Almost 1 in 3 teenage girls in some Australian areas haven't had the HPV vaccine. Why?

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The National HPV Vaccination Program has been shown to reduce rates of cervical abnormalities and genital warts in young women, yet in some parts of Australia more than one in four of teenage girls haven’t completed it, despite it being free for students.

According to a report from the National Health Performance Authority, roughly 38,400 of the 137,460 Australian girls who turned 15 in 2013 were not fully immunised against the human papillomavirus. That equates to around 28 per cent.

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Regions with the lowest coverage included the Blue Mountains, south-east Tasmania and rural South Australia, with the lowest coverage rate being just 56 per cent. Notably high coverage areas included Mackay, Warrnambool and inner south Melbourne.

The school-based National HPV Vaccination Program, which involves three injections beginning at age 12 to 13, was launched in 2007 to protect adolescent girls against HPV and its associated diseases, including cervical cancer. In 2013, this program was extended to include boys.

The HPV vaccine involves three injections.

HPV is a common viral infection of the reproductive tract that is a leading cause of cervical cancer and has also been linked to cancer of the anus, vagina, vulva and penis.

According to Dr Brian Morton, Chair of the AMA Council of General Practice, there are a number of possible explanations for low coverage rates, and it's not necessarily a case of outright objection from parents.

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For instance, from an administration point of view the process of parental approval required — as the children are underage when the first vaccine is administered — isn't fail-proof.

"You've got a letter for the parent's agreement or approval, that's got to get back to the school for the permission to actually be given it on the day. There are a couple of issues there, in either the letter not getting to the parents to sign, and secondly the delivery back to the school," Dr Morton says. (Post continues after gallery.)


The three-dose process could also be a contributing factor, as there's a higher chance of failure. "We actually see that in the childhood vaccinations - after the first, second and third, you start to get a drop in the 12 and 18 months... because of either parents being busy or forgetting about it or inadequate recall and reminders. There are those sorts of issues," Dr Morton says.

In some cases it could also be symptomatic of a lack of education, or misconceptions about why the vaccine is required.

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"The implication people might take is that it's sexual promiscuity or promoting early sexual intercourse, or 'It's not necessary because my child wouldn't do that'. It probably requires a high level of myth-busting and understanding by parents as to why it should be done," Dr Morton explains.

"I think also we need to recognise that one solution doesn't solve the problem for everyone in the community. Some kids have a terrible fear of injections ... we see kids coming in to our practice because they didn't want to do [the HPV vaccine] at school because they were too scared or saw a school friend faint due to it. That adds to the fear." (Post continues after gallery.)

Dr Morton says it's vital to educate parents about alternative arrangements they can make if their child misses one of the injections at school due to illness or administration. According to the HPV Vaccine website, the school's immunisation provider will usually contact parents if their child has missed a dose. In some cases catch-up injections will be available at school or a special catch-up clinic, but they can also be administered by a GP.

He adds that he Government's plans to extend the vaccination register to cover all ages, not just early childhood, will help to improve success rates. "For GPs to be notified and follow up on those who have missed it would be another thing. The government needs to invest in these programs."

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Although the benefits of the HPV vaccination received wide coverage when it was first invented and launched, Dr Morton says this knowledge has perhaps dropped from collective memory.

"We need to remind people about the benefits of it; it's a constant reminder because the health literacy levels in the community are not very high," he adds.

Have you, or your children, had the HPV vaccine? Are you surprised by these new findings?