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

被引：13

作者：

Sisnowski, J. ^{[1
,2
]}

Vujovich-Dunn, C. ^{[1
]}

Gidding, H. ^{[3
,4
,23
]}

Brotherton, J. ^{[5
,6
]}

Wand, H. ^{[1
]}

Lorch, R. ^{[1
]}

Veitch, M. ^{[7
]}

Sheppeard, V ^{[8
,9
]}

Effler, P. ^{[10
]}

Skinner, S. R. ^{[11
,12
]}

Venn, A. ^{[13
]}

Davies, C. ^{[11
,12
]}

Hocking, J. ^{[6
]}

Whop, L. ^{[2
,14
]}

Leask, J. ^{[4
,15
]}

Canfell, K. ^{[16
]}

Sanci, L. ^{[17
]}

Smith, M. ^{[9
,16
]}

Kang, M. ^{[18
]}

Temple-Smith, M. ^{[17
]}

Kidd, M. ^{[19
]}

Burns, S. ^{[20
]}

Selvey, L. ^{[21
]}

Meijer, D. ^{[22
]}

Ennis, S. ^{[22
]}

Thomson, C. ^{[10
]}

Lane, N. ^{[7
]}

Kaldor, J. ^{[1
]}

Guy, R. ^{[1
]}

机构：

[1] Univ New South Wales, Fac Med, Kirby Inst, Wallace Wurth Bldg,High St, Kensington, NSW, Australia

[2] Australian Natl Univ, Natl Ctr Epidemiol & Populat Hlth, Canberra, ACT, Australia

[3] Univ New South Wales, Sch Publ Hlth & Community Med, Kensington, NSW, Australia

[4] Natl Ctr Immunisat Res & Surveillance, Westmead, NSW, Australia

[5] VCS Fdn, Populat Hlth, East Melbourne, Vic, Australia

[6] Univ Melbourne, Melbourne Sch Populat & Global Hlth, Carlton, Vic, Australia

[7] Tasmanian Govt, Dept Hlth & Human Serv, Hobart, Tas, Australia

[8] Hlth Protect NSW, Communicable Dis Branch, St Leonards, NSW, Australia

[9] Univ Sydney, Sydney Sch Publ Hlth, Camperdown, NSW, Australia

[10] Communicable Dis Control Directorate, Dept Hlth, East Perth, WA, Australia

[11] Childrens Hosp Westmead, Sydney Childrens Hosp Network, Westmead, NSW, Australia

[12] Univ Sydney, Fac Med & Hlth, Specialty Child & Adolescent Hlth, Camperdown, NSW, Australia

[13] Univ Tasmania, Menzies Inst Med Res, Tasmanian, Australia

[14] Charles Darwin Univ, Menzies Sch Hlth Res, Cairns, Qld, Australia

[15] Univ Sydney, Fac Med & Hlth, Sydney Nursing Sch, Camperdown, NSW, Australia

[16] Canc Council, Canc Res Div, Woolloomooloo, NSW, Australia

[17] Univ Melbourne, Med Dent & Hlth Sci, Carlton, Vic, Australia

[18] Univ Sydney, Westmead Clin Sch, Sydney, NSW, Australia

[19] Flinders Univ S Australia, Southgate Inst Hlth Soc & Equ, Bedford Pk, SA, Australia

[20] Curtin Univ, Sch Populat Hlth, Perth, WA, Australia

[21] Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia

[22] Hlth Protect NSW, Immunisat Unit, St Leonards, NSW, Australia

[23] Univ Sydney, Northern Clin Sch, St Leonards, NSW, Australia

来源：

VACCINE | 2021年 / 39卷 / 41期

基金：

澳大利亚国家健康与医学研究理事会;

关键词：

Primary prevention; Cervical cancer; Immunisation programs; HUMAN-PAPILLOMAVIRUS VACCINATION; GENITAL WARTS; INEQUALITIES; PREVALENCE; DAUGHTERS;

D O I：

10.1016/j.vaccine.2021.08.076

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

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 < 25th percentile 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. (c) 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：6117 / 6126

页数：10

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