Differences in school factors associated with adolescent HPV vaccination initiation and completion coverage in three Australian states.

Adolescent Australia Humans Immunization Programs Papillomavirus Infections / prevention & control Papillomavirus Vaccines Schools Vaccination
Cervical cancer HPV vaccines Health equity Immunisation programs Primary prevention School

Journal

Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899

Informations de publication

Date de publication:
01 10 2021
Historique:
received: 14 04 2021
revised: 19 08 2021
accepted: 20 08 2021
pubmed: 9 9 2021
medline: 25 2 2023
entrez: 8 9 2021
Statut: ppublish

Résumé

Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake. Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage ≤ 25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage. Median initiation was 84.7% (IQR: 75.0%-90.4%) across 1,286 schools and median completion was 93.8% (IQR: 86.0%-97.3%) across 1,295 schools. There were strong correlations between a number of school characteristics, particularly higher Indigenous student enrolments and lower attendance, increasing remoteness, higher postcode socioeconomic disadvantage, and smaller school size. Characteristics most strongly associated with low initiation in univariate analyses were small school size, location in Tasmania, and schools catering for special educational needs. Low completion was most strongly associated with schools in Tasmania and Western Australia, remote location, small size, high proportion of Indigenous student enrolments, and low attendance rates. This study provides indicative evidence that characteristics of schools and school populations are associated with the likelihood of low initiation and completion of the HPV vaccination course. The findings will guide further research and help target initiatives to improve vaccination uptake in schools with profiles associated with lower coverage.

Sections du résumé

BACKGROUND
Schools are the primary setting for the delivery of adolescent HPV vaccination in Australia. Although this strategy has achieved generally high vaccination coverage, gaps persist for reasons that are mostly unknown. This study sought to identify school-level correlates of low vaccination course initiation and completion in New South Wales, Tasmania, and Western Australia to inform initiatives to increase uptake.
METHODS
Initiation was defined as the number of first doses given in a school in 2016 divided by vaccine-eligible student enrolments. Completion was the number of third doses given in a school in 2015-2016 divided by the number of first doses. Low initiation and completion were defined as coverage ≤ 25thpercentile of all reporting schools. We investigated correlations between covariates using Spearman's rank correlation coefficients. Due to multicollinearity, we used univariable logistic regression to investigate associations between school characteristics and low coverage.
RESULTS
Median initiation was 84.7% (IQR: 75.0%-90.4%) across 1,286 schools and median completion was 93.8% (IQR: 86.0%-97.3%) across 1,295 schools. There were strong correlations between a number of school characteristics, particularly higher Indigenous student enrolments and lower attendance, increasing remoteness, higher postcode socioeconomic disadvantage, and smaller school size. Characteristics most strongly associated with low initiation in univariate analyses were small school size, location in Tasmania, and schools catering for special educational needs. Low completion was most strongly associated with schools in Tasmania and Western Australia, remote location, small size, high proportion of Indigenous student enrolments, and low attendance rates.
CONCLUSION
This study provides indicative evidence that characteristics of schools and school populations are associated with the likelihood of low initiation and completion of the HPV vaccination course. The findings will guide further research and help target initiatives to improve vaccination uptake in schools with profiles associated with lower coverage.

Identifiants

DOI: 10.1016/j.vaccine.2021.08.076 PMID: 34493408
pubmed: 34493408
pii: S0264-410X(21)01124-5
doi: 10.1016/j.vaccine.2021.08.076
pii:
doi:

Substances chimiques

Papillomavirus Vaccines 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

6117-6126

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

J Sisnowski (J)

The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia; Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia. Electronic address: jsisnowski@kirby.unsw.edu.au.

C Vujovich-Dunn (C)

The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia. Electronic address: cvujovich-dunn@kirby.unsw.edu.au.

H Gidding (H)

University of New South Wales, School of Public Health and Community Medicine, Kensington, Australia; National Centre for Immunisation Research and Surveillance, Westmead, Australia; The University of Sydney Northern Clinical School, St Leonards, Australia. Electronic address: heather.gidding@sydney.edu.au.

J Brotherton (J)

Population Health, VCS Foundation, East Melbourne, Victoria, Australia; University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, Australia. Electronic address: jbrother@vcs.org.au.

H Wand (H)

The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia. Electronic address: hwand@kirby.unsw.edu.au.

R Lorch (R)

The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia. Electronic address: rlorch@kirby.unsw.edu.au.

M Veitch (M)

Tasmanian Government, Department of Health and Human Services, Hobart, Australia. Electronic address: mark.veitch@health.tas.gov.au.

