scholarly journals Local authority variation in uptake of the HPV vaccine in Greater Manchester and school-level factors: a cross-sectional ecological study

2019 ◽  
Author(s):  
Steven L. Senior ◽  
Rebecca Fletcher ◽  
Paul Cleary ◽  
Siobhan Farmer
Keyword(s):  
Hpv Vaccine ◽  
Policy Development ◽  
Local Authority ◽  
Vaccine Coverage ◽  
Mixed Effects ◽  
Vaccine Uptake ◽  
School Level ◽  
Local Authorities ◽  
Cross Sectional ◽  
School Based

ABSTRACTBackgroundHuman papillomavirus (HPV) is the main cause of cervical cancer and contributes to a number of other cancers that affect both men and women. Vaccines exist that offer protection against the most common cancer-causing HPV types. In England, a school-based vaccination programme for girls has been in place since 2008 but vaccine coverage rates have declined since its introduction. Understanding variation between schools and between local authorities may help to inform quality improvement and guide policy development and commissioning.MethodsCross-sectional, ecological analysis of vaccine uptake among 164 schools representing 13,127 children in eight out of ten local authorities in Greater Manchester. Logistic mixed effects regression models were used to test for associations between school level factors and vaccine uptake, while allowing for variation between local authorities.ResultsIn multivariable mixed effects models, lower vaccination rates were associated with: increasing numbers of children eligible for vaccination; increasing proportions of children eligible for free school meals; increasing proportions of children with English as an additional language; Ofsted ‘inadequate’ ratings; Christian and Muslim faith schools; independent schools and special schools.ConclusionsConsistent with previous studies on vaccine uptake, this study identifies a number of factors that are associated with uptake of the school-based HPV vaccine programme. We also show that local authority variation remains after adjustment for the mix of schools in each area. This evidence may be used to guide vaccine providers, commissioners, and policymakers who want to increase uptake of the school-based HPV vaccine.

Social determinants of community-level human papillomavirus vaccination coverage in aschool-based vaccination programme

2018 ◽  
Vol 94 (4) ◽  
pp. 248-253 ◽  
Author(s):  
Stephen Jean ◽  
Malak Elshafei ◽  
Alison Buttenheim
Keyword(s):  
Socioeconomic Status ◽  
Human Papillomavirus ◽  
Vaccination Coverage ◽  
Vaccination Programme ◽  
Hpv Vaccine ◽  
Local Authority ◽  
Hpv Vaccination ◽  
Vaccine Uptake ◽  
Socioeconomic Indicators ◽  
Local Authorities

ObjectiveTo assess social patterns in human papillomavirus (HPV) vaccine coverage in a school-based, government-funded vaccination programme located within a single-payer universal healthcare system.DesignWe conducted a cross-sectional analysis of HPV vaccine uptake data for the 2013–2014 school year for 131 local authorities in England, and then evaluated the association between vaccine uptake and socioeconomic status at the aggregate level.Data sourcesHPV vaccination coverage data from Public Health England’s vaccine uptake guidance and the UK’s March 2011 Census.Main outcome measuresWe measured three-dose local authority-level vaccine series initiation to completion.ResultsWe found that in local authorities where there are more high-income families, the vaccination rate is lower than in local authorities with more low-income families. Local authorities with a higher percentage of whites, compared with non-whites, had higher HPV vaccination rates. Additionally, local authorities with more non-migrants had higher rates of vaccination. Local authorities with more education deprivation had higher rates of vaccination. Local authorities’ higher proportions of high-status occupations had worse vaccination coverage. In bivariate analyses across all the socioeconomic indicators, a 1 SD change in the indicators was associated with about a 2.25 percentage point decrease (for income, education and occupation) or increase (for race and migrant composition) in HPV dose coverage in the local authority. In multivariable analyses, only race remained as a significant predictor of HPV coverage at the local authority level.ConclusionsAcross all three doses, there are notable variations by socioeconomic status, with steep reverse gradients in three socioeconomic indicators. More quantitative and qualitative research needs to be conducted to determine the effects of the 2014 transition from a three-dose regimen to two-dose regimen on vaccination coverage, especially in groups that experience lower rates of vaccination.

scholarly journals Health System Factors Influencing Uptake of Human Papilloma Virus (Hpv) Vaccine Among Adolescent Girls 9-15 Years in Mbale District, Uganda

