1887
Research Open Access
Like 0

Abstract

Background

In France, human papillomavirus (HPV) vaccination coverage varies across socioeconomic levels.

Aim

We aimed at assessing HPV vaccine awareness, uptake and vaccination intention among adolescents in France.

Methods

In a cluster-randomised study, 13–15-year-old students in 61 French middle schools completed a web-based questionnaire. We used multivariable logistic regression to evaluate determinants of HPV vaccine awareness, self-reported uptake and vaccination intention among unvaccinated students and interaction terms to explore effects of visits to family physician and remembering school lessons on vaccination. The French deprivation index of school municipalities served as proxy for socioeconomic levels.

Results

Among 6,992 participants, awareness was significantly associated with parental education (odds ratio (OR) = 0.82; 95% confidence interval (CI): 0.71–0.95), language spoken at home (OR = 0.59; 95% CI: 0.52–0.66) and deprivation level (OR = 0.57; 95% CI: 0.44–0.71), regardless of physician visit or school lessons. Vaccine uptake was associated with parental education without a recent physician visit (OR = 0.31; 95% CI: 0.16–0.59, vs OR = 0.64; 95% CI: 0.52–0.78 with a visit, interaction p = 0.045). Vaccination intention among unvaccinated was associated with deprivation level (moderate-low vs low) among students not remembering school lessons on vaccination (OR = 0.17; 95% CI: 0.05-0.62, vs OR = 0.93; 95% CI: 0.51–1.67 remembering school lessons, interaction p = 0.022). Parental education was associated with vaccination intention among students reporting a physician visit (OR = 0.41; 95% CI: 0.26–0.64 vs OR = 1.05; 95% CI: 0.50–2.20 without a visit, interaction p = 0.034).

Conclusion

Our results suggest that healthcare and school could promote vaccination and mitigate social inequalities in HPV vaccination coverage.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2023.28.46.2300166
2023-11-16
2024-12-26
/content/10.2807/1560-7917.ES.2023.28.46.2300166
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/28/46/eurosurv-28-46-4.html?itemId=/content/10.2807/1560-7917.ES.2023.28.46.2300166&mimeType=html&fmt=ahah