V Sheppeard (V)

Communicable Diseases Branch, Health Protection NSW, St Leonards, New South Wales, Australia; University of Sydney, Sydney School of Public Health, Camperdown, New South Wales, Australia. Electronic address: Vicky.Sheppeard@health.nsw.gov.au.

P Effler (P)

Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia. Electronic address: Paul.Effler@health.wa.gov.au.

S R Skinner (SR)

Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia; University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Camperdown, New South Wales, Australia. Electronic address: rachel.skinner@sydney.edu.au.

A Venn (A)

Menzies Institute for Medical Research, University of Tasmania, Tasmanian, Australia. Electronic address: alison.venn@utas.edu.au.

C Davies (C)

Children's Hospital Westmead, Sydney Children's Hospitals Network, Westmead, Australia; University of Sydney, Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Camperdown, New South Wales, Australia. Electronic address: cristyn.davies@sydney.edu.au.

J Hocking (J)

University of Melbourne, Melbourne School of Population and Global Health, Carlton, Victoria, Australia. Electronic address: j.hocking@unimelb.edu.au.

L Whop (L)

Australian National University, National Centre for Epidemiology & Population Health, Canberra, Australia; Menzies School of Health Research, Charles Darwin University, Cairns, Queensland, Australia. Electronic address: lisa.whop@anu.edu.au.

J Leask (J)

National Centre for Immunisation Research and Surveillance, Westmead, Australia; University of Sydney, Sydney Nursing School, Faculty of Medicine and Health, Camperdown, New South Wales, Australia. Electronic address: julie.leask@sydney.edu.au.

K Canfell (K)

Cancer Research Division, Cancer Council, New South Wales, Australia. Electronic address: karen.canfell@nswcc.org.au.

L Sanci (L)

University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, Victoria, Australia. Electronic address: l.sanci@unimelb.edu.au.

M Smith (M)

Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia; Cancer Research Division, Cancer Council, New South Wales, Australia. Electronic address: Megan.Smith@nswcc.org.au.

M Kang (M)

University of Sydney, Westmead Clinical School, New South Wales, Australia. Electronic address: Melissa.Kang@uts.edu.au.

M Temple-Smith (M)

University of Melbourne, Medicine, Dentistry and Health Sciences, Carlton, Victoria, Australia. Electronic address: m.temple-smith@unimelb.edu.au.

M Kidd (M)

Flinders University, Southgate Institute for Health, Society and Equity, South Australia, Australia. Electronic address: michael.kidd@flinders.edu.au.

S Burns (S)

Curtin University, School of Population Health, Western Australia, Australia. Electronic address: S.Burns@curtin.edu.au.

L Selvey (L)

University of Queensland, School of Public Health, Queensland, Australia. Electronic address: l.selvey@uq.edu.au.

D Meijer (D)

Immunisation Unit, Health Protection NSW, St Leonards, New South Wales, Australia. Electronic address: Dennis.Meijer@health.nsw.gov.au.

S Ennis (S)

Immunisation Unit, Health Protection NSW, St Leonards, New South Wales, Australia. Electronic address: Sonya.Ennis@health.nsw.gov.au.

C Thomson (C)

Communicable Disease Control Directorate, Department of Health, Western Australia, East Perth, Australia. Electronic address: Chloe.Thomson@health.wa.gov.au.

N Lane (N)

Tasmanian Government, Department of Health and Human Services, Hobart, Australia. Electronic address: nikki.lane@health.tas.gov.au.

J Kaldor (J)

The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia. Electronic address: Jkaldor@kirby.unsw.edu.au.

R Guy (R)

The Kirby Institute, Faculty of Medicine, University of New South Wales, Wallace Wurth Building, High St., Kensington, New South Wales, Australia. Electronic address: rguy@kirby.unsw.edu.au.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Differences in school factors associated with...
questionsmedicales.fr › Régions géographiques › Océanie › Australasie › Australie › Differences in school factors associated with...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Differences in school factors associated with...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Services de médecine préventive › Programmes de vaccination › Differences in school factors associated with...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladies transmissibles › Maladies sexuellement transmissibles › Maladies sexuellement transmissibles virales › Infections à papillomavirus › Differences in school factors associated with...
questionsmedicales.fr › Mélanges complexes › Produits biologiques › Vaccins › Vaccins antiviraux › Vaccins contre les papillomavirus › Differences in school factors associated with...
questionsmedicales.fr › Établissements non médicaux publics ou privés › Établissements scolaires › Differences in school factors associated with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Pratiques en santé publique › Prévention primaire › Immunisation › Vaccination › Differences in school factors associated with...