Beyond Averages: Unpacking Disparities in School-Based Vaccination Coverage in Eastern Sydney: An Ecological Analysis

Area of Science:

• Public Health
• Epidemiology
• Adolescent Health

Background:

• School vaccination programs are vital for adolescent immunisation coverage.
• Significant disparities in vaccination rates exist across schools and regions.
• Understanding factors influencing vaccine uptake in schools is crucial for program effectiveness.

Purpose of the Study:

• To examine associations between school characteristics and vaccination coverage for dTpa and HPV vaccines in Year 7 students.
• To identify school-level factors impacting adolescent immunisation rates in southeastern Sydney.

Main Methods:

• Ecological study analysing data from 70 mainstream schools in 2019.
• Quasi-Poisson regression models used to assess associations.
• Variables included school attendance, socio-educational status, Aboriginal and LBOTE enrolments, school sector, and coeducation status.

Main Results:

• Median coverage: 88% for dTpa, 88% for HPV-girls, 86% for HPV-boys.
• Higher school attendance correlated with increased dTpa coverage (PR 1.14).
• Single-sex schools had higher HPV vaccination coverage than coeducational schools for both girls (PR 2.24) and boys (PR 1.89).

Conclusions:

• School attendance and coeducational status significantly impact adolescent vaccination coverage for dTpa and HPV vaccines.
• Findings suggest a need for targeted interventions to reduce vaccination disparities in schools.
• Further qualitative research could explore beliefs and attitudes to tailor vaccination programs effectively.