School-level variation in coverage of co-administered dtpa and hpv dose 1 in three australian states

Cassandra Vujovich-Dunn*, Susan Rachel Skinner, Julia Brotherton, Handan Wand, Jana Sisnowski, Rebecca Lorch, Mark Veitch, Vicky Sheppeard, Paul Effler, Heather Gidding, Alison Venn, Cristyn Davies, Jane Hocking, Lisa J. Whop, Julie Leask, Karen Canfell, Lena Sanci, Megan Smith, Melissa Kang, Meredith Temple-SmithMichael Kidd, Sharyn Burns, Linda Selvey, Dennis Meijer, Sonya Ennis, Chloe A. Thomson, Nikole Lane, John Kaldor, Rebecca Guy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Background: Australian adolescents are routinely offered HPV and dTpa (diphtheria, tetanus, pertussis) vaccines simultaneously in the secondary school vaccination program. We identified schools where HPV initiation was lower than dTpa coverage and associated school-level factors across three states. Methods: HPV vaccination initiation rates and dTpa vaccination coverage in 2016 were calculated using vaccine databases and school enrolment data. A multivariate analysis assessed sociodemographic and school-level factors associated with HPV initiation being >5% absolute lower than dTpa coverage. Results: Of 1280 schools included, the median school-level HPV initiation rate was 85% (interquartile range (IQR):75–90%) and the median dTpa coverage was 86% (IQR:75–92%). Nearly a quarter (24%) of all schools had HPV vaccination initiation >5% lower than dTpa coverage and 11 % had >10% difference. School-level factors independently associated with >5% difference were remote schools (aOR:3.5, 95% CI = 1.7–7.2) and schools in major cities (aOR:1.8, 95% CI = 1.0–3.0), small schools (aOR:3.3, 95% CI = 2.3–5.7), higher socioeconomic advantage (aOR:1.7, 95% CI = 1.1–2.6), and lower proportions of Language-background-other-than-English (aOR:1.9, 95% CI = 1.2–3.0). Conclusion: The results identified a quarter of schools had lower HPV than dTpa initiation coverage, which may indicate HPV vaccine hesitancy, and the difference was more likely in socioeconomically advantaged schools. As hesitancy is context specific, it is important to understand the potential drivers of hesitancy and future research needs to understand the reasons driving differential uptake.

Original languageEnglish
Article number1202
JournalVaccines
Volume9
Issue number10
DOIs
Publication statusPublished - Oct 2021
Externally publishedYes

Bibliographical note

Funding Information:
Institutional Review Board Statement: Ethical approval was provided by the Human Research Ethics Committees of the University of New South Wales (HC17632), the Australian National University (2017/516), the University of Tasmania (1320/17), the Aboriginal Health and Medical Research Council of New South Wales (1320/17), the Aboriginal Health Council of Western Australia (818), and the Department of Health of Western Australia (RGS0000000456).

Funding Information:
Funding: The study was conducted as part of the HPV Partnership Project (NHMRC grant number APP1132344), which was formed between researchers, the National HPV Vaccination Program Register, and the health departments of three states, New South Wales, Tasmania, and Western Australia to understand why gaps persist in the HPV vaccination school-based program. JS was funded by an Australian Government Research Training Program Scholarship, LW was funded by the NHMRC Early Career Fellowship (#1142035), and MS was funded by NHRMC grant (APP1159491) Cancer Institute NSW. RG was funded by an NHMRC fellowship (GNT1124647) and is a co-investigator on a project which received funding from Seqirus [unrelated to this project]. KC reports she is co-PI of an investigator-initiated trial of cervical screening, “Compass”, run by the VCS Foundation Australia, which is a government-funded not-for-profit charity. The VCS Foundation has received equipment and a funding contribution from Roche Molecular Diagnostics. She is also co-PI on a major implementation program “Elimination of Cervical Cancer in the Western Pacific” which will receive support from the Minderoo Foundation and the Frazer Family Foundation and equipment donations from Cepheid Inc. However, neither KC nor her institution has received direct funding from industry for these or any other research project.

Funding Information:
Ethical approval was provided by the Human Research Ethics Committees of the University of New South Wales (HC17632), the Australian National University (2017/516), the University of Tasmania (1320/17), the Aboriginal Health and Medical Research Council of New South Wales (1320/17), the Aboriginal Health Council of Western Australia (818), and the Department of Health of Western Australia (RGS0000000456).

Funding Information:
The study was conducted as part of the HPV Partnership Project (NHMRC grant number APP1132344), which was formed between researchers, the National HPV Vaccination Program Regis-ter, and the health departments of three states, New South Wales, Tasmania, and Western Australia to understand why gaps persist in the HPV vaccination school-based program. JS was funded by an Australian Government Research Training Program Scholarship, LW was funded by the NHMRC Early Career Fellowship (#1142035), and MS was funded by NHRMC grant (APP1159491) Cancer Institute NSW. RG was funded by an NHMRC fellowship (GNT1124647) and is a co-investigator on a project which received funding from Seqirus [unrelated to this project]. KC reports she is co-PI of an investigator-initiated trial of cervical screening, ?Compass?, run by the VCS Foundation Australia, which is a government-funded not-for-profit charity. The VCS Foundation has received equipment and a funding contribution from Roche Molecular Diagnostics. She is also co-PI on a major implementation program ?Elimination of Cervical Cancer in the Western Pacific? which will receive support from the Minderoo Foundation and the Frazer Family Foundation and equipment donations from Cepheid Inc. However, neither KC nor her institution has received direct funding from industry for these or any other research project.

Publisher Copyright:
© 2021 by the authorsLicensee MDPI, Basel, Switzerland.

Keywords

  • Adolescent vaccination
  • Cancer prevention
  • Differential uptake
  • Evaluation and impact
  • Implementation
  • School-based immunisation
  • Vaccination
  • Vaccine specific hesitancy

Fingerprint

Dive into the research topics of 'School-level variation in coverage of co-administered dtpa and hpv dose 1 in three australian states'. Together they form a unique fingerprint.

Cite this