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Measuring school level attributable risk to support school-based HPV vaccination programs.

C Vujovich-Dunn1, H Wand2, J M L Brotherton3,4

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This summary is machine-generated.

School-level factors like size and Indigenous enrollment impact HPV vaccination initiation. Targeted support for smaller schools and those with lower attendance can improve HPV vaccine uptake in adolescents.

Keywords:
Cervical cancerHPV vaccinesHealth equityImmunisation programsPrimary preventionSchool-based

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Area of Science:

  • Public Health
  • Epidemiology
  • Adolescent Health

Background:

  • High HPV vaccine uptake in Australian 15-year-olds (89% females, 86% males in 2017).
  • Significant variation in HPV vaccination initiation rates exists between schools.
  • Understanding school-level factors is crucial for addressing disparities in HPV vaccination.

Purpose of the Study:

  • To identify school-level characteristics associated with lower HPV vaccination initiation.
  • To quantify the contribution of these factors to between-school variation in HPV vaccination uptake.

Main Methods:

  • Population-based ecological analysis using school-level data from three Australian jurisdictions (2016).
  • Logistic regression models to assess factors linked to low initiation (<75% first dose).
  • Estimation of population attributable risk (PAR) and school-level prevalence for identified factors.

Main Results:

  • Factors associated with lower initiation include: small school size (OR=9.3), special education schools (OR=5.6), higher Indigenous enrollment (OR=2.7), lower attendance (OR=2.6), remote location (OR=2.6), and lower socioeconomic status (OR=1.8).
  • Highest PARs were for small schools (79%), higher Indigenous enrollments (38%), and lower attendance rates (37%).

Conclusions:

  • Initiatives targeting smaller schools, those with higher Indigenous student populations, and lower attendance rates are most likely to reduce HPV vaccination uptake variation.
  • School-level analysis is valuable for informing policy and resource allocation for school-based vaccination programs.