HPV vaccination coverage and course completion rates for Indigenous Australian adolescents, 2015.

OBJECTIVE: To estimate human papillomavirus (HPV) vaccination coverage and course completion rates for Indigenous adolescents in four Australian states and territories. PARTICIPANTS, SETTING: Adolescents who were 12 years old in 2015 and received the quadrivalent HPV vaccine (three doses: 0, 2, 6 months) as part of the National HPV Vaccination Program in 2015 or 2016 in New South Wales, Queensland, the Northern Territory, or the Australian Capital Territory. MAIN OUTCOME MEASURES: Estimated HPV vaccination coverage by dose and by Indigenous status and sex, based on National HPV Vaccination Program Register data; vaccination course completion rates (proportion of dose 1 recipients who received dose 3) for 12-year-olds vaccinated during 2013-2016, by sex, jurisdiction, and Indigenous status. RESULTS: Dose 1 coverage exceeded 80% for all Indigenous status/jurisdiction/sex groups (range, 83.3-97.7%). Coverage was similar for Indigenous and non-Indigenous girls in Queensland (87.3% v 87.0%), lower for Indigenous girls in the ACT (88.7% v 97.7%) and the NT (91.1% v 97.0%), and higher in NSW (95.9% v 89.9%); it was similar for Indigenous and non-Indigenous boys in all jurisdictions except the NT (88.6% v 96.3%). Dose 3 coverage (range, 61.2-87.7%) was markedly lower for Indigenous than non-Indigenous 12-year-olds in all jurisdictions, except for girls in NSW (82.6% v 83.6%). CONCLUSION: HPV vaccine coverage is high, but course completion is generally lower for Indigenous adolescents. Strategies for improving completion rates for Indigenous Australians are needed to end the higher burden of cervical cancer among Indigenous than non-Indigenous women.

Human papillomavirus vaccine coverage among female Australian adolescents: success of the school-based approach.

OBJECTIVE: To describe quadrivalent human papillomavirus (HPV) vaccination coverage achieved in the HPV vaccination catch-up program for girls aged 12-17 years. DESIGN: Analysis of data from the Australian National HPV Vaccination Program Register. PARTICIPANTS: Girls aged 12-17 years as at 30 June 2007. MAIN OUTCOME MEASURES: HPV vaccine coverage by dose (1, 2 and 3), age and state of residence, using Australian Bureau of Statistics estimates of resident populations as the denominator. RESULTS: Notified vaccination coverage for girls aged 12-17 years nationally was 83% for dose 1, 78% for dose 2 and 70% for dose 3. The Australian Capital Territory and Victoria recorded the highest three-dose coverage for the 12-17-year-old cohort overall at 75%. The highest national three-dose coverage rate by age was achieved in 12-year-olds (74%). In Queensland, coverage among Indigenous girls compared with non-Indigenous girls was lower with each dose (lower by 4% for dose 1, 10% for dose 2 and 15% for dose 3). This pattern was not seen in the NT, where initial coverage was 17% lower among Indigenous girls, but the course completion rate among those who started vaccination was identical (84%). CONCLUSIONS: The catch-up HPV vaccination program delivered over 1.9 million doses of HPV vaccine to girls aged 12-17 years, resulting in 70% of girls in this age group being fully vaccinated. The range in coverage achieved and the lower uptake documented among Indigenous girls suggest that HPV vaccination programs can be further improved.

Achieving high immunisation rates amongst children in the Australian Capital Territory: a collaborative effort.

BACKGROUND: In September 2008 the ACT achieved the highest childhood coverage rates in Australia with rates of 93.5% (12-15-month age cohort), 94.9% (24-27-month age cohort) and 90.58% (60-63-month age cohort). PURPOSE: To analyse the key contributing factors and policy initiatives that have likely to have led to high childhood immunisation rates in the ACT. METHODS: Data used in this report were sourced from the Australian Childhood Immunisation Register (ACIR) held at Medicare Australia, General Practice Immunisation Incentives (GPII) 'calculation' data held at ACT Division of General Practice and internal immunisation databases held at Health Protection Service. OUTCOMES: Although the reasons for the high coverage rates seen in children are multi factorial (including national and consumer factors), key reasons locally in the ACT include: (a) the implementation of an ACT-wide immunisation strategy; (b) proactive follow up of children overdue for immunisation; (c) more sustainable provision of immunisation services across both public and private health providers; and (d) a centralised vaccine delivery service and 'cold chain' monitoring system. CONCLUSIONS: Although nationwide immunisation policy has been successful in increasing childhood coverage rates across all Australian jurisdictions, it is important to also acknowledge local factors that have likely to have contributed to the successful implementation of the Immunise Australia Program at the coal face.

Risk factor outcome comparison between exercise-based cardiac rehabilitation, traditional care, and an educational workshop.

BACKGROUND: This study examined risk factor outcomes among patients who attended cardiac rehabilitation sessions, those who received traditional care, and those who attended Leap for Life workshops. METHODS: A non-equivalent, three-group design was used in this observational study. Baseline and 12-month measurements were collected for 217 participants. Analysis of covariance was performed to determine differences between groups on outcome variables. RESULTS: The only significant finding was in participants with an initial high-density lipoprotein value of less than 40. High-density lipoprotein levels increased more in the cardiac rehabilitation group than in the traditional care group (30.54 to 37.48 versus 30.17 to 33.67 [F= 4.577, p = .035]). CONCLUSIONS: Based on these findings, a strong case can be made for the transition to more individually intense and focused risk factor modification strategies for patients in cardiac rehabilitation programs.