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.

Adolescent school-based vaccination in Australia.

Adolescents have become an increasingly prominent target group for vaccination in Australia and other developed countries. Over the past decade, voluntary school-based vaccination programs have evolved to become the primary method of delivering adolescent vaccines funded under Australia's National Immunisation Program (NIP). These programs operate at a state and territory level and offer NIP vaccines to adolescents in specific school grades using local teams of trained vaccine providers. This paper summarises the current operation of voluntary school-based vaccination programs in Australia. Information was obtained through a literature review, semi-structured interviews with those managing and implementing school-based vaccination programs in each jurisdiction and a review of program resources. Available coverage data was obtained from each state or territory. Vaccines are delivered at the school, during school hours, and typically target late primary or early secondary school grades. Written parental consent is required for any vaccine to be administered. Operation of the programs is influenced by various factors at the school and provider level. Despite variability in program implementation, collection and analysis of coverage data, comparable coverage has been achieved across all states and territories. Coverage is higher than that reported by other countries where adolescent vaccines are mandated for school entry or available only through community vaccination providers. Voluntary school-based vaccination programs are an established mechanism for the delivery of adolescent vaccines in Australia and vaccines offered will continue to evolve in light of national recommendations. Current gaps in evidence include a detailed understanding of the influence of procedural factors on uptake, the best ways to maximise consent form return and, standardisation of coverage data reporting.

Interim estimates of human papillomavirus vaccination coverage in the school-based program in Australia.

In November 2006, the Australian Government announced the National HPV Vaccination Program, consisting of a course of prophylactic human papillomavirus (HPV) vaccine for all Australian females aged 12-26 years. Females aged 12-18 years are vaccinated through school-based programs. The school-based component commenced in April 2007, with the school years targeted varying across jurisdictions. Each jurisdiction maintains comprehensive records of HPV doses delivered in the school-based programs although how this is captured varies. This report presents interim coverage estimates for Year 1 (2007) of the program. Both New South Wales and Victoria achieved coverage of 70% or more among almost all school cohorts vaccinated in the program. Some of the variation in coverage achieved may reflect different levels of experience with school-based programs, and varying methods for school-based vaccine delivery and recording of doses administered. Except for some doses in South Australia, these interim coverage estimates do not include catch-up doses delivered by general practitioners or persons who were vaccinated prior to the onset of the program. Therefore, these data should be considered minimum estimates of coverage. The 1st year of the school-based HPV vaccination program should be considered a success, given time and resource constraints. Public sector immunisation providers across Australia should be commended for planning and implementing a new national immunisation program in approximately 4 months.