Objective: To describe the process and challenges in the roll out of a large cervical cancer vaccination program to protect against human papilloma virus (HPV) infection. Methods: This article describes the process of planning and implementing a HPV vaccination program using the existing state‐wide framework that supports vaccine delivery to all 219 high schools in South Australia. The decision was made to offer three doses of HPV vaccine to 50,191 female students in Years 8‐12 during the 2007 school year. Results: By November 2007, despite many challenges, the school vaccination program had delivered 107,541 doses of HPV vaccine. Coverage of dose 1 was highest in Years 8 (83%) and 10 (70%), but was reduced for doses 2 and 3 in all year levels, with dose 3 coverage ranging from 55% (Year 11) to 77% (Year 8). Conclusions: The introduction of a large school‐based vaccination program at short notice posed new challenges for the co‐ordination and implementation. Not all schools supported the introduction of HPV vaccine, resulting in reduced access for some students. Negative media messages provided a strong platform for individuals who opposed vaccination. These factors may have contributed to the less‐than‐expected uptake of HPV vaccine. Implications: Historically, there has been high uptake of other vaccines given to adolescents. However, the introduction of HPV vaccine may have adversely affected the uptake of Hepatitis B vaccine, given concurrently in the school program. Further studies are needed to determine if this is likely to have a negative effect on the public perception of the value of vaccine programs in general.
This study presents a qualitative exploration and analysis of the experience students had participating in college level, campus based educational programs with the assistance of a clubhouse based "mobile" supported education program. The study offers an analysis of responses to a structured interview schedule provided by 26 former and current students of the program during a series of focus groups at the clubhouse. The study presents findings regarding the dilemma faced by students who must choose discretion in disclosing information about their past psychiatric backgrounds, the nature of "support" in supported education, and the role of those who provide that support. The study concludes that students' perceptions of stigma on campus become a significant source of anxiety and concern. The fear of being labeled "mentally ill" by others persists on campus despite a very accepting and helpful attitude by students, teachers, and other campus support staff. In addition, the nature of support and the role of the support givers described by students suggest that the students' primary group relationships (e.g., friends, other students, other program members), are crucial aspects of their support both on and off campus.
Objective To describe five outbreaks of hepatitis A virus (HAV) infection associated with illicit drug use during a statewide outbreak of HAV infection in Queensland. Design Risk factor prevalence survey. Patients and setting All 875 cases of HAV infection notified to Public Health Units in Queensland in the 12 months to 30 November 1997. Main outcome measure Type and prevalence of illicit drug use. Results Risk factor assessment was completed for 804 cases (91.9%). We identified five outbreaks of HAV infection linked to illicit drug use. These outbreaks accounted for 24.6% (215/875) of all notified cases and 39% (190/482) of notified cases in the 15‐34 years age group. The main type of illicit drug use in four of the five outbreaks was injecting drug use (74%; 118/160), while in the other outbreak it was sharing of smoking implements for marijuana (38%; 21/55). Conclusion Illicit drug use may be an under‐recognised risk factor for HAV infection, particularly in young people. Faecal‐oral transmission through poor personal hygiene, including sharing of implements for smoking marijuana, is the most probable route of transmission in these drug‐linked outbreaks. The role of contaminated drug and needle‐sharing remains to be clarified.
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