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Improvements in equity and course completion important for HPV vaccination programs in Australia

New analysis of human papillomavirus (HPV) vaccination coverage by the National Centre for Immunisation Research and Surveillance (NCIRS) has shown that although Australia is currently on track to eliminate targeted HPV types, an ongoing focus on equity in vaccine delivery systems to ensure course completion is needed.

The analysis published in The Australian and New Zealand Journal of Public Health on 1 April compared Australian Immunisation Register (AIR) HPV vaccination coverage against historical data from the former National HPV Vaccination Program Register (HPV Register), and aimed to estimate two-dose vaccination coverage.

Comparison of HPV vaccination coverage estimates derived from AIR and the HPV Register is important to assess accuracy and consistency of trend data following the transition to use of AIR in 2018. Assessment of coverage achieved under the new two-dose schedule, implemented in 2018, is important to assess impact of the change on uptake, identify equity gaps, and assess whether current predictions of elimination timelines are accurate.

The study found that HPV vaccination coverage estimated using AIR data is broadly consistent with historical data from the HPV Register, although slightly lower using AIR than HPV register estimates.

“Moving from three to two doses has slightly improved completion, likely due to the wider dose spacing, but equity gaps remain, particularly for Aboriginal and Torres Strait Islander and socioeconomically disadvantaged women, and those living in remote areas. Addressing these equity issues is important given the higher rates of cervical cancer in these women.” said Professor Julia Brotherton, from the Australian Centre for the Prevention of Cervical Cancer, who is a Professor of Cancer Prevention Policy and Implementation at the Melbourne School of Population and Global Health, University of Melbourne, and Professorial Fellow at the National Centre for Immunisation Research and Surveillance (NCIRS).

The impact of COVID-19 is also evident on HPV vaccination completion rates with disruptions to school-based vaccination programs due to school closures during the pandemic. This highlights the importance of catch-up programs.

“With school closures and disruption to school-based vaccination programs in 2021 we expect to see continued impacts of the pandemic on adolescent vaccination. This is a reminder of the need to ensure that systems are in place to systematically and actively identify students who have missed out on routine HPV vaccination in the school setting and may require provision of flexible alternative catch-up opportunities.” said Prof Brotherton.

“Immunisation providers are encouraged to offer opportunistic HPV vaccination catch-up during routine consultations; they can use the AIR to identify adolescents requiring vaccination, particularly their second dose" Prof Brotherton added.

Read the full analysis here