Immunisation medical contraindication and natural immunity on the Australian Immunisation Register (AIR) 011-10060000

The recording of immunisation medical contraindications or natural immunity on AIR is governed by legislation:

• A New Tax System (Family Assistance) Act 1999, and
• the Australian Immunisation Register Act 2015

The References page contains links to the Acts.

Family Assistance Act 1999

A child must meet immunisation requirements to be considered eligible for Family Tax Benefit (FTB) or childcare fee assistance. Payments may be stopped or reduced if a child does not meet requirements. If a child is unable to have a vaccine for a medical reason, an immunisation medical contraindication and/or natural immunity must be recorded on AIR. This ensures their immunisation status is considered as up to date (not overdue) and will not impact negatively on payment eligibility and assessments.

AIR Act 2015 and AIR Rules 2026 - Mandatory reporting

Under the Australian Immunisation Register Rules 2026 vaccination providers must submit immunisation information electronically or by using the approved form. It is also mandatory to report the following to the AIR:

• COVID-19 vaccinations administrated on or after 20 February 2021
• Influenza vaccinations administered on or after 1 March 2021
• NIP vaccinations administered on or after 1 July 2021, and
• Japanese encephalitis virus (JEV) vaccines administered on or after 21 December 2022

The Australian Immunisation Register Act 2015 specifies the data elements to report, and how and when to report these, specifically:

• A customer’s immunisation status, including if they have an immunisation medical contraindication or natural immunity recorded on AIR
• Only certain medical practitioners are eligible to certify immunisation medical contraindications or natural immunity

To meet immunisation requirements, the following can be recorded on AIR:

• A temporary or permanent medical contraindication to a vaccine or a component of a vaccine
• Natural immunity to a disease
• A Catch-up schedule

Note: Service Officers must not offer medical or policy advice on immunisation medical contraindications or natural immunity. Refer customers to their medical practitioner or vaccination provider for advice. Medical practitioners can refer to the Australian Immunisation Handbook or seek further advice from their state or territory health department. See the Resources page for links.

The Australian Immunisation Handbook states a medical contraindication is:

• a medical condition, or
• risk factor in an individual that makes getting a specific vaccine potentially harmful

Therefore, the individual should not be vaccinated with that vaccine or component during the recorded period.

Medical contraindications are assessed and determined by eligible medical providers, and can be recorded on AIR for a vaccine as either:

• permanent medical contraindication if there is no end date, or
• temporary medical contraindication if - the end date is in the future

The customer may also be considered up to date for the purposes of:

• meeting requirements for family assistance payments
• overdue reminder letters and overdue reports for providers
• child care and school enrolments

Valid reasons for eligible providers to record a permanent immunisation medical contraindication on AIR are:

• previous anaphylaxis (to vaccine/vaccine component)
• significant immunocompromise (for live attenuated vaccines only)

Valid reasons for eligible providers to record a temporary immunisation medical contraindication on AIR are:

• acute major medical illness
• significant immunocompromise of short duration (live attenuated vaccines only)
• the individual is pregnant (live attenuated vaccines only)

Service Officers must record all the vaccine brands the medical practitioner has ticked on the form. Even if they contain the same antigens (components), non-live and live.

Generic vaccine codes can be recorded. For example, generic diphtheria (GF) or generic tetanus (GT). See Navigate AIR system for full list of vaccine codes.

Natural immunity is when an individual is assessed as not requiring a vaccination because they previously contracted a disease/s and, as a result, have developed natural immunity to that disease. natural immunity:

• is recorded for diseases, unlike medical contraindications, which are recorded for vaccines and their components
• is confirmed by a laboratory test or physician based clinical diagnosis
• has no end date
• can only be recorded for hepatitis A, hepatitis B, measles, mumps, rubella, varicella (chicken pox), and Q fever on AIR

Recording a natural immunity to a disease means the individual is not required to receive that disease component of a vaccine. An individual is considered up to date with immunisations for the purposes of:

• meeting requirements for family assistance payments
• overdue reminder letters, and overdue reports for providers
• child care and school enrolments

The Department of Health, Disability and Ageing may consider the individual due/overdue for any remaining antigens in the vaccine. For example, if a customer has a recorded natural immunity to mumps, they may be due/overdue for measles and rubella. This will display on their immunisation history.

