Implementing a Statewide School-Based Vaccination Program - An Australian Program Manager's Perspective

Background: Vaccinating individuals against human papillomavirus (HPV) and boosting immunity against diphtheria, tetanus and pertussis (dTpa) is carried out in adolescence in Australia.  Vaccinating adolescents against hepatitis B and varicella was also introduced to provide more rapid community protection as a complementary strategy when these vaccines were introduced into younger cohorts.    Adolescents are not generally motivated to seek vaccination against diseases from which they perceive minimal risk and face numerous barriers to accessing health services.  However, most adolescents under the age of sixteen attend school on a regular basis and this provides an opportunity to vaccinate this group on a large scale.

Setting: Secondary schools in Queensland, Australia.

Population: 13 year old students eligible for HPV, varicella and hepatitis B vaccination. 15 year old students eligible for a dTpa booster.

Project Description: The Queensland and Australian Governments have been providing funded vaccines to service providers for adolescents for many years.  In 2007, Queensland Health commenced a school based vaccination program to deliver vaccination services in all Queensland secondary schools (approx. 1,200 schools).  Service providers visit schools three times each year and are expected to provide vaccination records to the program for inclusion on VIVAS (Vaccination Information and Vaccination Administration System), Queensland's population vaccination database.

Results/Lessons Learned:

• Hepatitis B vaccination completion rates for 13 year olds increased from 36.3% in 2006 to 58.5% in 2008;
• 69.1% first HPV dose coverage for 15 year olds was achieved in 2007;
• Costs were approximately AUD$14 per vaccine administered in addition to the cost of the vaccine;
• School based vaccination programs are an effective strategy to provide vaccination services to adolescents;
• Flexible service delivery models are needed to respond to the unique needs of some schools;
• The program increases the capacity of the health workforce to be able to respond to pandemics as well as local disease outbreaks.