National HPV Vaccination Program Register, VCS Inc., PO Box 310, East Melbourne 8002, Victoria, Australia; Discipline of Paediatrics and Child Health, University of Sydney, Locked Bag 4001, Westmead 2145, New South Wales, Australia; Melbourne School of Population and Global Health, 207 Bouverie Street, The University of Melbourne, Parkville, Victoria 2010, Australia.
The Kirby Institute, University of New South Wales, Sydney 2052, New South Wales, Australia.
Vaccine. 2014 Jan 23;32(5):592-7. doi: 10.1016/j.vaccine.2013.11.075. Epub 2013 Dec 5.
Accurate estimates of coverage are essential for estimating the population effectiveness of human papillomavirus (HPV) vaccination. Australia has a purpose built National HPV Vaccination Program Register for monitoring coverage, however notification of doses administered to young women in the community during the national catch-up program (2007-2009) was not compulsory. In 2011, we undertook a population-based mobile phone survey of young women to independently estimate HPV vaccination coverage.
Randomly generated mobile phone numbers were dialed to recruit women aged 22-30 (age eligible for HPV vaccination) to complete a computer assisted telephone interview. Consent was sought to validate self reported HPV vaccination status against the national register. Coverage rates were calculated based on self report and weighted to the age and state of residence structure of the Australian female population. These were compared with coverage estimates from the register using Australian Bureau of Statistics estimated resident populations as the denominator.
Among the 1379 participants, the national estimate for self reported HPV vaccination coverage for doses 1/2/3, respectively, weighted for age and state of residence, was 64/59/53%. This compares with coverage of 55/45/32% and 49/40/28% based on register records, using 2007 and 2011 population data as the denominators respectively. Some significant differences in coverage between the states were identified. 20% (223) of women returned a consent form allowing validation of doses against the register and provider records: among these women 85.6% (538) of self reported doses were confirmed.
We confirmed that coverage rates for young women vaccinated in the community (at age 18-26 years) are underestimated by the national register and that under-notification is greater for second and third doses. Using 2011 population estimates, rather than estimates contemporaneous with the program rollout, reduces register-based coverage estimates further because of large population increases due to immigration since the program.
准确的覆盖率估计对于评估人乳头瘤病毒（HPV）疫苗接种的人群效果至关重要。澳大利亚有一个专门的国家 HPV 疫苗接种计划登记处，用于监测覆盖率，但在全国性补种计划（2007-2009 年）期间，社区内为年轻女性接种的剂量并未强制通知。2011 年，我们对年轻女性进行了一项基于人群的手机调查，以独立估计 HPV 疫苗接种率。
随机生成的手机号码被拨打，以招募年龄在 22-30 岁（有 HPV 疫苗接种资格）的女性完成计算机辅助电话访谈。征求同意，以国家登记处为准，验证自我报告的 HPV 疫苗接种状况。根据自我报告计算了接种率，并根据澳大利亚女性人口的年龄和居住州结构进行了加权。这些结果与使用澳大利亚统计局估计的居民人数作为分母的登记处估计值进行了比较。
在 1379 名参与者中，自我报告的 HPV 疫苗接种剂量 1/2/3 的全国估计值分别为 64/59/53%，经年龄和居住州加权后。相比之下，基于登记处记录，使用 2007 年和 2011 年的人口数据作为分母，登记处记录的覆盖率分别为 55/45/32%和 49/40/28%。发现各州之间的覆盖率存在一些显著差异。20%（223 名）的女性返回了同意表，允许根据登记处和提供者记录验证剂量：在这些女性中，85.6%（538 名）自我报告的剂量得到了证实。
我们证实，社区（18-26 岁）接种疫苗的年轻女性的覆盖率率被国家登记处低估，第二和第三剂的通知不足。使用 2011 年的人口估计数，而不是与计划推出同时期的估计数，会进一步降低登记处的覆盖率估计数，因为自该计划以来，由于移民，人口大量增加。
