TENS of thousands of Australian children are behind with their vaccinations and at risk from contagious diseases.
The threat is heightened further for those too young or ill to be vaccinated.
The biggest problem is among children aged five, according to a report released on Thursday by the National Health Performance Authority.
The report, based on 2011/12 data from the Childhood Immunisation Register, assesses the number of children considered fully immunised at one year, two years and five years.
It says 76,769 out of nearly 900,000 are not up to date and identifies 32 geographical areas where people are most at risk.
In these areas, at least 15 out of 100 children are behind in at least one of the age groups.
On the upside, 77 of 325 areas have immunisation rates of at least 95 per cent in at least one of the three age groups.
The best performing area across all three age groups is Maitland in NSW, where 95 per cent or more children are fully vaccinated.
The worst performer across all three age groups is "Richmond Valley - coastal" in NSW, where 85 per cent or fewer children are up to date.
Overall, two year olds have the best vaccination rates but many children fall behind by the age of five.
National Health Performance Authority CEO Dr Diane Watson says the report "shows we have done well to protect children in most local areas and is intended to help local communities better target their efforts".
She says more work is needed to explain why the drop-off occurs among five year-olds and why areas with similar demographics have significantly different figures.
Another question is why the rates for Aboriginal and Torres Strait Islander children are high in some areas and low in others.
The results are reported by Medicare Local catchment areas and some are broken down into 325 smaller areas used by the Australian Bureau of Statistics.
Results are also available for more than 1500 postcodes at www.nhpa.gov.au
NSW Director of Health Protection Jeremy McAnulty says immunisation rates have improved dramatically over the past 15 years but "getting those last few is really hard".
Dr McAnulty says a major problem is that parents are busy and forget how important it is to have vaccinations done on time.
Victoria Chief Health Officer Rosemary Lester says immunisation protects individual children against dangerous diseases but also protects people who are not immunised.
"If you have a very high rate of immunisation, diseases like measles cannot find enough susceptible people to circulate," Dr Lester said.
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