HPV vaccination uptake

Published

26 Sep, 2022

Chronic infection with some types of Human papillomavirus (HPV) is the primary cause of cervical cancer. The most high-risk types such as Types 16 and 18 are estimated to cause about 70% of cervical cancers, but Australian data indicate that this figure is closer to 80%.¹ Infection with HPV is also a risk factor for cancers of the vulva, vagina, penis, anus, and the oral cavity and oropharynx.² It has also been estimated that HPV types 6 and 11 cause approximately 95% of genital warts.²

Data

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Notes

• The National Centre for Immunisation Surveillance (NCIRS) will release the 2018 HPV Vaccination data (with adolescent data to be presented in a future report) after transition to the Australian Immunisation Register.
• From 2018, Gardasil 9 - which provides protection against the HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 – was administered, with two doses considered to be sufficient if given at age 14 years or younger.
• Data sourced from the National HPV Vaccination Program Register website: http://www.hpvregister.org.au/
• Includes females and males turning 15 years old in each reporting year.
• The data refer to doses administered and reported to the HPV Register, excluding those for individuals who did not wish their details to be recorded on the Register.

Proportion of the population aged 15 years who have received the first/second/third dose of the HPV vaccine, 2007 to 2020
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Notes

• Data are sourced from the National HPV Vaccination Program Register website: http://www.hpvregister.org.au/
• Remoteness was classified according to the Australian Statistical Geography Standard (ASGS) Remoteness Areas, July 2011.
• See 'About the data' for more information on changes to the National HPV Vaccination Program over time.

Proportion of the population aged 12-13 years who have received the HPV vaccine, by dose number and remoteness, 2014
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• Data are sourced from the National HPV Vaccination Program Register website: http://www.hpvregister.org.au/
• See 'About the data for more information on changes to the National HPV Vaccination Program over time.

Proportion of the population aged 12-13 years who had received the HPV vaccine, by dose number and socioeconomic status, 2014

About this measure

In 2007, the school-based National HPV Vaccination Program, a joint Commonwealth-state/territory initiative, was implemented in Australia.² The vaccine used in the program was Gardasil, a quadrivalent prophylactic vaccine which can prevent infection and disease caused by HPV types 6, 11, 16 and 18. The program initially targeted females aged 12-13 years, and was available until end of 2009 to all females aged up to 26 years, and from 2013, was extended to males aged 12-13 years, with a two year catch up to age 15. The vaccine was administered for both males and females in three doses over a period of about six months.² From 2018, Gardasil 9 - which provides protection against the HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58 - is being administered, with two doses considered sufficient if given at age 14 or under.³

Widespread uptake of the HPV vaccine across the population will play a key role in decreasing the incidence of cervical cancer over time.⁴ Additionally, the monitoring and evaluation of uptake will provide insights into the variation of coverage across population groups. Coverage refers to the number of doses notified by estimated resident population, expressed as a percentage. It is measured at age 15 as by that age children in all states and territories have had the opportunity to complete the vaccine course.

Current status

In 2017, 80.2% of females aged 15 years had received all three doses of the HPV vaccine. This was higher than the corresponding proportion for males (75.9%). Males were only included in the National HPV Vaccination Program from 2013, and vaccine coverage in younger cohorts demonstrate that coverage is increasing over time.

Aboriginal and Torres Strait Islander peoples

The collection of Aboriginal and Torres Strait Islander status is not mandatory for individuals vaccinated in the National HPV Vaccination Program. As such, coverage data by Indigenous status are not readily available. However, previous research suggests that 3-dose coverage for Indigenous females is high, although still lower than for non-Indigenous females (for example, an estimated 15% lower coverage than among 12-17 year old non-Indigenous females in Queensland in 2007).⁶

Remoteness and socioeconomic status (SES)

Coverage data by remoteness and SES areas are available for males and females aged 12-13 years. In 2014, 3-dose vaccine coverage for residents of Very Remote areas (59.9% for males and 64.5% for females) was lower than in other remoteness areas. By comparison, the 3-dose vaccine uptake was higher for residents of Major Cities (76.1% for males and 81.2% for females).

Though less notable than the 3-dose coverage pattern by remoteness, there was also a difference in 3-dose vaccine uptake by SES area, with higher 3-dose coverage in the highest SES areas (SES 5; 79.4% for males and 82.9% for females) and lower 3-dose coverage for lowest SES areas (SES 1; 70.5% for males and 77.8% for females).

Trends

With females being the initial target of the Program, trend data for 3-dose vaccine coverage for females 15 years of age are available from 2007, and for each individual dose number from 2012. From 2007 to 2013, 3-dose coverage ranged between 71.9% and 73.8%. Since 2013, uptake across all three doses of the vaccine has increased with 3-dose coverage increasing in 2014 (74.8%), 2015 (78.7%), 2016 (79.7%) and 2017 (80.2%).

For males of 15 years of age, trend data for 3-dose vaccine coverage are available from 2013 and for each individual dose number from 2014. Three-dose coverage increased from 62.4% in 2014 to 75.9% in 2017, and similarly sized increases were observed for each individual dose from 2014 to 2016 compared to the previous year.

