HPV vaccination in Aotearoa New Zealand: Impact of a school-based program on adolescent vaccine coverage

In Aotearoa New Zealand (NZ), differing Human Papillomavirus (HPV) vaccination programs are utilized. In the present study, we describe one-dose HPV vaccination coverage under a school-based vaccination program (SBVP) in NZ and coverage under a primary care practice-based program, or mixed-model program (non-SBVP), amongst adolescents born 13 years earlier.

We describe coverage across the SBVP and non-SBVP regions through a repeated cross-sectional analysis, using HPV vaccination data from the Aotearoa Immunization Register.

From 2014 to 2018, female one-dose HPV vaccination coverage was lower in the non-SBVP region than in the SBVP regions. 2013 is an exception, with higher coverage in the non-SBVP region than the SBVP region (77.93 % vs 67.13 %). Coverage improved in the non-SBVP region following the introduction of a mixed-model vaccine delivery program in 2016, and from 2019 to 2023 coverage was similar between the two models. Male vaccination coverage, whilst not showing the same drastic differences in coverage by region as the female coverage, was higher in the SBVP region from 2018 to 2023, with the exception of 2017. Over time the difference in male coverage between the SBVP and non-SBVP regions increased, reaching 79.0 % and 68.1 %, respectively, in 2023. Coverage declined during the COVID-19 pandemic, however, coverage increased after COVID-19 emergence most rapidly in SBVP regions.

School-based delivery of HPV vaccines to adolescents in NZ was successful, with lower coverage seen under Canterbury's non-SBVP approach, although the introduction of a mixed schools and primary care practitioner program in Canterbury in 2016 did appear to improve coverage.