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 - Publisher Copyright:
© 2021 by the authorsLicensee MDPI, Basel, Switzerland.
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
SN - 2076-393X
VL - 9
JO - Vaccines
JF - Vaccines
IS - 10
M1 - 1202
ER -