From 14 April 2024, vaccination providers can report a temporary or permanent medical contraindication to 'influenza vaccines' instead of reporting each individual brand.

The Immunisation History Statement will show the medical contraindication as 'influenza vaccine'.

The vaccine codes for recording medical contraindications in mainframe are:

• vaccine code - FLUMC
• antigen code - FLU
• operator code - F1

Recording medical contraindication for COVID-19 is no longer restricted to 6 months.

Staff can record a temporary medical contraindication for COVID-19 for the period noted on the form.

The IM011 form includes all COVID-19 vaccines approved by the Therapeutic Goods Administration (TGA) to be administered in Australia. It is not possible to record a medical contraindication for COVID-19 vaccines that are not approved for use in Australia. COVID-19 antiviral medications cannot be recorded on AIR because they are not vaccines.

Some states and territories have their own forms for people who cannot be vaccinated due to medical reasons. These forms:

• are generally used for employment purposes
• are only acceptable under state and territory public health orders as evidence of a medical contraindication to vaccinations
• cannot be accepted or recorded on AIR

Under the Australian Immunisation Register Act 2015, the following medical practitioners can record a medical contraindication or natural immunity on AIR:

• General practitioners - defined by the Health Insurance Act 1973 as:
  • Fellows of the Royal Australian College of General Practitioners
  • Fellows of the Australian College of Rural and Remote Medicine, or
  • Medicare's Vocational Register of General Practitioners
  • General practice registrars on an approved 3GA training placement
• Paediatricians
• Public health physicians
• Infectious diseases physicians
• Clinical immunologists

The Resources page contains information about specialty codes.

The Process page contains information about how to search for a provider's specialty code in Provider Directory System (PDS).

The Health Insurance Act 1973 does not deem the following practitioners to be equivalent to general practitioners. Therefore, the Australian Immunisation Register Act 2015 deems the following medical practitioners not eligible for recording immunisation medical contraindications or natural immunity on AIR:

• Those specialising in oncology
• Practitioners on an old specialist pathway
• Non-vocationally registered general practitioners
• After hours medical practitioners
• Those with no relevant Australian Health Practitioner Regulation Agency (AHPRA) registration

The Resources page contains information about specialty codes.

A medical practitioner (provider) with an end dated specialty code is not eligible to record an immunisation medical contraindication or natural immunity regardless of the signature date on the IM011 form. Ineligible, end dated or suspended medical practitioners are not able to make updates to the AIR.

In these cases, Service Officers must not record details from the IM011 form.

The AIR can only accept an immunisation medical contraindication or natural immunity notification from an eligible medical practitioner:

• online directly through the AIR site
• through their Practice Management Software (if software has this function), or
• by completing an IM011 form and lodging it:
  • online using HPOS Messages Form Upload function
  • post, or
  • fax

The AIR does not accept medical contraindication or natural immunity notifications sent by:

• any other forms that are not IM011, reports or statements
• vaccine trial or test group notifications
• serology or clinical test results
• provider/practice letterhead
• statutory declarations
• verbal updates
• state and territory health department immunisation medical contraindication forms

An amendment to a currently recorded medical contraindication or natural immunity may be required if:

• the Provider reported incorrect details, and/or
• Services Australia made a processing error

The Process page includes amendment requests the agency may get and what is required for the request to be addressed. This may include:

• explaining why the request cannot be actioned
• the provider resubmitting the IM011 form
• the provider submitting a request in writing through a secure online channel (HPOS)

Vaccination objections (formerly referred to as 'conscientious objection') are not recorded on AIR. The A New Tax System (Family Assistance) Act 1999 removed the provisions for conscientious objections to immunisations from 1 January 2016.