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The recent introduction of the human papillomavirus (HPV) vaccine into the routine immunisation schedule for girls in the UK has reaffirmed the possibility of widespread adolescent immunisation, assuming appropriate prior consultation and resource allocation. On the back of this success, it is timely to consider the case for extending the programme of school-based adolescent immunisations to include the provision of both additional primary immunisations as well as important booster doses of vaccines given earlier in childhood. Such a programme, if well designed, would ensure that individual protection from vaccine preventable disease was maximised prior to school leaving and, of equal importance in some cases, that herd immunity was sustained more effectively in the population as a whole. The possible contents of a re-invigorated adolescent immunisation programme are discussed considering those vaccines which are already available and for which cost-benefit calculation may therefore be of prime importance, as well as vaccines which may become available in the future and for which the issues may be more complicated. The importance of providing balanced, accurate, appropriate and accessible information regarding adolescent immunisation is also highlighted.
Introduction of the HPV vaccination programme
The introduction of routine human papillomavirus (HPV) vaccination for 12-year-old girls in 2008 represented a return to a public health strategy which had been abandoned in the UK with the discontinuation of routine BCG: namely the use of a rolling school-based adolescent immunisation programme. Although not without problems,1 the programme has been very successful to date, with uptake rates of between 80% and 90%.2 Furthermore, despite concerns to the contrary, a workable and effective means of involving both parents and children in the consent process has been implemented.3,–,5 Inevitably, disorders developing during the days, weeks and months after immunisation will continue to be attributed to the vaccine by some, despite the …
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