PAEDS was established in 2007, and was based on the Canadian model, the Immunisation Monitoring Program ACTive (IMPACT), which has been operating for over 25 years. IMPACT operates on the basis of dedicated nursing positions to be based in hospitals and to actively seek new admissions with the 'target' condition(s). The nurses are responsible for collecting relevant clinical data through review of clinical/medical charts and liaising with medical staff involved in the care of the patient. This model is well suited to Australia, which, like Canada, has a dispersed population, but nevertheless the majority live in reasonably close proximity to paediatric referral hospitals.

One way to enhance surveillance of rare but important childhood conditions is by active hospital-based surveillance. To address this gap in existing surveillance systems in Australia, the National Centre for Immunisation Research and Surveillance (NCIRS) and the Australian Paediatric Surveillance Unit (APSU) developed the Paediatric Active Enhanced Disease Surveillance system, PAEDS.

PAEDS initially commenced with 4 hospitals and has since expanded to 7 sites across Australia.

Surveillance is ongoing for the three conditions monitored by PAEDS since 2007 - acute flaccid paralysis (AFP), intussusception and varicella/herpes zoster. Since then, additional conditions have been added to ongoing surveillance, including - pertussis (2012), acute childhood encephalitis (2013), influenza (2014), invasive meningococcal disease, invasive group A streptococcus disease (GAS; 2016) and Kawasaki disease, Gram-negative blood stream infections (2019).

In previous years, PAEDS has also studied important conditions such as pandemic influenza in 2009 and Guillain-Barré syndrome following pandemic influenza vaccine. Surveillance of febrile seizures (2013-2014) was also conducted following introduction of the new vaccines to the National Immunisation Program.