HPV vaccine closing the gap in Indigenous cervical cancer rates

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High HPV vaccination rates in Indigenous teenagers is an encouraging sign for closing the gap in cervical cancer rates, according to Aussie researchers who are now focusing on how to increase course completion rates. Cervical cancer rates are higher in Indigenous women than other Aussies and the three-dose HPV vaccination rates have historically been much lower in Indigenous women. Researchers analysed data from 12-year-olds who received the first dose in 2015 and found dose one coverage exceeded 80 per cent in Indigenous groups, but dropped to as low as 61.2 per cent for the third dose. Researchers hope these rates will only increase as the new HPV vaccines are only a two-dose course.

Journal/conference: MJA

Link to research (DOI): 10.5694/mja2.20221

Organisation/s: Menzies School of Health Research, Victorian Cytology Service, VIC

Funder: The National HPV Vaccination Program Register was owned and funded by the Australian Department of Health and operated by the VCS Foundation. The Department of Health permitted publication of the data in this article but played no role in its preparation. All authors had full access to all study data. Lisa Whop was supported by a National Medical and Health Research Council (NHMRC) Early Career Fellowship (1142035). Julia Brotherton, Karen Winch and Genevieve Chappell are employed by the VCS Foundation. Carolyn Banks, Dennis Meijer, Sonya Ennis, Karen Peterson and Rosalind Webby are employed by their respective state or territory health departments.

Media Release

From: Medical Journal of Australia (MJA)

INDIGENOUS HPV VACCINATION COVERAGE: MUCH TO CELEBRATE

HIGH levels of vaccination coverage for human papillomavirus in Indigenous teenagers is an encouraging sign for closing the gap in cervical cancer rates, according to the authors of research published online today by the Medical Journal of Australia.

The research, led by Associate Professor Julia Brotherton, Medical Director of the VCS Foundation’s Population Health Services, analysed data from adolescents who were 12 years old in 2015 and received the quadrivalent, three-dose HPV vaccine as part of the National HPV Vaccination Program in 2015 or 2016, in Queensland, New South Wales, the Northern Territory or the Australian Capital Territory.

“Dose 1 coverage exceeded 80% for all Indigenous status/jurisdiction/sex groups,” the authors wrote.

“Coverage was similar for Indigenous and non-Indigenous girls in Queensland (87.3% v 87.0%), lower for Indigenous girls in the ACT (88.7% v 97.7%) and NT (91.1% v 97.0%), and higher in NSW (95.9% v 89.9%); it was similar for Indigenous and non-Indigenous boys in all jurisdictions except the NT (88.6% v 96.3%).

“Dose 3 coverage (range, 61.2–87.7%) was markedly lower for Indigenous than non-Indigenous 12-year-olds in all jurisdictions, except for girls in NSW (82.6% v 83.6%).”

Since the research was completed the HPV vaccination has become a 9-valent, two-dose course.

“In each jurisdiction, estimated HPV vaccination coverage of Indigenous students was much higher than reported in many countries, including the United States, New Zealand and France,” Brotherton and colleagues wrote.

“This high level of coverage is consistent with findings of large falls in the prevalence of HPV and the incidence of genital warts in Indigenous people. The vaccine achieves strong herd protection even at relatively low coverage, and the benefits of vaccination were substantially augmented in Australia by the large-scale catch-up program.”

The priority now was to develop strategies for increasing course completion rates, the authors wrote.

“The move to the two-dose HPV vaccination schedule in 2018 may further improve completion rates. However, the wider spacing of doses (dose 2 is given 6–12 months after the first) may be as much a barrier to completion as was the 6-month span of the three doses of the old program.

“Our findings indicate there is much to celebrate in terms of high initiation rates. However, further work is required to ensure that vaccination courses are completed. Engagement with Indigenous communities to explore their experiences and understanding of HPV vaccination, and to seek guidance on culturally appropriate strategies for improving coverage, is needed,” they concluded.

Please remember to credit The MJA.

The Medical Journal of Australia is a publication of the Australian Medical Association.

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