Estimating coverage of the National HPV Vaccination Program: where are we at?

  • Brotherton J
  • Mullins R
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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 80percent and three-dose
coverage of approximately 70percent.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
(39percent) 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.

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  • Julia M L Brotherton

  • Robyn M. Mullins

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