Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK.
Immunisation and Countermeasures Division, National Infection Service, Public Health England, London, UK.
Vaccine. 2020 Mar 30;38(15):3149-3156. doi: 10.1016/j.vaccine.2020.01.031. Epub 2020 Jan 21.
Schools are increasingly being used to deliver vaccines. In 2015/16 three school-based vaccination programmes were delivered to adolescents in England: human papillomavirus (HPV), meningococcal groups A, C, W and Y disease (MenACWY) and tetanus, diphtheria and polio (Td/IPV). We assessed how school delivery models impact vaccine coverage and how a delivery model for one programme may impact another. Routinely collected national data were analysed to ascertain the school grade achieving highest coverage within each one-dose programme and to compare two-dose delivery models (within year vs across years) for the HPV vaccine. We also assessed whether the HPV delivery model was associated with coverage in other programmes. MenACWY and Td/IPV coverage was highest in younger school grades. Overall similar HPV coverage was achieved with both models (86.7% two doses within one year, 85.8% two doses across two years, p = 0.20). High two-dose HPV coverage in 2015/16 was reported in areas that achieved high HPV coverage in 2013/14 when three doses were required. Areas with high three-dose coverage in 2013/14 achieved higher coverage with a within-one-year approach (92.0% vs 85.2%, p < 0.001), whilst areas reporting low coverage in 2013/14 achieved lower but similar coverage in 2015/16 with both models (79.2% vs 80.9% p = 0.29). MenACWY and Td/IPV coverage were higher in areas with high HPV coverage in 2013/14. Among high HPV coverage areas, MenACWY coverage was higher when HPV doses were delivered within year. School-based programmes should be offered as early as feasible and acceptable to optimise coverage. The choice of delivery model for HPV should take into account local performance and provider experience. Single providers may delivery multiple vaccines and the delivery for one programme may affect the performance of other programmes. Providers should consider local circumstances including past and current vaccine coverage and factors influencing coverage when deciding what delivery model to adopt.
学校越来越多地被用于接种疫苗。2015/16 年，英格兰为青少年实施了三项基于学校的疫苗接种计划：人乳头瘤病毒（HPV）、脑膜炎球菌 A、C、W 和 Y 疾病（MenACWY）以及破伤风、白喉和脊髓灰质炎（Td/IPV）。我们评估了学校接种模式如何影响疫苗接种率，以及一种疫苗接种模式如何影响另一种疫苗接种率。通过分析常规收集的全国数据，确定了每个单剂疫苗计划中达到最高接种率的学校年级，并比较了 HPV 疫苗的两年内完成两剂接种和跨年度完成两剂接种两种模式。我们还评估了 HPV 接种模式是否与其他疫苗接种计划的接种率相关。MenACWY 和 Td/IPV 的接种率在较低年级的学校最高。总体而言，两种模式的 HPV 接种率相似（一年内完成两剂接种的比例为 86.7%，跨两年完成两剂接种的比例为 85.8%，p=0.20）。2015/16 年报告的 HPV 两剂接种率较高的地区，在需要接种三剂疫苗的 2013/14 年时，HPV 接种率也较高。2013/14 年三剂接种率较高的地区，采用一年内完成两剂接种的方法，接种率更高（92.0% 对 85.2%，p<0.001），而 2013/14 年报告接种率较低的地区，两种模式的接种率在 2015/16 年也较低，但相似（79.2% 对 80.9%，p=0.29）。2013/14 年 HPV 接种率较高的地区，MenACWY 和 Td/IPV 的接种率也较高。在 HPV 接种率较高的地区，HPV 疫苗接种年内完成时，MenACWY 疫苗接种率更高。学校接种计划应尽早提供，并尽可能得到接受，以优化接种率。HPV 疫苗接种模式的选择应考虑当地的表现和提供者的经验。单一提供者可能会接种多种疫苗，而且一种疫苗的接种可能会影响其他疫苗的接种率。提供者在决定采用哪种接种模式时，应考虑当地的具体情况，包括过去和当前的疫苗接种率以及影响接种率的因素。
