Open Access
Feature Article

Adolescent vaccination – the important role of GPs

Open Access
Feature Article

Adolescent vaccination – the important role of GPs

CRISTYN DAVIES, S. Rachel Skinner

Figures

© whyframe/shutterstock model used for illustrative purposes only
© whyframe/shutterstock model used for illustrative purposes only
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.

Abstract

GPs have an important role in supporting adolescent vaccination, including ensuring vaccinations are up to date and in promoting health literacy among parents and adolescents. With the recently approved COVID-19 vaccines and boosters for adolescents, it is timely for GPs to consider missed doses and catch-up vaccination as part of standard preventive health activity for the adolescent patient in general practice.

This article was first published in 2021 (Med Today 2021; 22(1-2): 57-61). It has been updated to include important advice on recently approved COVID-19 vaccinations for adolescents aged 12 years and above.

Key Points

  • Australia has high rates of vaccination in children, which also need to be achieved in adolescents.
  • School-based vaccination programs include human papillomavirus (9vHPV), diphtheria–tetanus–acellular pertussis (dTpa) and meningococcal vaccines, and are an effective and cost-efficient means to promote relatively high vaccination coverage for adolescents.
  • Providing catch-up vaccinations to low-coverage groups, such as Aboriginal and Torres Strait Islander adolescents, is important.
  • GPs should actively assess the immunisation status of adolescents attending their practice for other reasons and opportunistically vaccinate them if needed.
  • Recommendation from a health-care provider is the most important driver to increase vaccination uptake; therefore, GPs are in a unique position to help promote health and vaccine literacy among adolescents and parents.
  • COVID-19 vaccination is now recommended for adolescents aged 12 years and above in a two-dose schedule, with two mRNA vaccines available; a booster is also approved for those aged 16 years and above.
  • COVID-19 vaccines, including the booster, are not part of the school-based vaccination program.

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 GPs 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, the influenza vaccine for  vulnerable groups, and now coronavirus disease 2019 (COVID-19) vaccines (Table 1).3 Equally high rates of vaccination need to be achieved in adolescents as in young children. 

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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, not only in achieving the same high coverage that is seen in early childhood vaccination programs for routine vaccines, but also for improving COVID-19 vaccine coverage. 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 crucial 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.