2019 ◽  
Author(s):  
JULIET NABIRYE ◽  
Okwi Livex Andrew ◽  
Rebecca Nuwematsiko ◽  
George Kiwanuka ◽  
Fiston Muneza ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health System ◽  
Hpv Vaccine ◽  
Health Workers ◽  
Vaccine Coverage ◽  
Cross Sectional Study ◽  
Vaccine Uptake ◽  
District Health ◽  
Cross Sectional ◽  
Adequate Information

Abstract Introduction Globally, cervical cancer is the fourth most common cancer in women with more than 85% of the burden in developing countries. In Uganda, cervical cancer has shown an increase of 1.8% per annum over the last twenty years. The availability of the Human Papillomavirus (HPV) vaccine presents an opportunity to prevent cervical cancer. Understanding how the health system influences uptake of the vaccine is critical to improve it. This study aimed to assess how the health systems is influencing uptake of HPV vaccine so as to inform policy for vaccine implementation and uptake in Mbale district, Eastern Uganda. Methods We conducted a cross sectional study of 407 respondents, selected from 56 villages. Six key informant interviews were conducted with District Health Officials involved in implementation of the HPV vaccine. Quantitative data was analyzed using Stata V.13. Prevalence ratios with their confidence intervals were reported. Qualitative data was audio recorded, transcribed verbatim and analyzed using MAXQDA V.12, using the six steps of thematic analysis developed by Braun and Clarke. Results 56 (14%) of 407 adolescents self-reported vaccine uptake. 182 (52.3%) of 348 reported lack of awareness about the HPV vaccine as the major reason for not having received it. Receiving vaccines from outreach clinics (p=0.02), having many options from which to receive the vaccine (p=0.02), getting an explanation on possible side-effects (p=0.024), and receiving the vaccine alongside other services (p=0.024) were positively associated with uptake. Key informants reported inconsistency in vaccine supply, inadequate training on HPV vaccine, and the lack of a clear target for HPV vaccine coverage as the factors that contribute to low uptake. Recommendation We recommend training of health workers to provide adequate information on HPV vaccine, raising awareness of the vaccine in markets, schools, and radio talk shows, and communicating the target to health workers. Conclusion Uptake of the HPV vaccine was lower than the Ministry of health target of 80%. We recommend more training of health workers to clearly provide adequate information on HPV vaccine, increasing awareness about the vaccine to the adolescents and reaching out to adolescents in and out of school for vaccination..

scholarly journals Health System Factors Influencing Uptake Of Human Papilloma Virus (Hpv) Vaccine Among Adolescent Girls 9-15 Years In Mbale District, Uganda

2019 ◽  
Author(s):  
JULIET NABIRYE ◽  
Okwi Livex Andrew ◽  
Rebecca Nuwematsiko ◽  
George Kiwanuka ◽  
Fiston Muneza ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health System ◽  
Hpv Vaccine ◽  
Health Workers ◽  
Vaccine Coverage ◽  
Cross Sectional Study ◽  
Vaccine Uptake ◽  
District Health ◽  
Cross Sectional ◽  
Adequate Information

Abstract Introduction Globally, cervical cancer is the fourth most common cancer in women with more than 85% of the burden in developing countries. In Uganda, cervical cancer has shown an increase of 1.8% per annum over the last twenty years. The availability of the Human Papillomavirus (HPV) vaccine presents an opportunity to prevent cervical cancer. Understanding how the health system influences uptake of the vaccine is critical to improve it. This study aimed to assess how the health systems is influencing uptake of HPV vaccine so as to inform policy for vaccine implementation and uptake in Mbale district, Eastern Uganda. Methods We conducted a cross sectional study of 407 respondents, selected from 56 villages. Six key informant interviews were conducted with District Health Officials involved in implementation of the HPV vaccine. Quantitative data was analyzed using Stata V.13. Prevalence ratios with their confidence intervals were reported. Qualitative data was audio recorded, transcribed verbatim and analyzed using MAXQDA V.12, using the six steps of thematic analysis developed by Braun and Clarke. Results 56 (14%) of 407 adolescents self-reported vaccine uptake. 182 (52.3%) of 348 reported lack of awareness about the HPV vaccine as the major reason for not having received it. Receiving vaccines from outreach clinics (p=0.02), having many options from which to receive the vaccine (p=0.02), getting an explanation on possible side-effects (p=0.024), and receiving the vaccine alongside other services (p=0.024) were positively associated with uptake. Key informants reported inconsistency in vaccine supply, inadequate training on HPV vaccine, and the lack of a clear target for HPV vaccine coverage as the factors that contribute to low uptake. Recommendation We recommend training of health workers to provide adequate information on HPV vaccine, raising awareness of the vaccine in markets, schools, and radio talk shows, and communicating the target to health workers. Conclusion Uptake of the HPV vaccine was lower than the Ministry of health target of 80%. We recommend more training of health workers to clearly provide adequate information on HPV vaccine, increasing awareness about the vaccine to the adolescents and reaching out to adolescents in and out of school for vaccination..

