Optimising HPV vaccination delivery in Tasmanian schools (Australia): Lessons from parents and providers

Introduction Despite having well-established relationships and processes for the school-based immunisation program (SBIP), Tasmania has sub-optimal HPV vaccine completion. The HPV Vaccination Partnership Project aimed to understand facilitators and barriers to students' initiation and completion of vaccination in Tasmanian schools. Methods In this qualitative study, semi-structured interviews were undertaken with school personnel, council (local government) immunisation providers and parents of HPV vaccine-eligible adolescents (2021−2023). We chose a sample of Tasmanian secondary schools across sectors, regions, and demographic variables with varying coverage levels. Council staff providing the SBIP, key school personnel involved in program delivery, and parents of adolescents with incomplete HPV vaccination status were invited to participate. Interviews explored roles and relationships across health and education sectors, parents, and adolescents; HPV vaccination information, communication, and processes; the school vaccination environment; and parents' perspectives on HPV vaccination for their adolescents. Transcripts were analysed using thematic analysis and reported using the Consolidated Criteria for Reporting qualitative research. Knowledge mobilisation principles were adopted to support research translation and dissemination. Results We recruited 18 council personnel, 15 school personnel, and 14 parents. HPV vaccination program facilitators included collaborative partnerships with clear roles between health and education sectors, proactive leadership, well-established practices and processes, a supportive vaccination environment, and clear communication and information sharing between stakeholders. Barriers included consent form return processes and complex information for parents, poor communication among stakeholders, unfamiliarity with SBIP roles and processes, and unwelcoming vaccination environments. Parents with poor experiences of school-based vaccination as adolescents, and adolescents with poor experiences of healthcare more broadly, generated unfavourable attitudes towards HPV vaccination. Conclusion Findings highlight the importance of clear strategies to promote strong relationships, define roles, ensure access to easily understood vaccine information, and to streamline consent form processes. The Tasmanian Department of Health is using study findings to inform SBIPs.