About the data

These measures show vaccination coverage with three doses of human papillomavirus vaccine for females and males. Age groups represented are: adolescent females and males turning 15 years old (for most recent data), females and males aged 14-15 years (trend data), and females and males aged 12-13 years (for remoteness and socioeconomic status data).

This page combines three NCCI framework measures as follows:

Proportion of the (female) population aged 15 years in the reference year who have received the first dose of the HPV vaccine;
Proportion of the (female) population aged 15 years vaccine in the reference year who have received the second dose of the HPV vaccine;
Proportion of the (female) population aged 15 years in the reference year who have received the third dose of the HPV vaccine.

Numerator: Females (or males) in relevant age range vaccinated as per the Australian Immunisation Handbook and reported to the HPV Register.

Denominator: Females (or males) in relevant age range, based on Estimated Residential Population at 30 June in the reference year.

Data source

National HPV Vaccination Program Register: http://www.hpvregister.org.au (accessed April 2019).

Data are based on vaccinations delivered through the National HPV Vaccination Program. The Program initially provided quadrivalent HPV vaccine for all females aged 12-26 years in mid-2007. The school program commenced in April 2007, whereas the GP/community program commenced in July 2007, continuing until the end of December 2009. From 2009 the Program offered HPV vaccination routinely to females in the first year of high school (usually aged 12-13 years). From 2013, males were also offered HPV vaccination routinely in the first year of high school (usually aged 12-13 years), with a catch-up program available for males aged 14-15 years in 2013 and 2014.⁷

HPV Vaccination doses administered through general practice and in other community settings may be incompletely notified to the HPV Register. The extent of under notification differs by jurisdiction, with the Northern Territory and Queensland likely having the most complete notification.⁷

Definitions

Socioeconomic group SES 1 refers to the fifth of the population resident in the geographical areas experiencing greatest socioeconomic disadvantage; SES 5 refers to the fifth of the population experiencing the least socioeconomic disadvantage.

Methodology

Remoteness

The Australian Statistical Geography Standard (ASGS) 2011, was used to allocate participants to a remoteness area based on their area of usual residence. (Note that earlier data may have used the now superceeded 2006 Australian Standard Geographical Classification (ASGC)).

Socioeconomic status

The 2011 Socio-Economic Indexes for Areas (SEIFA) Index for Relative Socio-Economic Disadvantage was used to allocate participants to a SEIFA quintile based on their usual residence.

References

Activity in this area

Data:

National HPV Vaccination Register - Coverage Data:

https://www.health.gov.au/resources/collections/historical-data-from-the... (accessed January 2022).

Policy:

Immunise Australia Program:

http://www.immunise.health.gov.au/ (accessed April 2019).

References

1. Brotherton JM. 2008. How much cervical cancer in Australia is vaccine preventable? A meta-analysis. Vaccine 26(2): 250-6

2. Australian Technical Advisory Group on Immunisation. The Australian Immunisation Handbook. 10th ed. Canberra: Australian Government Department of Health, 2013.

3. National HPV Vaccination Program Register 2019. https://www.health.gov.au/sites/default/files/hpv-vaccine-gardasil-9-clinical-advice-fact-sheet-for-gps.pdf (accessed January 2022).

4. Kulasingam S, Connelly L, Conway E, Hocking JS, Myers E, Regan DG, Roder D, Ross J, Wain G. A cost-effectiveness analysis of adding a human papillomavirus vaccine to the Australian National Cervical Cancer Screening Program. Sex Health. 2007 Sep;4(3):165-75.

5. Barbaro B & Brotherton JM. 2014. Assessing HPV vaccine coverage in Australia by geography and socioeconomic status: are we protecting those most at risk? Aust N Z J Public Health. 38(5):419-23.

6. Brotherton JM et al. 2013. Human papillomavirus vaccine coverage among female Australian adolescents: success of the school-based approach. Med J Aust 2013; 199 (9): 614-617. doi: 10.5694/mja13.10272.

7. National HPV Vaccination Register. Coverage Data (data quality notes). See https://www.health.gov.au/resources/collections/historical-data-from-the... (accessed January 2022).

Summary

HPV vaccination coverage differs by sexIn 2020, 80.5% of females and 78% of males aged 15 years were reported to have received the full course of the HPV vaccine. 

Uptake (ie coverage) of HPV vaccinations in females has increasedThe uptake in females of a complete vaccination course by 15 years of age increased from 72% in 2012 to 80.5% in 2020.

Uptake of HPV vaccinations in males has increasedThe uptake in males of a complete vaccination course by 15 years of age increased from 62% in 2014 to 78% in 2020.

HPV vaccination coverage is lower in very remote areas, and in lower socioeconomic status (SES) areasIn 2014, the proportion among males and females aged 12-13 years who had received all 3 doses was lower in very remote areas than in other remoteness areas, and lower in low SES areas than in higher SES areas. 

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Data

Summary

HPV vaccination coverage differs by sex

Uptake (ie coverage) of HPV vaccinations in females has increased

Uptake of HPV vaccinations in males has increased

HPV vaccination coverage is lower in very remote areas, and in lower socioeconomic status (SES) areas