This presentation will describe the development of the New Zealand (NZ) HPV vaccination programme from commencement in 2008 to 2017 with comprehensive free access as well as future plans for the NZ school programme.
Challenges and coverage rates will also be discussed.
Information in this presentation is gleaned from literature review, government websites, the author's own knowledge and experience as a regional immunisation coordinator and unpublished research undertaken for her PhD.
The NZ HPV vaccination programme commenced in late 2008 with a catch-up programme for girls born in 1990-1991. The school programme started in 2009 for Year 8 girls (age 12). Females could also access Gardasil in primary care until their 20th birthday. Gardasil, with a three-dose schedule at 0, 2 and 6 months was utilised for all eligible groups until January 2017.
From January 2017, enhanced access:
- Gardasil 9 replaces Gardasil (4)
- Gender neutral vaccine - offered to boys and girls in Year 8 at school
- Dose schedule change: <15s two doses at 0 and 6-12 months; 15+ three doses at 0, 2 and 6 months
- Expanded age eligibility: vaccine now funded in primary care for males and females aged 9 to 26 years
Future developments: In 2018 the Ministry of Health plans to introduce the vaccine programme to Year 7 students (age 11). This may lead to cost savings as the vaccine will be delivered concurrently with the Boostrix vaccine.
Overall coverage rates for girls have never met targets, set at 75% for three doses. Reasons for decline include safety concerns and age the vaccine is offered in school is too young. Lower HPV knowledge is associated with poorer acceptance of the vaccine.
School based HPV vaccination started in 2009 for girls only. From 2017 NZ has a comprehensive gender neutral programme. In 2018 the vaccine will be offered in Year 7. This may lead to savings in service delivery, but may also lower acceptance, as (young) age has been a factor in parent's decision making.
Coverage rates in NZ have never been high. Reasons for decline need to be addressed in order to increase acceptance.
Ministry of Health (2008). The HPV immunisation programme: School-based programme professional standards for service delivery. Wellington, New Zealand: Ministry of Health.
Litmus (2011). HPV Immunisation programme implementation evaluation. Volume 1: Final Report.
www.health.govt.nz
www.pharmac.govt.nz