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Australia’s goal to eliminate cervical cancer by 2035 is under threat amid a worrying national decline in vaccinations.
Adolescent human papillomavirus (HPV) vaccination coverage tumbled to a record low of 78.7 per cent in girls and 75.6 per cent in boys last year, according to the latest statistics from the National Centre for Immunisation Research and Surveillance.
Vaccination coverage for HPV peaked in 2020 and at 85.7 per cent, but has been slipping ever since, sparking alarm among public health experts who warn decades of progress against the disease could be undone.
The 2025 figures are well below the 2030 target of 90 per cent coverage outlined in Australia’s strategy to be the first country to achieve cervical cancer elimination by 2035.
Experts warn the decline was part of a concerning broader trend of dwindling vaccination rates among Australian children, which is leading to a resurgence in serious diseases and infections including whooping cough, measles and diphtheria.
HPV is a common sexually transmissible infection that can spread quickly and cause genital warts and various cancers, including cervical cancer, anal cancer, other anogenital cancers and some head and neck cancers.
Leading immunisation researcher Professor Margie Danchin said there had been a “phenomenal” drop in HPV vaccines, which protect against the high-risk strains of the virus, in the last five years.
“It has absolutely plummeted,” Danchin said. “It’s very concerning.”
The paediatrician and vaccination expert at the University of Melbourne said the decline was being fuelled by several factors, including access and resourcing barriers, the rise in homeschooling and student absenteeism, and cuts to public health.
A switch to a single dose of the vaccine in 2023, amid evidence one dose was enough to protect against the HPV, had also contributed to the decline, Danchin said. This meant if a child was away on the day the vaccine was administered or had forgotten their consent forms they were often losing their only chance to get vaccinated at school.
“Previously those children would have been mopped up when the second dose was rolled out,” she said.
Asked about the prospect of Australia reaching its 2035 goal, Danchin said it was now in doubt.
“Unless governments take it seriously and really start resourcing public health and school-based immunisation delivery, we’re not going to turn it around,” she said.
She also noted that immunisation rates for children under five in Australia was the worst it had been in more than a decade.
“It’s a very depressing story all round,” Danchin said.
University of Melbourne Professor Julia Brotherton, an expert in cervical screening, HPV vaccination and fellow at the National Centre for Immunisation Research and Surveillance, said statistics for Indigenous teenagers were even more grim, with rates falling to 72.6 per cent coverage for girls and 66.8 per cent for boys.
“The saddest thing about this is that decades of equity work we’ve been doing, particularly in school programs … has all come undone,” the professor of cancer prevention policy and implementation said.
“Those big equity gaps are widening, and they’re bigger than they’ve ever been.”
She said while undoubtedly a section of the community had lost trust in the government and some had shifted towards more anti-vaccination views following COVID-19, the true picture of why the decline was occurring was far more complex than a sudden explosion in vaccine hesitancy.
“We’re still seeing residual disruption from the pandemic,” she said.
“We need the political will between health and education to make immunisation of our adolescents an absolute priority. We don’t want to threaten Australia’s leading role in finally getting rid of or eliminating cervical cancer. It’s getting really urgent now.”
Since the national vaccine program began in 2007 Australia had made remarkable progress in the fight against HPV. In 2021, there was not a single documented case of cervical cancer among women under 25 across Australia.
People with HPV often have no symptoms, making it difficult to detect and control. While practising safe sex can help reduce the risk, condoms offer only partial protection against the virus.
The vaccine remains the strongest safeguard and is available for free to young people aged 12 and 13 through school-based programs, with catch-up vaccines provided at no cost up to the age of 26 for those who were missed.
Associate Professor Frank Beard, associate director of surveillance, coverage, evaluation and social science at the National Centre for Immunisation Research and Surveillance said he believed many parents were still not aware they could get their child vaccinated against HPV by a GP or pharmacist if they missed out at school.
He added that while electronic consent (e-consent) for vaccines allowed parents to review information and provide approval digitally, it could also be problematic for families who struggled with digital literacy.
Cervical cancer screening has also dropped off, and it is now estimated more than one in four people are overdue for routine testing.
Chief executive officer of the Australian Cervical Cancer Foundation Joe Tooma said that while increasing uptake of the vaccine was crucial, there were about two million Australian women who had either never been tested for HPV or were overdue for their routine screening.
“If you’re in the system, and you’re being screened regularly your chances of cervical cancer are pretty slim and your chances if it is found early of having a successful journey with treatment is much higher,” Tooma said.
The federal government expanded eligibility for a self-collected cervical screening test in 2022, prompting a surge in people doing their own tests rather than having a routine pap smear.
University of Queensland researcher and 2006 Australian of the year Professor Ian Frazer started developing a vaccine for HPV in the 1990s, along with his colleague, the late Dr Jian Zhou. Australia was the first country to roll it out in 2007.
Last year, a federal government report said Australia remained on track to become the first country to eliminate cervical cancer by 2035.
It noted, however, HPV vaccination rates and cervical screening participation have both declined from previous years, indicating that more work needs to be done.
Ovarian Cancer Research Foundation chief executive officer Robin Penty said a reduction in immunisation rates for HPV also had implications for other cancers that could benefit from preventive vaccines.
“Ovarian cancer is yet to benefit from an early detection test and a vaccine, which exists for cervical cancer,” she said.
“For ovarian cancer, which has a five-year survival rate much lower than other cancers… vaccines are one avenue being explored to save women’s lives.”
The government has been contacted for comment.
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Melissa Cunningham is a health reporter for The Age. She has previously covered crime and justice.Connect via X or email.From our partners
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