Background
Aboriginal and Torres Strait Islander peoples, or First Nations Australians, have higher rates of some vaccine-preventable diseases (VPD) than non-Indigenous Australians. This is due to a variety of factors, including access barriers to health care and preventative care, higher burden of chronic medical conditions and social determinants such as overcrowding and socioeconomic factors. For this reason, Aboriginal and Torres Strait Islander peoples are prioritised for additional protection through the funding of further vaccines on the National Immunisation Program (NIP).
Variations to recommendations for additional vaccines vary from state to state, based on local disease burden. In addition to this, individual immunisation providers (e.g. hospital immunisation services) may have varying approaches to additional vaccines; this should be clarified with the local health service.
Recommendations
All First Nations Australians are recommended to receive the same vaccines given to non-Indigenous Australians. Additional vaccines prioritised for First Nations Australians are summarised in the table below.
Table 1: NIP-funded vaccine priorities for Aboriginal and Torres Strait Islander peoples
| Jurisdiction | Disease (vaccine) | Notes |
| ACT NSW Tas Vic | Meningococcal B (Bexsero) | Given at 2, 4 and 12 months (additional dose at 6 months for some underlying medical conditions)^ |
| Influenza (age-appropriate brands) | Given annually from ≥ 6 months (2 doses in the first year of being vaccinated for those < 9 years) | |
| Pneumococcal (Prevenar 13) | Single dose at ≥ 50 years | |
| Pneumococcal (Pneumovax 23) | 2 doses at ≥ 50 years (1st dose 2–12 months after Prevenar 13,# 2nd and final dose ≥ 5 years after 1st dose) | |
| Herpes zoster (Shingrix) | 2 doses at ≥ 50 years (2–6 months apart if immunocompetent, 1–2 months apart if immunocompromised)* | |
| NT | Disease (vaccine) | Notes |
| Meningococcal B (Bexsero) | Given at 2, 4 and 12 months (additional dose at 6 months for some underlying medical conditions)^ | |
| Influenza (age-appropriate brands) | Given annually from ≥ 6 months (2 doses in the first year of being vaccinated for those < 9 years) | |
| Pneumococcal (Prevenar 13) | Single dose at 6 months (to make total of 4 doses in the infant schedule)¥ Single dose at ≥ 50 years | |
| Hepatitis A (Vaqta) | Given at 18 months and 4 years (total 2 doses) | |
| Pneumococcal (Pneumovax 23) | Single dose at ≥ 4 years (minimum 2 months after last Prevenar 13 dose), followed by a second dose ≥ 5 years later (total 2 Pneumovax 23 doses in a lifetime) 2 doses at ≥ 50 years (1st dose 2–12 months after Prevenar 13,# 2nd and final dose ≥ 5 years after the 1st dose) | |
| Herpes zoster (Shingrix) | 2 doses at ≥ 50 years (2–6 months apart if immunocompetent, 1–2 months apart if immunocompromised)* | |
| SA Qld | Disease (vaccine) | Notes |
| Tuberculosis (BCG) | SA: Given at birth to all babies on Anangu Pitjantjara Yankunytjatjara (APY) Lands. Catch-up can be given up to 5 years Qld: Given at birth to all Aboriginal and Torres Strait Islander babies and to all children < 5 years of age living in Aboriginal and Torres Strait Islander communities | |
| Meningococcal B (Bexsero) | Given at 2, 4 and 12 months (additional dose at 6 months for some underlying medical conditions)^ | |
| Influenza (age-appropriate brands) | Given annually from ≥ 6 months (2 doses in the first year of being vaccinated for those < 9 years) | |
| Pneumococcal (Prevenar 13) | Single dose at 6 months (to make total of 4 doses in the infant schedule)¥ ≥ Single dose at 50 years | |
| Hepatitis A (Vaqta) | Given at 18 months and 4 years (total 2 doses) | |
| Pneumococcal (Pneumovax 23) | Single dose at ≥ 4 years (minimum 2 months after last Prevenar 13 dose), followed by a second dose ≥ 5 years later (total 2 Pneumovax 23 doses in a lifetime) 2 doses at ≥ 50 years (1st dose 2–12 months after Prevenar 13,# 2nd and final dose ≥ 5 years after the 1st dose) | |
| Herpes zoster (Shingrix) | 2 doses at ≥ 50 years (2–6 months apart if immunocompetent, 1–2 months apart if immunocompromised)* | |
