Elsevier

Vaccine

Volume 33, Issue 20, 11 May 2015, Pages 2387-2394
Vaccine

Factors related to vaccine uptake by young adult women in the catch-up phase of the National HPV Vaccination Program in Australia: Results from an observational study

https://doi.org/10.1016/j.vaccine.2015.01.024Get rights and content
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open access

Highlights

  • HPV vaccination in Australia commenced in 2007, and included vaccination of 12–13 year old girls at school and a catch-up for females aged 12–26 years. The catch-up was delivered through schools, general practices and community-based programs.

  • Women 18–26 years of age vaccinated in the Australian catch-up program have yet to be fully characterized in terms of their socio-demographic, clinical and behavioural profiles.

  • Young adult women vaccinated in the catch-up were more likely to be Australian-born, nulliparous, single and living in higher socioeconomic status areas than unvaccinated women.

  • Vaccinated women had fewer sexual partners but also reported factors associated with potentially increased risk of prior HPV exposure, such as a history of sexually transmitted infections.

  • Although the vaccination catch-up program in Australia has been very effective, the findings reinforce the continuing need to prioritise equitable delivery of vaccination to various population subgroups.

Abstract

Background

Australia commenced a publically-funded, National Human Papillomavirus (HPV) Vaccination Program in 2007 with a two year catch-up phase for females aged 12–26 years.

Objective

To identify the factors associated with the uptake of the HPV vaccine (which has a recommended 3-dose schedule in Australia) by young adult women vaccinated by general practitioners and community-based programs within the catch-up phase.

Methods

1139 women who were eligible to receive the free HPV vaccine during the catch-up period were recruited in 2008–2009 (age 20–29 years at recruitment), in New South Wales, after having a normal (negative) cervical smear result recorded on the NSW Pap Test Register. Participants completed a self-administered questionnaire providing information on vaccination status, and sociodemographic and other factors.

Results

Overall, 880 (77%) women reported receiving ≥1 dose of the vaccine and 777 women (68%) reported receiving ≥2 doses. In multivariable analysis (adjusting for the period for which each woman was eligible for free HPV vaccination), uptake of ≥1 dose of the vaccine was significantly associated with being born in Australia (p < 0.01), being single (p = 0.02), being nulliparous (p < 0.01), living in a higher socioeconomic status area (p-trend = 0.03), living in more remote areas (p = 0.03), drinking alcohol (p < 0.01) and using hormonal contraceptives (p < 0.01). Although vaccinated women were more likely to have fewer sexual partners than unvaccinated women (p-trend = 0.02), they were also more likely to report a prior sexually transmitted infection (STI) (p = 0.03). Similar factors were associated with receiving ≥2 doses.

Conclusions

In this group, women living in higher socioeconomic status areas were more likely to be vaccinated against HPV in the catch-up phase of the national program. Although vaccinated women tended to have fewer sexual partners, they also reported prior STIs, which may be a marker of increased risk of prior exposure to HPV. The findings of this study reinforce the continuing need to prioritise equitable delivery of vaccination to various population subgroups.

Keywords

HPV vaccine
Sexual behaviour
Inequality
Cervical smears
Socioeconomic status

Abbreviations

GP
general practitioner
PTR
Pap Test Register
SES
socioeconomic status
STI
sexually transmitted infections

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