Department of Neurodevelopment and Disability, The Royal Children's Hospital, Melbourne, Australia; The Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Developmental Disability and Rehabilitation Research Group, Murdoch Children's Research Institute, Melbourne, Australia.
The Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Department of Haematology, The Royal Children's Hospital, Melbourne, Australia; Nursing Research, The Royal Children's Hospital, Melbourne, Australia; Clinical Haematology Research Group, Murdoch Children's Research Institute, Australia; The Department of Nursing, The University of Melbourne, Melbourne, Australia.
Vaccine. 2019 Jan 7;37(2):272-279. doi: 10.1016/j.vaccine.2018.11.034. Epub 2018 Dec 3.
As part of the National Immunisation Program (NIP) students in Australia receive adolescent immunisations through the School Immunisation Program at 12 to 13 years. For children with disabilities attending specialist schools, no vaccine uptake data is collected at this time point. We aimed to determine uptake of diphtheria-tetanus-pertussis (dTpa) and Human Papillomavirus (HPV) immunisations amongst young people with disabilities in specialist schools in Victoria.
A prospective cohort study was conducted in Victoria, Australia. Data was collected on immunisation days in the 2017 school year from specialist schools in Victoria. The school immunisation coordinator entered data online for eligible students for receipt of dTpa and HPV on each school immunisation day. Demographic data, motor and intellectual function of students and reasons for non-receipt of dTpa and HPV vaccine were recorded. Data were analysed using descriptive statistics.
Of 73 eligible specialist schools in Victoria, 28 (38%) participated. dTpa was received by 63% (237/374) of participating students and HPV dose 1 (HPV1) was received by 66% (76/114) females and 67% (174/260) male students respectively. Three doses of HPV were received by only 41% (100/241) of students. The main reasons for missed immunisation were absence from school, lack of consent and inability to immunise due to the student's behaviour and/or anxiety.
This is the first study in Australia to report that uptake of adolescent immunisations in specialist schools for young people with a disability is significantly lower than in mainstream settings. Comparative data during the same time period for students in mainstream schools demonstrated higher uptake, at 89% for dTpa and 75% for three doses of HPV. These data highlight the inequity of receipt of school-based immunisations for this group of adolescents, the barriers to which could be more thoroughly explored through qualitative inquiry from a socio-ecological perspective.
作为国家免疫计划（NIP）的一部分，澳大利亚的学生在 12 至 13 岁时通过学校免疫计划接受青少年免疫接种。对于在特殊学校就读的残疾儿童，此时并未收集疫苗接种数据。我们旨在确定维多利亚州特殊学校残疾青少年对接种白喉、破伤风、百日咳（dTpa）和人乳头瘤病毒（HPV）疫苗的情况。
在澳大利亚维多利亚州进行了一项前瞻性队列研究。在 2017 学年，从维多利亚州的特殊学校收集免疫接种日的数据。学校免疫协调员在线为符合条件的学生输入在每次学校免疫接种日接受 dTpa 和 HPV 的数据。记录学生的人口统计学数据、运动和智力功能以及未接种 dTpa 和 HPV 疫苗的原因。使用描述性统计数据进行数据分析。
在维多利亚州的 73 所符合条件的特殊学校中，有 28 所（38%）参与了研究。参与研究的学生中，有 63%（237/374）接种了 dTpa，66%（76/114）的女性和 67%（174/260）的男性学生接种了 HPV1 疫苗。只有 41%（100/241）的学生接种了三剂 HPV。错过免疫接种的主要原因是缺课、缺乏同意以及因学生的行为和/或焦虑而无法接种。
这是澳大利亚第一份报告表明，残疾青少年在特殊学校接受青少年免疫接种的比例明显低于主流环境的研究。同一时期对主流学校学生的比较数据显示，dTpa 的接种率为 89%，三剂 HPV 的接种率为 75%。这些数据突出了这一群体青少年接受基于学校的免疫接种的不平等性，通过从社会生态学的角度进行定性探究，可以更深入地探讨这些障碍。
