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http://hdl.handle.net/10609/146599
Title: | Determinants of Human Papillomavirus Vaccine Uptake by Adult Women Attending Cervical Cancer Screening in 9 European Countries |
Author: | Robles, Claudia Bruni, Laia Acera Perez, Amèlia Carles Riera, Joan Prats, Laia Poljak, Mario Mlakar, Jana Oštrbenk Valenčak, Anja Eriksson, Tiina Lehtinen, Matti Louvanto, Karolina Hortlund, Maria Dillner, Joakim Faber, Mette Tuxen Munk, Christian Kjaer, Susanne K. Petry, Karl Ulrich Denecke, Agnieszka Xu, Lan Arbyn, Marc Cadman, Louise Cuzick, Jack DALSTEIN, Véronique CLAVEL, Christine de Sanjose, Silvia BOSCH JOSÉ, FRANCESC XAVIER |
Others: | Universitat Oberta de Catalunya (UOC) Catalan Institute of Oncology Institut Català de la Salut University of Ljubljana University of Tampere Karolinska Institutet University of Copenhagen Belgian Cancer Centre Queen Mary University of London |
Citation: | Robles, C., Bruni, L., Acera, A., Riera, J.C., Prats, L., Poljak, M., Mlakar, J., Ostrbenk Valencak, A., Eriksson, T., Lehtinen, M., Louvanto, K., Hortlund, M., Dillner, J., Faber, M., Munk, C., Kjaer, S., Petry, K.U., Denecke, A., Xu, L., Arbyn, M., Cadman, L., Cuzick, J., Dalstein, V., Clavel, C., de Sanjosé, S. & Bosch Jose, F.X. (2021). Determinants of Human Papillomavirus Vaccine Uptake by Adult Women Attending Cervical Cancer Screening in 9 European Countries. American Journal of Preventive Medicine, 60(4), 478-487. doi: 10.1016/j.amepre.2020.08.032 |
Abstract: | Introduction Human papillomavirus–vaccinated cohorts, irrespective of age, will likely reduce their subsequent screening requirements, thus opening opportunities for global cost reduction and program sustainability. The determinants of uptake and completion of a 3-dose human papillomavirus vaccination program by adult women in a European context were estimated. Study design This was an intervention study. Setting/participants Study participants were women aged 25–45 years, attending opportunistic or population-based cervical cancer screening in Belgium, Denmark, Finland, France, Germany, Slovenia, Spain, Sweden, and the United Kingdom between April 2016 and May 2018. Intervention Study participants completed a questionnaire on awareness and attitudes on adult female human papillomavirus vaccination and were invited to receive free human papillomavirus vaccination. Main outcome measures Main outcome measures were acceptance, uptake, and completion of vaccination schedule. Determinants of vaccine uptake were explored using multilevel logistic models in 2019. Results Among 3,646 participants, 2,748 (range by country=50%–96%) accepted vaccination, and 2,151 (range=30%–93%) received the full vaccination course. The factors associated with higher vaccine acceptance were previous awareness of adult female (OR=1.22, 95% CI=1.00, 1.48) and male (OR=1.59, 95% CI=1.28, 1.97) vaccination. Women in stable relationships (OR=0.56, 95% CI=0.45, 0.69) or with higher educational level (OR=0.76, 95% CI=0.63, 0.93) were more likely to refuse vaccination. Recruitment by postal invitation versus personal invitation from a healthcare professional resulted in lower vaccine acceptance (OR=0.13, 95% CI=0.02, 0.76). Vaccination coverage of >70% of adolescent girls in national public programs was of borderline significance in predicting human papillomavirus vaccine uptake (OR=3.23, 95% CI=0.95, 10.97). The main reasons for vaccine refusal were vaccine safety concerns (range=30%–59%) and the need for more information on human papillomavirus vaccines (range=1%–72%). No safety issues were experienced by vaccinated women. Conclusions Acceptance and schedule completion were largely dependent on recruitment method, achieved coverage of national vaccination programs, and personal relationship status. Knowledge of benefits and safety reassurance may be critical to expanding vaccination target ages. Study results suggest that there are no major opinion barriers in adult women to human papillomavirus vaccination, especially when vaccination is offered face to face in healthcare settings. |
Keywords: | papillomavirus Vaccine cervical screening |
DOI: | https://doi.org/10.1016/j.amepre.2020.08.032 |
Document type: | info:eu-repo/semantics/article |
Version: | info:eu-repo/semantics/publishedVersion |
Issue Date: | 1-Apr-2021 |
Publication license: | http://creativecommons.org/licenses/by/4.0 |
Appears in Collections: | Articles Articles cientÍfics |
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PIIS0749379720304347.pdf | Determinants of Human Papillomavirus Vaccine Uptake by Adult Women Attending Cervical Cancer Screening in 9 European Countries | 467,97 kB | Adobe PDF | View/Open |
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