References

  1. Markowitz LE, Unger ER. Human papillomavirus vaccination. N Engl J Med. 2023;388(19):1790-8.  https://doi.org/10.1056/NEJMcp2108502  PMID: 37163625 
  2. Ministère de la santé et de la prévention (MDS). Calendrier des vaccinations et recommandations vaccinales 2023. [Vaccination calendar and vaccine recommendations 2023]. Paris: MDS. [Accessed: 15 Oct 2023]. French. Available from: https://sante.gouv.fr/IMG/pdf/calendrier_vaccinal_maj-juin23.pdf
  3. Nguyen-Huu N-H, Thilly N, Derrough T, Sdona E, Claudot F, Pulcini C, et al. Human papillomavirus vaccination coverage, policies, and practical implementation across Europe. Vaccine. 2020;38(6):1315-31.  https://doi.org/10.1016/j.vaccine.2019.11.081  PMID: 31836255 
  4. Hanguehard R, Gautier A, Soullier N, Barret AS, Parent du Chatelet I, Vaux S. Couverture vaccinale contre les infections à papillomavirus humain des filles âgées de 15 à 18 ans et determinants de vaccination, France, 2021. [Vaccination coverage against human papillomavirus infections in girls aged 15 to 18 and determinants of vaccination, France, 2021]. Bull Epidemiol Hebd (Paris). 2022;(24-25):446-55. French.
  5. Karafillakis E, Simas C, Jarrett C, Verger P, Peretti-Watel P, Dib F, et al. HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe. Hum Vaccin Immunother. 2019;15(7-8):1615-27.  https://doi.org/10.1080/21645515.2018.1564436  PMID: 30633623 
  6. Collange F, Fressard L, Pulcini C, Sebbah R, Peretti-Watel P, Verger P. General practitioners’ attitudes and behaviors toward HPV vaccination: A French national survey. Vaccine. 2016;34(6):762-8.  https://doi.org/10.1016/j.vaccine.2015.12.054  PMID: 26752063 
  7. Polonijo AN, Carpiano RM. Social inequalities in adolescent human papillomavirus (HPV) vaccination: a test of fundamental cause theory. Soc Sci Med. 2013;82:115-25.  https://doi.org/10.1016/j.socscimed.2012.12.020  PMID: 23337830 
  8. Blondel C, Barret AS, Pelat C, Lucas E, Fonteneau L, Lévy-Bruhl D. Influence des facteurs socioéconomiques sur la vaccination contre les infections à HPV chez les adolescentes en France. [Influence of socioeconomic factors on vaccination against HPV infections among adolescent girls in France]. Bull Epidemiol Hebd (Paris). 2019;(22-23):441-50. French.
  9. Herman R, McNutt L-A, Mehta M, Salmon DA, Bednarczyk RA, Shaw J. Vaccination perspectives among adolescents and their desired role in the decision-making process. Hum Vaccin Immunother. 2019;15(7-8):1752-9.  https://doi.org/10.1080/21645515.2019.1571891  PMID: 30735440 
  10. Cadeddu C, Castagna C, Sapienza M, Lanza TE, Messina R, Chiavarini M, et al. Understanding the determinants of vaccine hesitancy and vaccine confidence among adolescents: a systematic review. Hum Vaccin Immunother. 2021;17(11):4470-86.  https://doi.org/10.1080/21645515.2021.1961466  PMID: 34473589 
  11. Pelullo CP, Di Giuseppe G. Vaccinations among Italian adolescents: Knowledge, attitude and behavior. Hum Vaccin Immunother. 2018;14(7):1566-72.  https://doi.org/10.1080/21645515.2017.1421877  PMID: 29303677 
  12. Bocquier A, Michel M, Giraudeau B, Bonnay S, Gagneux-Brunon A, Gauchet A, et al. Impact of a school-based and primary care-based multicomponent intervention on HPV vaccination coverage among French adolescents: a cluster randomised controlled trial protocol (the PrevHPV study). BMJ Open. 2022;12(3):e057943.  https://doi.org/10.1136/bmjopen-2021-057943  PMID: 35332045 
  13. Rey G, Jougla E, Fouillet A, Hémon D. Ecological association between a deprivation index and mortality in France over the period 1997 - 2001: variations with spatial scale, degree of urbanicity, age, gender and cause of death. BMC Public Health. 2009;9(1):33.  https://doi.org/10.1186/1471-2458-9-33  PMID: 19161613 
  14. Strecher VJ, Champion VL, Rosenstock IM. The health belief model and health behavior. In: Gochman DS, editor. Handbook of health behavior research 1: Personal and social determinants. New York: Plenum Press; 1997. P. 71-91.
  15. Lai D, Bodson J, Davis FA, Lee D, Tavake-Pasi F, Napia E, et al. Diverse families’ experiences with HPV vaccine information sources: a community-based participatory approach. J Community Health. 2017;42(2):400-12.  https://doi.org/10.1007/s10900-016-0269-4  PMID: 27734247 
