, hospitalisations, mortality and vaccine coverage) contained in this report provide an ongoing picture of progress across the spectrum of Australian immunisation activity.