Primary Health Care Nurse Immunisation Service
Targeted nurse-led support to general practices to improve childhood immunisation coverage through recall systems, catch-up planning, family engagement and practice capability building.
Community need
Northern NSW has the lowest childhood immunisation coverage rates of any region in Australia. As at March 2025, only 81.8% of one-year-olds, 79.2% of two-year-olds and 83.7% of five-year-olds were fully immunised, compared with NSW averages of 91.9%, 89.4% and 93.2% respectively. Significant localised coverage gaps also exist across the region, particularly in areas such as Byron Shire, Tweed Shire and Grafton.
Healthy North Coast’s Health Needs Assessment and the Better Health for North Coast Communities 5-Year Immunisation Plan identified that under-vaccination is influenced by a range of factors, including barriers to access, vaccine hesitancy, workforce capacity limitations, difficulties navigating immunisation services, and lower engagement among some priority populations. These challenges can contribute to increased risk of vaccine-preventable disease and widening health inequities.
While existing partnerships between Healthy North Coast, North Coast Population and Public Health, Local Health Districts and general practice have supported immunisation education and quality improvement activities, vaccination coverage rates have not improved sufficiently. Additional targeted, practice-based support is required to identify under-vaccinated children, strengthen recall and reminder systems, support catch-up planning, improve confidence in vaccine conversations and increase access to immunisation services.
The Nurse Immunisation Service addresses these gaps through data-informed, nurse-led support to general practices, proactive family engagement and culturally responsive approaches that improve childhood vaccination coverage and strengthen the long-term capability of primary care services.
Our approach
The service uses a targeted, data-driven approach to improve childhood immunisation coverage in priority locations. A dedicated Primary Health Care Nurse Immuniser works directly with participating general practices to identify children who are overdue or not up to date, strengthen recall and reminder systems, support catch-up planning and improve practice workflows relating to immunisation delivery.
The service combines practice support, workforce capability building, family engagement and evidence-based vaccine conversations. Australian Immunisation Register (AIR) and practice-level data are used to identify coverage gaps and inform targeted interventions. The service also supports culturally responsive engagement with Aboriginal and CALD families and promotes collaboration between general practice, public health and community partners to improve immunisation outcomes.
Consultation
The Nurse Immunisation Service has been developed through collaboration between Healthy North Coast, North Coast Population and Public Health, Local Health District immunisation teams and primary care stakeholders. Service design has been informed by regional immunisation coverage data, local immunisation priorities and the Better Health for North Coast Communities 5-Year Immunisation Plan.
Ongoing implementation is informed by practice feedback, public health expertise and data-driven identification of local coverage gaps. The service works closely with participating practices and community partners to identify barriers to vaccination and develop locally appropriate solutions that improve access and confidence in immunisation services.
Key activities
Identify children who are overdue or not up to date with scheduled immunisations.
Support practices to strengthen recall and reminder systems.
Develop and support catch-up immunisation planning.
Provide structured immunisation support to participating practices.
Build capability of GPs and Practice Nurses to address vaccine hesitancy.
Support evidence-based vaccine conversations with families.
Analyse immunisation data and identify local coverage gaps.
Deliver culturally responsive engagement with Aboriginal and CALD communities.
Improve coordination between general practice, public health and community services.
Monitor immunisation outcomes and support continuous quality improvement.
Objectives
Increase childhood immunisation coverage in priority locations across Northern NSW.
Reduce the number of children who are overdue or not up to date with scheduled immunisations.
Improve the capability of general practices to deliver sustainable immunisation improvement activities.
Strengthen recall, reminder and catch-up planning systems within primary care.
Improve confidence in immunisation through evidence-based engagement with families.
Increase access to immunisation services for priority populations, including Aboriginal and CALD families.
Strengthen collaboration between primary care, public health and community partners.
Support implementation of the Better Health for North Coast Communities 5-Year Immunisation Plan.