| WA | Disease (vaccine) | Notes |
| Meningococcal ACWY (Nimenrix) | Given at 2, 4 and 12 months (additional dose at 6 months for some underlying medical conditions)^ | |
| Meningococcal B (Bexsero) | Given at 2, 4 and 12 months (additional dose at 6 months for some underlying medical conditions)^ | |
| Influenza (age-appropriate brands) | Given annually from ≥ 6 months (2 doses in the first year of being vaccinated for those < 9 years) | |
| Pneumococcal (Prevenar 13) | Single dose at 6 months (to make total of 4 doses in the infant schedule)¥ Single dose at ≥ 50 years | |
| Hepatitis A (Vaqta) | Given at 18 months and 4 years (total 2 doses) | |
| Pneumococcal (Pneumovax 23) | Single dose at ≥ 4 years (minimum 8 weeks after last Prevenar 13 dose), followed by a second dose ≥ 5 years later (total 2 Pneumovax 23 doses in a lifetime) 2 doses at ≥ 50 years (1st dose 2–12 months after Prevenar 13,# 2nd and final dose ≥ 5 years after the 1st dose) | |
| Herpes zoster (Shingrix) | 2 doses at ≥ 50 years (2–6 months apart if immunocompetent, 1–2 months apart if immunocompromised)* |
^ Refer to MVEC: Meningococcal for specific medical conditions and vaccination guidance.
# If Pneumovax 23 is inadvertently given before Prevenar 13 dose, wait 12 months before administering Prevenar 13.
* Shingrix vaccination is funded from 18 years of age for those with a history of haematopoietic stem cell transplant, solid organ transplant, blood cancer and advanced/untreated HIV).
¥ If 6-month dose is not given, refer to Australian Immunisation Handbook for catch up advice.
shaded boxes indicate live attenuated vaccines
Vaccine-preventable diseases (VPD) targeted through funding
Hepatitis A
Factors associated with hepatitis A transmission include (but are not limited to) overcrowding and poor sanitation conditions. Before the introduction of the NIP-funded Hepatitis A vaccination program, Hepatitis A was particularly prevalent in Aboriginal and Torres Strait Islander communities. Rates in First Nations children aged under 5 years were over 20 times higher than those in non-Indigenous children in the same age group. This disease burden was most prominent in more remote areas, particularly in northern Australia.
For more information, refer to Australian Immunisation Handbook: Hepatitis A
Herpes zoster (shingles)
Herpes zoster (shingles) is caused by a reactivation of the varicella zoster virus, the same virus that causes varicella (chickenpox) disease. Zoster episodes requiring primary care presentation and/or hospitalisation impact Aboriginal and Torres Strait Islander people at an earlier age than non-Indigenous Australians. In addition, the increased burden of chronic and complex diseases means that First Nations Australians are more likely to develop herpes zoster and its associated complications compared with other Australians.
For more information, refer to MVEC: Zoster
Influenza
First Nations Australians are three times more likely than non-Indigenous people to be admitted to hospital for influenza and pneumonia. Vaccination can offer protection against disease and its complications.
For more information, refer to MVEC: Influenza page
Meningococcal
First Nations Australians have a 10-fold increased incidence of invasive meningococcal disease compared to non-Indigenous people across some age groups. Certain medical conditions further increase the likelihood of experiencing disease (e.g. immunosuppression, asplenia). Protection is offered through vaccination at the ages where disease affects individuals at the highest rates.
For more information, refer to MVEC: Meningococcal
Pneumococcal
Rates of invasive pneumococcal disease (IPD) are 6 to 7 times higher for Aboriginal and Torres Strait Islander peoples compared with non-Indigenous Australians. The risk of invasive pneumococcal disease (IPD) is greatest in young children under 5 and adults over 50 years. Protection is offered through vaccination at the ages where disease affects individuals at the highest rates.
