Australians' uptake of the annual influenza vaccine heading into winter is at its lowest level in years, with top doctors pointing the finger at increasing barriers to accessing GPs as a key culprit.
Just over one in five Australians (21.8 per cent) had received a flu shot by May 19.
That is a 10 per cent drop compared to the same time last year, according to Australian Immunisation Register records.
That's despite health authorities' warnings over an early surge in respiratory illnesses in recent weeks.
In New South Wales, especially, cases of influenza have recorded a sharp uptick in recent weeks with 29,000 laboratory-confirmed cases so far this year.
Children under five - who are particularly at risk of severe complications - are eligible for a free flu jab across all states and territories, yet less than one in seven (13.8 per cent) have done so.
In 2019, that figure was at 40 per cent by August.
School-aged children are the least vaccinated group of all against the flu, with just 8.4 per cent of five- to 15-year-olds having got the shot so far this year.
Even among those most vulnerable to life-threatening complications - those aged over 65 - only half have so far been vaccinated.
Australian Medical Association (AMA) President, Professor Steve Robson, said the fall in vaccinations was "absolutely a big concern".
He said vaccination rates would need to more than double to "well above 50 per cent" in order to provide a level of herd immunity and stem the spread of a severe flu season.
"There's no doubt that influenza is seen as taking a backseat to COVID, and I understand that, but influenza still is a very serious disease," Robson said.
Thirty-nine people died from the flu in Australia last year, including nine children under 16 years old.
The Royal Australian College of General Practitioners (RACGP)'s Vice President attributes part of the drop to a fall in people accessing their General Practitioner.
That is borne out by the immunisation figures.
While 1.38 million Australians got a flu shot at their pharmacy this year - up five per cent from last year - the number who went to their GP for the jab plummeted from four million to 3.41 million.
"We know that when people are visiting the GP less - which we know is happening - there are less opportunities to remind them about all of the preventative activities that they should be doing," Associate Professor Michael Clements told 9News.
"We don't get to remind them about their pap smear, their blood pressure, their cholesterol - and their flu vaccine."
He believes rising cost of living pressures are also having an impact on some families.
The number of people who reported avoiding or delaying going to their GP due to cost doubled in 2022-23 to seven per cent, according to ABS data.
Currently, only Queensland and Western Australia have made the flu jab free for everyone.
In all other states and territories, it incurs a fee of around $25 for anyone aged from five to 65 who doesn't have a chronic health condition.
"We've got to acknowledge that if the state governments were truly invested in this and then they would copy what WA and Queensland did," Clements said.
As bulk billing GPs become increasingly scarce and regional and rural towns face closures of their GP clinics altogether, more and more people are delaying going to the GP or finding alternative methods of care.
Clements said that while there would always be a sector of the population who would line up to receive their influenza vaccines, a large proportion of the population required a nudge, which, traditionally, came from their GP when they attended for an appointment.
"If you are a 30-year-old, active person, catching the flu is more of an inconvenience than a danger to you," he said.
"But if you take it home to your infant child, if you take it home to your grandmother or mother who are frail, then you're going to make them very sick and potentially hospitalised."
Robson agreed that increasing barriers to GPs were having an impact, but urged Australians to nevertheless be proactive about their health care.
"We know around the country that it's increasingly difficult for Australians to have access to general practice - that's been acknowledged by the government, that's been acknowledged by the peak health bodies," he said.
"But that doesn't mean that general practices aren't there. They will make appointments available.
"The cost of the vaccination is likely to save you much more money than if you get influenza, irrespective of how ill you get."
