Open Access
Adolescent health

Vaccination for adolescents

CRISTYN DAVIES, S. Rachel Skinner
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GPs are often unaware of their important role in supporting adolescent vaccination, which primarily occurs through the school-based vaccination program. Ensuring vaccinations are up to date and missed doses are completed should be considered a standard preventive health activity for the adolescent patient in general practice.

Australia has achieved high rates of childhood vaccination, with substantial increases over the past 20 years.1,2 Much of this success can be attributed to the commitment of general practitioners and the effective strategies they have implemented. Vaccination of adolescents has become increasingly important, especially since the introduction of the national human papillomavirus (HPV) vaccination program, which has had a substantial impact on HPV-related disease, and other vaccines relevant to this age group. These have included the pertussis booster (diphtheria-tetanus-acellular pertussis [dTpa] vaccine), meningococcal ACWY and B vaccines and influenza vaccine for vulnerable groups (Table 1).3 Equally high rates of vaccination need to be achieved in adolescents as in young children. 

As vaccination of adolescents primarily occurs through the school-based vaccination program, GPs may not see themselves as playing an important role. However, working alongside the school program, GPs are crucial in achieving the same high coverage that is seen in early childhood vaccination programs. GPs can ensure all adolescent patients in their practice are up to date with their vaccinations and provide any that have been missed in the school program. Disruption to student attendance at school from closures or restrictions during the COVID-19 pandemic may have interrupted vaccination initiation or completion, especially when more than one vaccine dose is required.4 Although GPs have always had a vital role in providing vaccinations to adolescents with anxiety or special needs, as well as those who are Aboriginal or Torres Strait Islander, culturally and linguistically diverse, homeless or do not regularly attend school, reviewing all adolescents’ vaccination status in general practice has never been more timely.


School-based vaccination and vaccination coverage 

The Australian National Immunisation Program (NIP) funds vaccination across the lifespan, with vaccines listed in the schedule provided free for target groups. Unlike other populations, adolescents are primarily vaccinated en masse at school after parental consent is obtained.5 School-based vaccination has proven to be an effective and cost-efficient means to promote relatively high vaccination coverage for adolescents.6-9 In 2017, when the Australian quadrivalent HPV vaccine schedule required three doses, 80.2% of girls aged 15 years and 75.9% of boys aged 15 years received a full course of the vaccine.2 Of Aboriginal and Torres Strait Islander girls and boys aged 15 years who received the first dose, 79% and 77%, respectively, completed the three doses, compared with 91% and 90% of non-Indigenous girls and boys, respectively.2 Data are not yet available on coverage of the two-dose nonavalent HPV vaccine (implemented from 2018 for adolescents aged 14 years or younger at the first dose) or dTpa and meningococcal ACWY vaccines.




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Ms Davies is a Research Fellow and PhD candidate in Child and Adolescent Health at the Faculty of Medicine and Health, The University of Sydney. Dr Skinner is a Paediatrician and Adolescent Physician at the Sydney Children’s Hospitals Network and Professor of Child and Adolescent Health at the Faculty of Medicine and Health, The University of Sydney, Sydney, NSW.