Search Results (5)

Background: Human papillomavirus (HPV) infection is the leading cause of cervical cancer, which presents a significant health burden in low- and middle-income settings such as Kosovo^†, where it is the second leading cause of death among women. HPV vaccines are highly effective and integral to global cervical cancer elimination efforts. In 2024, Kosovo^† introduced the HPV vaccine into its immunisation schedule via a school-based program targeting sixth-grade girls. Rapid, theory-based insights supported development of a tailored communication and intervention plan ahead of the introduction. Methods: Over a two-week period, qualitative research was conducted with 102 participants, including healthcare professionals, parents, girls in the target age group, school staff, and community influencers. Data collection, analysis, and intervention development were carried out using the Behaviour Change Wheel (BCW) model, underpinned by the Capability, Opportunity, and Motivation for Behaviour change (COM-B) theoretical framework. Results: Trust in school-based immunisation and healthcare professionals emerged as key drivers, while a predominance of capability- and physical-opportunity-related barriers across target groups underscored the need for targeted communication and capacity-building efforts for all stakeholders. Using the BCW model, communication and intervention activities were developed for implementation by partners. Conclusions: Using rapid insight research grounded in the BCW model enabled the timely identification of behavioural drivers and barriers to HPV vaccine acceptance and supported development of a targeted intervention plan. The findings echoed global research on HPV vaccine introduction, highlighting context-specific needs and enablers and contributing to a successful rollout marked by high uptake within the first six months. Full article

Background/Objectives: Given the discrepancies in immunisation coverage, the goal of this study was to explore the barriers and facilitators to effective communication across the school-based vaccination program in South Eastern Sydney schools. Methods: A qualitative study was undertaken with purposively selected immunisation staff, school coordinators, and parents of Year 7 students who had not received two vaccinations (dTpa and HPV) at school. A focus group with immunisation staff and interviews with school coordinators explored the barriers and facilitators to vaccination uptake, including communication across stakeholders. The parent interviews explored attitudes to vaccination and the school program and investigated the program communication methods. Results: Five immunisation staff, eleven school coordinators, and eleven parents participated in the study. The barriers to participation in the school vaccination program included low parent recall of vaccination information, challenges encountered by school staff in consent tracking, no communication channel between health staff and parents, a greater school focus on vaccination facilitation than student education, and limited communication between stakeholders about catch-up vaccinations. The facilitators included established school/parent relationships for vaccine communication, effective communication between health and school staff, and using multiple methods to promote clinic and consent requirements. Conclusions: Opportunities exist to increase program participation by enhancing vaccination information and education for students and parents, with better communication about vaccination catch-ups and consent. Full article

School vaccination programs are crucial for achieving high immunisation coverage among adolescents, but substantial disparities exist across schools and regions. This ecological study aimed to determine associations between school characteristics and vaccination coverage for diphtheria–tetanus–acellular pertussis (dTpa) and human papillomavirus (HPV) vaccines among year 7 students in southeastern Sydney. An analysis of data from 70 mainstream schools participating in the 2019 South Eastern Sydney Local Health District School Vaccination Program utilised quasi-Poisson regression models to assess associations between vaccination coverage and school attendance, socio-educational status, Aboriginal enrolments, language background other than English (LBOTE), school sector (government, Catholic, or independent), and coeducation status. Median school coverage was 88% for dTpa, 88% for HPV—girls, and 86% for HPV—boys, with interquartile ranges of 82–93%, 84–92%, and 78–91%, respectively. Higher school attendance was associated with increased dTpa vaccination coverage (PR 1.14, 95% CI 1.02–1.27). Single-sex schools showed higher HPV vaccination coverage compared to coeducational schools for both girls (PR 2.24, 95% CI 2.04–2.46) and boys (PR 1.89, 95% CI 1.72–2.08). No significant associations were found for ICSEA, Aboriginal enrolments, LBOTE, or school sector. School attendance and coeducational status significantly influenced vaccination coverage, with differential impacts on dTpa and HPV vaccines. These findings highlight the need for targeted strategies to address disparities in school-based vaccination programs. Research using qualitative methods could be useful to understand the beliefs and attitudes contributing to these disparities in vaccine uptake so that programs can be tailored to maximise participation. Full article

Australia has been a world leader in human papillomavirus (HPV) vaccination and was the first country to implement a fully funded national HPV vaccination program, from 2007 for girls and 2013 for boys. In 2018 the program changed from a 4-valent to 9-valent HPV vaccine and a 3-dose to 2-dose standard schedule. We assessed stakeholder perspectives on factors influencing program outcomes and impact as part of a comprehensive program evaluation. In late 2019 and early 2020, we conducted 26 interviews with 42 key stakeholder participants and received 1513 survey responses from stakeholders including general practice staff and school-based nurse immunisers. Findings included that the 2-dose schedule is better accepted by schools and students and has reduced program cost and resource requirements. However, course completion rates have not increased as much as anticipated due to the 6–12 month dosing interval and reduced opportunities for school-based catch-up vaccination. Major reported barriers to increased vaccine coverage were absenteeism and consent form return. Vaccine hesitancy is not currently a major issue but remains a potential threat to the program. While Australia’s HPV vaccination program is perceived as highly successful, measures to further enhance the program’s impact and mitigate potential threats are important. Full article

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. Full article