All persons aged 13 to 14 years who have received the second (completing) dose of the HPV vaccine within each reporting area (local authority LA) as a percentage of all persons aged 13 to 14 years within each area
Rationale
The national human papillomavirus (HPV) immunisation programme was introduced in 2008 for secondary school year 8 females (12 to 13 years of age) to protect them against the main causes of cervical cancer. While it was initially a three dose vaccination programme, it was run as a two dose schedule from September 2014 following expert advice.
The first HPV vaccine dose is usually offered to females in Year 8 (aged 12 to 13 years) and the second dose 12 months later in Year 9, but some local areas have scheduled the second dose from six months after the first. Therefore the completed course coverage is not available until the end of Year 9.From September 2019, 12 to 13 year old males became eligible for HPV immunisation alongside females, based on JCVI advice.
Definition of numerator
Number of persons in school year 9 (aged 13 to 14) who have received the second dose of HPV vaccine within each LA.
Definition of denominator
Number of year 9 (aged 13 to 14) persons in each LA.
Caveats
On 23 March 2020, all educational settings in England were advised to close by the UK Government as part of COVID19 pandemic measures. Although the importance of maintaining good vaccine uptake was impressed, operational delivery of all school aged immunisation programmes was paused for a short period of time as a consequence of school closures limiting access to venues for providers and children who were eligible for vaccination.
The NHSEI central public health commissioning and operations team rapidly established an Immunisation Task and Finish Group, with regional NHSEI and PHE representation. The group was established to:
- assess the impact of COVID19 on all immunisation programmes, including school aged programmes
- develop technical guidance and a plan for restoration and recovery of school aged programmes, once education settings were re opened
From 1 June 2020 some schools partially re-opened for some year groups for a mini summer term. NHSEI published clinical guidance for healthcare professionals on maintaining immunisation programmes during COVID19, and the Department of Education published further guidance which led to schools allowing vaccination sessions to resume on site. NHSEI commissioned, school aged immunisation providers were able to implement their restoration and recovery plans to commence catch up during the summer of 2020. This included delivery of programmes in school and community settings following a robust risk assessment and in line with UK government public health COVID19 guidance. The aim was to ensure that those eligible for HPV vaccination had been offered at least one dose of vaccine in line with JCVI recommendations with the second dose scheduled at a later date.
In September 2020, schools across the UK reopened for general in person attendance. During the 2020 to 2021 academic year, students were required to stay at home and learn remotely if they tested positive for COVID 19 or if they were a contact of a confirmed COVID19 case and so school attendance rates in England were lower than normal, especially in areas with very high COVID19 incidence rates. In England, as part of a wider national lockdown in January 2021, schools were closed to all, except children of keyworkers and vulnerable children. From early March 2021, primary schools reopened, with a phased reopening of secondary schools.
Although this led to some disruption of school-based immunisation programme delivery in the 2020 to 2021 academic year, NHSEI Regional Public Health Commissioning teams worked with NHSEI commissioned school aged immunisation providers to maintain the delivery of the routine programme and catch up. As the routine programme is commissioned for a school aged cohort rather than a school based cohort, providers were able to build on existing arrangements such as community based clinics in place for home school children. A wide variety of local arrangements were established to ensure programme delivery continued effectively and safely in the school and community premises, during the term time and school breaks.