TY - JOUR
T1 - School-level variation in coverage of co-administered dTpa and HPV dose 1 in three Australian states
AU - Vujovich-Dunn, Cassandra
AU - Skinner, Susan Rachel
AU - Brotherton, Julia
AU - Wand, Handan
AU - Sisnowski, Jana
AU - Lorch, Rebecca
AU - Veitch, Mark
AU - Sheppeard, Vicky
AU - Effler, Paul
AU - Gidding, Heather
AU - Venn, Alison
AU - Davies, Cristyn
AU - Hocking, Jane
AU - Whop, Lisa J.
AU - Leask, Julie
AU - Canfell, Karen
AU - Sanci, Lena
AU - Smith, Megan
AU - Kang, Melissa
AU - Temple-Smith, Meredith
AU - Kidd, Michael
AU - Burns, Sharyn
AU - Selvey, Linda
AU - Meijer, Dennis
AU - Ennis, Sonya
AU - Thomson, Chloe A.
AU - Lane, Nikole
AU - Kaldor, John
AU - Guy, Rebecca
N1 - 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.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/10
Y1 - 2021/10
N2 - 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.
AB - 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.
KW - Adolescent vaccination
KW - Cancer prevention
KW - Differential uptake
KW - Evaluation and impact
KW - Implementation
KW - School-based immunisation
KW - Vaccination
KW - Vaccine specific hesitancy
UR - http://www.scopus.com/inward/record.url?scp=85117920891&partnerID=8YFLogxK
U2 - 10.3390/vaccines9101202
DO - 10.3390/vaccines9101202
M3 - Article
AN - SCOPUS:85117920891
VL - 9
SP - 1
EP - 14
JO - Vaccines
JF - Vaccines
SN - 2076-393X
IS - 10
M1 - 1202
ER -