School-based vaccination programmes: An evaluation of school immunisation delivery models in England in 2015/16

Area of Science:

• Public Health
• Vaccinology
• Epidemiology

Background:

• Schools are key sites for adolescent vaccination programs in England.
• Key vaccines administered include human papillomavirus (HPV), meningococcal groups A, C, W and Y (MenACWY), and tetanus, diphtheria, and polio (Td/IPV).

Purpose of the Study:

• To evaluate the impact of school-based delivery models on vaccine coverage.
• To assess how the delivery model for one vaccine program affects others.

Main Methods:

• Analysis of routinely collected national data on adolescent vaccination in England (2015/16).
• Comparison of school grades for highest one-dose vaccine coverage.
• Evaluation of two-dose HPV vaccine delivery models (within-year vs. across-years).
• Assessment of HPV delivery model impact on MenACWY and Td/IPV coverage.

Main Results:

• MenACWY and Td/IPV coverage were highest in younger school grades.
• Similar HPV vaccine coverage was achieved with both within-year and across-years delivery models (86.7% vs. 85.8%).
• High HPV coverage in 2015/16 was associated with high HPV coverage in 2013/14.
• MenACWY and Td/IPV coverage were higher in areas with high prior HPV coverage.
• MenACWY coverage was higher when HPV doses were delivered within the same year.

Conclusions:

• School-based vaccination programs should be implemented early to maximize coverage.
• HPV vaccine delivery models should consider local performance and provider experience.
• Interdependencies exist between different school-based vaccination programs; delivery strategies should be holistic.