McIndoe Leigh, Wilson Elizabeth, Ferson Mark J, Sheppeard Vicky
Public Health Unit, South Eastern Sydney Local Health District, Sydney, NSW 2031, Australia.
New South Wales Ministry of Health, Sydney, NSW 2065, Australia.
Vaccines (Basel). 2024 Aug 5;12(8):888. doi: 10.3390/vaccines12080888.
School vaccination programs are crucial for achieving high immunisation coverage among adolescents, but substantial disparities exist across schools and regions. This ecological study aimed to determine associations between school characteristics and vaccination coverage for diphtheria-tetanus-acellular pertussis (dTpa) and human papillomavirus (HPV) vaccines among year 7 students in southeastern Sydney. An analysis of data from 70 mainstream schools participating in the 2019 South Eastern Sydney Local Health District School Vaccination Program utilised quasi-Poisson regression models to assess associations between vaccination coverage and school attendance, socio-educational status, Aboriginal enrolments, language background other than English (LBOTE), school sector (government, Catholic, or independent), and coeducation status. Median school coverage was 88% for dTpa, 88% for HPV-girls, and 86% for HPV-boys, with interquartile ranges of 82-93%, 84-92%, and 78-91%, respectively. Higher school attendance was associated with increased dTpa vaccination coverage (PR 1.14, 95% CI 1.02-1.27). Single-sex schools showed higher HPV vaccination coverage compared to coeducational schools for both girls (PR 2.24, 95% CI 2.04-2.46) and boys (PR 1.89, 95% CI 1.72-2.08). No significant associations were found for ICSEA, Aboriginal enrolments, LBOTE, or school sector. School attendance and coeducational status significantly influenced vaccination coverage, with differential impacts on dTpa and HPV vaccines. These findings highlight the need for targeted strategies to address disparities in school-based vaccination programs. Research using qualitative methods could be useful to understand the beliefs and attitudes contributing to these disparities in vaccine uptake so that programs can be tailored to maximise participation.
学校疫苗接种计划对于在青少年中实现高免疫覆盖率至关重要，但不同学校和地区存在显著差异。这项生态学研究旨在确定悉尼东南部7年级学生中，学校特征与白喉-破伤风-无细胞百日咳（dTpa）疫苗和人乳头瘤病毒（HPV）疫苗接种覆盖率之间的关联。对参与2019年悉尼东南部地方卫生区学校疫苗接种计划的70所主流学校的数据进行分析，利用准泊松回归模型评估接种覆盖率与学校出勤率、社会教育地位、原住民入学人数、非英语语言背景（LBOTE）、学校部门（政府、天主教或独立）以及男女同校状况之间的关联。dTpa疫苗的学校覆盖率中位数为88%，HPV疫苗女孩为88%，男孩为86%，四分位间距分别为82 - 93%、84 - 92%和78 - 91%。较高的学校出勤率与dTpa疫苗接种覆盖率增加相关（PR 1.14，95% CI 1.02 - 1.27）。与男女同校的学校相比，单性别学校的HPV疫苗接种覆盖率在女孩中更高（PR 2.24，95% CI 2.04 - 2.46），在男孩中也更高（PR 1.89，95% CI 1.72 - 2.08）。未发现与ICSEA、原住民入学人数、LBOTE或学校部门有显著关联。学校出勤率和男女同校状况显著影响接种覆盖率，对dTpa疫苗和HPV疫苗有不同影响。这些发现凸显了需要采取针对性策略来解决基于学校的疫苗接种计划中的差异。使用定性方法的研究可能有助于了解导致疫苗接种率存在这些差异的信念和态度，以便能够调整计划以最大限度地提高参与度。
