Decline in HPV vaccination across three scheduled doses: A tale of two sexes
As part of Western Australia's school-based vaccination program, males and females in year 8 are offered 3 doses of the human papillomavirus (HPV) vaccine to protect them against a number of cancers, including cervical and throat cancers, as well as genital warts. Girls have been offered this vaccine at school since 2009, with boys joining the program in 2013.
It is important that children receive all three doses to gain full and effective protection. Recent data extracted by the WA Department of Health show a decline in uptake over the course of the 3-dose schedule, particularly in boys. Data analysed from 2012 and 2013 showed that only 86% of males were recorded as having received dose 3 compared with 98% receiving dose 1 (a 12% decline), and only 92% of females having received dose 3 compared to 99% receiving dose 1 (a 7% decline) (Figure 1).
Figure 1 – Proportion of children who returned consent for HPV to receive doses 1 – 3, females (2012) and males (2013)
Absence from school (largely due to illness) has been reported as a major reason for non-completion of the 3-dose schedule in a study of Australian females1. Although the reasons for these differences in decline between sexes have not been fully investigated, females have had an additional year to receive any previously missed doses. Figures for males may therefore improve over the course of 2014, however the proportion of all children who have returned consent forms but not completed the full schedule is still of concern.
These data highlight the importance of ‘catch ups’ for children who do not complete the full HPV schedule at school. A child who has not received a scheduled dose is eligible to receive a free catch-up vaccination at their school, community health or local government vaccination clinic or from their general practitioner. The details of this vaccination should be forwarded to the Department of Health to ensure the child’s vaccination record is up to date and prevent over-vaccination.
To raise HPV vaccination rates:
- parents and providers should familiarise themselves with the school-based vaccination program schedule
- all eligible (year 8) children should be encouraged to have their HPV vaccines at school
- catch-up vaccinations should be offered to children who did not complete their HPV vaccine course either in the current school year, or when they are in year 9.
1. Watson M, Lynch J, D'Onise K, Brotherton J. Barriers to better three-dose coverage with HPV vaccination in school-based programs. Australian and New Zealand Journal of Public Health. 2014;38(1):91-2.