For more information, refer to MVEC: Pneumococcal
Tuberculosis
In most areas of Australia, rates of tuberculosis are similar for First Nations Australians and non-Indigenous Australians. However, there are some specific regions where the burden of disease is higher amongst First Nations people. The reasons for this increased burden are varied; it may be associated with high density living conditions (contributing to ease of transmission) and being in close proximity to other countries with high rates of disease (contributing to imported cases by travellers).
For more information about tuberculosis vaccination (with advice specific to Victoria), refer to MVEC: Tuberculosis
Access
Easy access to vaccines is important. High vaccine coverage and being vaccinated on time are key to reducing the burden of many VPDs among Aboriginal and Torres Strait Islander peoples.
All routine and additional immunisations can be administered via GP services, councils, hospital immunisation services, some pharmacies and local Aboriginal Health Services.
Other considerations
Individuals may also benefit from other vaccines not previously mentioned on this page, depending on other factors, such as:
- vaccination history
- medical conditions
- sexual orientation
- proximity to local outbreaks
- travel plans
- occupational risk.
Resources
National
- Department of Health and Aged Care: Immunisation for Aboriginal and Torres Strait Islander people
- NCIRS: Aboriginal and Torres Strait Islander Immunisation
- HealthInfoNet
- NCIRS: Vaccination for Our Mob
State
Vic
Authors: Rachael McGuire (MVEC Education Nurse Coordinator), Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute) and Rebecca Feore (Immunisation Nurse, The Royal Children’s Hospital)
Reviewed by: Rachael McGuire (MVEC Education Nurse Coordinator) and Katie Butler (MVEC Education Nurse Coordinator)
Date: December 2023
Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.
You should not consider the information on this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.
Background
It is widely recognised that Aboriginal and Torres Strait Islander peoples have higher rates of some vaccine preventable diseases (VPD) than non-Indigenous persons. This is not necessarily due to being of Aboriginal and/or Torres Strait Islander background, but rather due to the higher rates of underlying chronic health conditions and social circumstances that can lead to an increase in disease burden. For this reason, additional vaccines are recommended, some of which are available through the National Immunisation Program (NIP).
The recommendations and funding for additional vaccines for Aboriginal and Torres Strait Islander peoples vary from state to state, based on local disease burden. In addition, individual immunisation providers may have varying approaches to non-NIP vaccines, and this should be clarified with the local health service.
Accessing immunisations
Routine and additional immunisations can be administered via GP services, councils, hospitals, local Aboriginal Health Services and some pharmacies.
Additional funded vaccines for Aboriginal and Torres Strait Islander people living in Victoria
Hepatitis B
Rates of hepatitis B infection in Aboriginal and Torres Strait Islander peoples population are up to 3 times higher than the non-Indigenous with notification rates increasing with age.
Hepatitis B vaccination is funded on the NIP with routine doses given at birth, 6-weeks, 4-months and 6-months of age. A booster dose is also given at 12-months of age for those who were born at < 32-weeks gestation and/or < 2000g birth weight.
In addition to this, hepatitis B vaccination is also funded in Victoria for all non-immune Aboriginal and Torres Strait Islander peoples of any age.
Pneumococcal
The risk of invasive pneumococcal disease (IPD) is greatest in young children and older adults. Rates of IPD are 6–7 times higher in Aboriginal and Torres Strait Islander people.
Aboriginal and Torres Strait Islander children living in Australian Capital Territory (ACT), New South Wales (NSW), Tasmania (Tas) or Victoria (Vic) are funded for 1 dose of Prevenar 13® (13vPCV) at ages 6 weeks, 4-months and 12-months (3 doses in total). For those with a risk condition/< 28-weeks gestation an extra dose of 13vPCV is given at 6-months of age (4 doses in total) as well as a dose of Pneumovax 23® (23vPPV) at 4-years of age.
Aboriginal and Torres Strait Islander children in Northern Territory (NT), Queensland (Qld), South Australia (SA) and Western Australia (WA) are funded to receive an extra dose of pneumococcal vaccine at age 6 months followed by two further doses of 23vPPV at age 4-years and at least 5 years later.
