Volume 191 - Issue 3
Estimating coverage of the National HPV Vaccination Program: where are we at?
Authors: Julia M L Brotherton and Robyn M Mullins
Med J Aust 2009; 191 (3): 188. || doi: 10.5694/j.1326-5377.2009.tb02738.x
Published online: 3 August 2009
Published online: 3 August 2009
To the Editor: Australia’s world-leading government-funded National Human Papillomavirus (HPV) Vaccination Program for women aged 12–26 years is made up of two components: an ongoing school-based program and a time-limited catch-up program delivered through schools, general practices and community vaccination services. The catch-up program started in April 2007 and was due to finish by July 2009, but has been extended to 31 December 2009 to allow women to complete the three-dose schedule.
Assessing the coverage achieved by the National HPV Vaccination Program will be an important measure of the Program’s success, particularly in terms of ensuring equity in vaccine uptake — so that the current gap in cervical cancer incidence and mortality between Indigenous and non-Indigenous women is reduced, not widened.1 Vaccination coverage data are also needed to monitor vaccine effectiveness in preventing cervical lesions and cancer. Accordingly, an integral part of the Program was the establishment, enabled by legislation passed in August 2007, of Australia’s first national adult vaccine register — the National HPV Vaccination Program Register.
The Register began collecting data in mid 2008 and is currently uploading notifications of the 5 million doses of HPV vaccine distributed in Australia to date. Initial coverage estimates from the Register will be published by the end of the year, with all notifications from the catch-up program due to be submitted to the Register by March 2010. General practitioner incentive payments of $6 per notification will be available until that time.
Interim coverage data provided by various jurisdictions are encouraging; school-based program data for 2007 from New South Wales and Victoria estimate one-dose coverage of more than 80% and three-dose coverage of approximately 70%.2 Unfortunately, there are no routine systems in place to provisionally estimate coverage in women vaccinated outside of schools. In a small population-based telephone survey that was conducted by the Cancer Council Victoria 3 months after the Program commenced, 35 of 90 women aged 18–26 years (39%) had received HPV vaccine.
Australian women are taking advantage of Australia’s most expensive vaccination program to date. We encourage vaccination providers to notify the Register3 of doses administered to ensure that this facet of Australian women’s health can be followed into the future. Although we anticipate complete notification of vaccinations given at schools, the accuracy and completeness of total coverage data will depend on GPs notifying the Register.
Competing interests
PapScreen Victoria funded the telephone survey. Julia Brotherton has previously been involved with epidemiological studies of HPV in which some unrestricted funding was received from GlaxoSmithKline and CSL, and HPV testing of samples was provided by Merck through funding by CSL.
Acknowledgements
We thank Jenny Anderson, Natalie Herd and Carol Chenco for their work on the telephone survey.
References
- Australian Institute of Health and Welfare. Cervical screening in Australia 2005–2006. Canberra: AIHW, 2008. (Cancer Series No. 41; AIHW Cat. No. CAN 36.)
- Brotherton JML, Deeks SM, Campbell-Lloyd S, et al. Interim estimates of human papillomavirus vaccination coverage in the school-based program in Australia. Commun Dis Intell 2008; 32: 457-461. 0_CBBCIJAB
- Information for health professionals. Melbourne: National HPV Vaccination Program Register. http://www.hpvregister.org.au/health-professionals/ (accessed Jul 2009).
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