NSW high schools, Local Health Districts and Health Protection NSW. Centre for Epidemiology and Evidence, NSW Ministry of Health.
HPV= Human papillomavirus; Hep B= Hepatitis B; Varicella= chickenpox; dTpa= diphtheria, tetanus, acellular pertussis (whooping cough); 4vMenCV= Meningococcal ACWY.
The coverage rates for NSW and Local Health Districts may underestimate the true vaccination coverage as they represent only those vaccinations administered through the school program and do not include doses administered by general practitioners or other immunisation providers. Variations in coverage between Local Health Districts may be the result of differences in school attendance or numbers of resident vaccine objectors.
There have been significant changes to the NSW School Vaccination Program over time relating to the introduction or cessation of vaccines, changes in the recommended sex and ages for vaccination and policy changes to extend the opportunity to provide catch-up vaccination.
- The data for HPV vaccination for 2011 to 2012 relates to female students in Year 7 only as the program was expanded to include males from 2013.
- In 2017 NSW adopted a 2-dose HPV schedule based on the latest international evidence that two doses given to individuals aged 9-14 years (i.e. Year 7 students) at least 6 months apart gives equivalent protection to a 3-dose schedule.
- From 2012, extended catch-up vaccination has been offered to students who commenced the course of HPV vaccine in Year 7 to support course completion. HPV vaccination coverage from 2012 to 2015 for dose 2 and 3 includes catch-up vaccination for students who commenced the course in Year 7 and were provided with catch-up doses in Year 8 in 2013 (to the end of Term 2) and 2014-2018 (to the end of Term 4) respectively. 2018 is the last year final data are available as it includes catch-up vaccination offered in Year 8 in 2019.
- In 2017 NSW implemented an emergency meningococcal ACWY vaccination (4vMenCV) program targeting Year 11 and 12 students in response to the emergence of meningococcal serogroup W as a significant cause of invasive meningococcal disease (IMD) in Australia. In 2018 the program was offered to Year 10 and 11 students and has been offered routinely to Year 10 students since 2019.
- dTpa vaccine is offered to all students in Year 7 to provide protection against diphtheria, tetanus and pertussis. dTpa vaccine was previously offered to Year 10 students but was transitioned to Year 7 over a three-year period from 2010-2012 as part of a national strategy to provide adolescents with earlier protection against pertussis.
- Varicella vaccine was offered between 2006 and 2017 as a catch-up for adolescents who did not have a history of chickenpox or vaccination. The decline in coverage for varicella vaccination in 2014 is associated with vaccine supply issues in that year. The Australian Government ceased the varicella catch-up program at the end of 2017, as children were vaccinated at 18 months of age from November 2005 onwards.
- Hepatitis B vaccine was offered between 2004 and 2013 as a catch-up for adolescents who had not had a primary course of hepatitis B vaccine. The Australian Government ceased the hepatitis B vaccination catch-up program at the end of 2013, as hepatitis B vaccine had been offered to babies at birth, two, four and six months of age from May 2000 onwards.
See Methods tab for more information.
School vaccination programs have been shown to be an effective method to vaccinate a high proportion of adolescents. The ongoing NSW School Vaccination Program was established in 2004 to offer National Immunisation Program vaccines to adolescents.
Public Health Units in Local Health Districts are responsible for implementation of the NSW School Vaccination Program and provide aggregate data at the end of each school term.
Vaccination coverage rates for the NSW School Vaccination Program are calculated using the number of vaccine doses administered in the program and the number of eligible students based on enrolment data sourced from schools at the beginning of each school year. The data are aggregated to calculate vaccination coverage rates for each vaccine dose for NSW and Local Health Districts and are used to monitor coverage rates over time.
• The NSW School Vaccination Program achieves high coverage for human papillomavirus (HPV) and diphtheria-tetanus-pertussis (dTpa) vaccination.
• Vaccination coverage rates have generally increased since 2011 with the introduction of new initiatives to simplify the consent process, improve the return of parental consent forms and extend the opportunity to provide catch-up vaccination.
School vaccination programs have been shown to be a very effective method to vaccinate a high proportion of adolescents. The ongoing NSW School Vaccination Program was established in 2004 to offer National Immunisation Program vaccines to adolescents.
Eligible students in the NSW School Vaccination Program are offered vaccination to provide protection against a range of vaccine-preventable diseases, including:
• Human papillomavirus (HPV) is the name given to a group of viruses that affect both females and males. Most people who are sexually active will have a genital HPV infection at some time in their lives. While the body usually clears the infection naturally and there are no symptoms, the virus persists in a minority of infections. Almost all cases of cervical cancer and genital warts are due to HPV infection. HPV also causes cancers in other parts of the body, including the vulva, vagina, penis and anus.
• Diphtheria is a contagious and potentially life-threatening bacterial infection that causes severe breathing difficulties, heart failure and nerve damage.
• Tetanus is a severe, often fatal disease of the nervous system. The person suffers severe painful muscle spasms, convulsions and lockjaw. Even with modern intensive care about 1 in 10 people will die.
• Pertussis (Whooping Cough) is a highly infectious bacterial disease that causes bouts of coughing. Adolescents and adults can have an annoying cough for up to 3 months. Severe bouts of coughing can cause vomiting, rib fractures, rupture of small blood vessels and hernias. About 1 in 200 babies aged less than 6 months who catch whooping cough from an infected person die from pneumonia or brain damage.
• Hepatitis B is a viral disease that causes symptoms such as fever, jaundice and feeling generally unwell and can lead to cirrhosis or cancer of the liver. Some people can develop hepatitis B disease and not be aware that they are infected. These people can pass on the disease without knowing it. The program ceased in 2013.
• Varicella (Chickenpox) is a highly contagious infection caused by the varicella-zoster virus. It is usually a mild disease of short duration in healthy children with symptoms such as slight fever, runny nose, feeling generally unwell and a skin rash that turns to blisters. However, it is more severe in adults and can cause serious and even fatal illness in individuals who are immunosuppressed. One in 5,000 infected patients develop encephalitis (brain inflammation) and approximately 3 in 100,000 infected patients die. Infection during pregnancy can result in congenital abnormalities in the baby.
The NSW School Vaccination Program is a partnership between health and education authorities:
• Health Protection NSW provides program funding, distributes vaccines, develops program guidelines and consent materials and maintains a register of vaccination encounters
• Local Health Districts conduct school vaccination clinics, perform quality assurance audits and report aggregate coverage data
• the NSW Department of Education and Communities, the Catholic Education Commission of NSW and the Association of Independent Schools of NSW support schools to implement the program and facilitate program changes
• high schools provide the venue for vaccination, distribute and collect consent materials, supply student enrolment data and provide teacher support.
NSW Health. NSW School Vaccination Program. Web page available at www.health.nsw.gov.au/immunisation/Pages/schoolvaccination.aspx
Australian Government. Department of Health and Ageing. Australian Immunisation Handbook. Web page available at https://immunisationhandbook.health.gov.au/