All Aboriginal and Torres Strait Islander individuals aged > 12 months with risk conditions are recommended to receive 1 additional dose of 13vPCV unless they have previously received a total of 4 doses of 13vPCV (according to the routine schedule for Aboriginal and Torres Strait Islander infants in NT, Qld, SA and WA) followed by two doses of 23vPPV. These doses are funded for some but not all risk conditions.
All Aboriginal and Torres Strait Islander adults ≥ 50 years of age are eligible for 1 dose of 13vPCV and two doses of 23vPPV.
The maximum number of doses of 23vPPV received in a lifetime is two.
For more information please refer to MVEC: Pneumococcal.
Influenza
Aboriginal and Torres Strait Islander people are three times more likely than non-Indigenous people to be admitted to hospital for influenza and pneumonia.
Annual influenza vaccination is funded on the NIP for all Aboriginal and Torres Strait Islander peoples from 6 months of age.
Meningococcal B and ACWY
In 2019, Aboriginal and Torres Strait Islander people had a 10-fold increased incidence of meningococcal disease than non-Indigenous people across some age groups. The most common strains causing infection were types B and W. The recommendation for all Aboriginal and Torres Strait Islander peoples is immunisation against meningococcal disease from 6 weeks of age.
Nimenrix® (meningococcal ACWY) is currently funded on the NIP as a single dose at 12-months of age and an adolescent dose at 14-15 years of age (Year 10 equivalent).
Meningococcal B vaccine (Bexsero®) is free and recommended under the NIP for Aboriginal and Torres Strait Islander infants at 2, 4, and 12 months of age. An additional dose at 6 months of age is required for Aboriginal and Torres Strait Islander infants with certain medical risk conditions.
Meningococcal B and meningococcal ACWY vaccines are also funded under the NIP for people of all ages with specified medical risk conditions that increase their risk of IMD.
For more information refer to MVEC: Meningococcal.
COVID-19 vaccines
A primary course of COVID-19 vaccines are recommended for all Aboriginal and Torres Strait Islander person > 5 years of age. Additional booster doses are also recommended for certain age groups. Aboriginal and Torres Strait Islander people are prioritised for immunisation as there is an increased risk of severe COVID-19 disease and death due to a number of factors. This includes a higher prevalence of underlying medical conditions, as well as a greater likelihood of living in communities where other preventative measures (social distancing, mask wearing and hand hygiene) cannot be maintained.
Please refer to COVID-19 vaccination – ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021 and COVID-19 vaccination information for Aboriginal and Torres Strait Islander people.
Additional funded vaccines for Aboriginal and Torres Strait Islander people living in other states
| Vaccine | Age group | State |
|---|---|---|
| BCG (tuberculosis) | Children < 5 years | QLD |
| Prevenar 13® (13-valent pneumococcal conjugate vaccine) | 6 months | NT, QLD, SA, WA |
| Vaqta® Paediatric (hepatitis A – 2 dose course) | 18 months and 4 years | NT, QLD, SA, WA |
SA Health- Aboriginal and Torres Strait Islander people immunisation recommendations QLD Health- Aboriginal and Torres Strait Islander people immunisation recommendations WA Department of Health – Immunisation schedule ATAGI clinical advice on hepatitis A vaccine
Resources
Aboriginal health services
Other resources
- Australian Immunisation Handbook: Vaccination for Aboriginal and Torres Strait Islander people
- National Aboriginal Community Controlled Health Organisation: COVID-19 Vaccine Updates and Information
- ATAGI clinical advice on vaccination recommendations for Aboriginal and Torres Strait Islander people from 1 July 2020
- ATAGI clinical guidance for COVID-19 vaccine providers
- National Immunisation Program schedule for all Aboriginal and Torres Strait Islander people
- NCIRS: Aboriginal and Torres Strait Islander Immunisation
Authors: Rachael McGuire (MVEC Education Nurse Coordinator), Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute) and Rebecca Feore (Immunisation Nurse, The Royal Children’s Hospital)
Reviewed by: Rachael McGuire (MVEC Education Nurse Coordinator)
Date: February 22, 2024
Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.
You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.