  16. Lee HY, Luo Y, Neese J, Daniel C, Hahm HC. The role of English proficiency in HPV and HPV vaccine awareness: a cross-sectional study across race/ethnicity. Asian Pac J Cancer Prev. 2021;22(2):349-57.  https://doi.org/10.31557/APJCP.2021.22.2.349  PMID: 33639647 
  17. Gilkey MB, McRee AL. Provider communication about HPV vaccination: A systematic review. Hum Vaccin Immunother. 2016;12(6):1454-68.  https://doi.org/10.1080/21645515.2015.1129090  PMID: 26838681 
  18. Leung SOA, Akinwunmi B, Elias KM, Feldman S. Educating healthcare providers to increase Human Papillomavirus (HPV) vaccination rates: A Qualitative Systematic Review. Vaccine X. 2019;3:100037.  https://doi.org/10.1016/j.jvacx.2019.100037  PMID: 31463471 
  19. López N, Garcés-Sánchez M, Panizo MB, de la Cueva IS, Artés MT, Ramos B, et al. HPV knowledge and vaccine acceptance among European adolescents and their parents: a systematic literature review. Public Health Rev. 2020;41(1):10.  https://doi.org/10.1186/s40985-020-00126-5  PMID: 32435520 
  20. Loke AY, Kwan ML, Wong YT, Wong AKY. The uptake of Human Papillomavirus vaccination and its associated factors among adolescents: a systematic review. J Prim Care Community Health. 2017;8(4):349-62.  https://doi.org/10.1177/2150131917742299  PMID: 29161946 
  21. Huon JF, Grégoire A, Meireles A, Lefebvre M, Péré M, Coutherut J, et al. Evaluation of the acceptability in France of the vaccine against papillomavirus (HPV) among middle and high school students and their parents. PLoS One. 2020;15(10):e0234693.  https://doi.org/10.1371/journal.pone.0234693  PMID: 33091021 
  22. López N, Garcés-Sánchez M, Panizo MB, de la Cueva IS, Artés MT, Ramos B, et al. HPV knowledge and vaccine acceptance among European adolescents and their parents: a systematic literature review. Public Health Rev. 2020;41(1):10.  https://doi.org/10.1186/s40985-020-00126-5  PMID: 32435520 
  23. Konstantinou P, Georgiou K, Kumar N, Kyprianidou M, Nicolaides C, Karekla M, et al. Transmission of vaccination attitudes and uptake based on social contagion theory: A scoping review. Vaccines (Basel). 2021;9(6):607.  https://doi.org/10.3390/vaccines9060607  PMID: 34198885 
  24. Maisonneuve AR, Witteman HO, Brehaut J, Dubé È, Wilson K. Educating children and adolescents about vaccines: a review of current literature. Expert Rev Vaccines. 2018;17(4):311-21.  https://doi.org/10.1080/14760584.2018.1456921  PMID: 29569498 
  25. Ortiz RR, Smith A, Coyne-Beasley T. A systematic literature review to examine the potential for social media to impact HPV vaccine uptake and awareness, knowledge, and attitudes about HPV and HPV vaccination. Hum Vaccin Immunother. 2019;15(7-8):1465-75.  https://doi.org/10.1080/21645515.2019.1581543  PMID: 30779682 
  26. Bruel S, Cochard J, Espinouse S, Frappé P. Revue de la littérature sur les interventions en milieu scolaire concernant la vaccination anti-HPV. Sante Publique. 2020;32(1):29-41.  https://doi.org/10.3917/spub.201.0029 
  27. Lefevere E, Theeten H, Hens N, De Smet F, Top G, Van Damme P. From non school-based, co-payment to school-based, free Human Papillomavirus vaccination in Flanders (Belgium): a retrospective cohort study describing vaccination coverage, age-specific coverage and socio-economic inequalities. Vaccine. 2015;33(39):5188-95.  https://doi.org/10.1016/j.vaccine.2015.07.088  PMID: 26254978 
  28. Musto R, Siever JE, Johnston JC, Seidel J, Rose MS, McNeil DA. Social equity in Human Papillomavirus vaccination: a natural experiment in Calgary Canada. BMC Public Health. 2013;13(1):640.  https://doi.org/10.1186/1471-2458-13-640  PMID: 23837819 
  29. Chyderiotis S, Sicsic J, Raude J, Bonmarin I, Jeanleboeuf F, Le Duc Banaszuk AS, et al. Optimising HPV vaccination communication to adolescents: A discrete choice experiment. Vaccine. 2021;39(29):3916-25.  https://doi.org/10.1016/j.vaccine.2021.05.061  PMID: 34088507 
  30. Ministère de la culture (MDC). Langues et usages des langues dans les consommations culturelles en France. [Languages and language usages in cultural consumption in France]. Paris: MDC; 13 Mar 2023. French. Available from: https://www.culture.gouv.fr/Thematiques/Etudes-et-statistiques/Publications/Collections-de-synthese/Culture-etudes-2007-2023/Langues-et-usages-des-langues-dans-les-consommations-culturelles-en-France-CE-2023-3
/content/10.2807/1560-7917.ES.2023.28.46.2300166
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error