scholarly journals Factors associated with childhood influenza vaccination in Israel: a cross-sectional evaluation

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Aharona Glatman-Freedman ◽  
Kanar Amir ◽  
Rita Dichtiar ◽  
Hila Zadka ◽  
Ifat Vainer ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Vaccine Coverage ◽  
Population Group ◽  
Vaccine Uptake ◽  
Arab Population ◽  
Cross Sectional ◽  
Vaccine Acceptance ◽  
Factors Associated ◽  
Beneficial Effects

Abstract Background Vaccinating children against influenza has shown both direct and indirect beneficial effects. However, despite being offered free of charge, childhood influenza vaccine coverage in Israel has been low. Our objective was to evaluate the factors associated with childhood influenza vaccination in Israel. Methods A cross-sectional language-specific telephone survey was conducted among adults 18 years or older, to examine childhood influenza vaccination practices and their associations with socio-demographic and relevant health variables. We further explored the reasons for these practices among parents. Multivariate logistic regression was used to identify factors associated with childhood influenza vaccine acceptance. Results Of a total of 6518 individuals contacted by mobile phone, 1165 eligible parents, ≥18 years old with children 1–18 years of age, were interviewed, and 1040 of them completed the survey successfully. Overall, factors associated with childhood influenza vaccination were younger child’s age, influenza vaccination of other family members and belonging to the Arab population group. No association was found between childhood influenza vaccination and routine childhood vaccine uptake. Several of the parents’ reasons for vaccine acceptance - preventing influenza or its transmission, awareness regarding the need for influenza vaccination and receipt of invitation to get vaccinated - differed significantly between Jewish and Arab parents. Several reasons reported by parents for not vaccinating children against influenza, indicated a likelihood to accept influenza vaccine outreach efforts. Such reasons were reported by 27.5% of Jewish parents and 37.5% of Arab parents. Conclusions We found that certain demographic factors were associated with childhood influenza vaccination in Israel. Several reasons described by the parent for not vaccinating their children indicate that outreach efforts are likely to increase childhood influenza vaccination. Addressing population group-specific needs is recommended to optimize the success of influenza vaccine outreach efforts.

scholarly journals Knowledge of Healthcare Workers on Immunization: New and Under-utilized and Perception towards Future Vaccines

2019 ◽  
Vol 2 (4) ◽  
pp. 202-207
Author(s):  
AM Jibo ◽  
RS Karaye ◽  
AU Gajida ◽  
AA Abulfathi
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Health Workers ◽  
Vaccine Coverage ◽  
Sampling Technique ◽  
Vaccine Uptake ◽  
Good Knowledge ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Care Workers

Nigeria is making effort to address the child mortality burden by increasing vaccine coverage rates, yet the vaccine coverage falls short of 90% target. Scaling up of new and under-used vaccines to 90% coverage could save more than 600,000 Nigerian children. Healthcare givers knowledge of vaccine used for immunization is essential to increase the vaccine uptake rates. This study assesses the knowledge of routine, underutilized and future vaccines among health workers. A cross sectional descriptive study was done among health care workers at a tertiary health facility in Nigeria. Using a pre-tested semi structured interviewer administered questionnaire, 220 respondents were selected by cluster sampling technique. The health workers’ knowledge of these vaccines was assessed using a scale developed for the study. Data collected were analyzed using SPSS version 22.The mean age of the respondents was 31.9 + 5.7 years . Doctors and nurses formed more than half of the respondents, 51.8% (n=114). About three quarters of respondents 72.3% (n=159) had good knowledge of vaccines used in routine immunizations. Knowledge of under-utilized and future vaccine was low with less than a fifth 18.6% (n=41) and one tenth 9.1% (n=20) having good knowledge scores respectively. Similarly, poor perception scores of future vaccines were observed in 90.1% (n=218) of the respondents. Only marital status was associated with knowledge of underutilized vaccines (p<0.05) and no association was observed between other sociodemographic variables and knowledge of these vaccines (P>0.05). The awareness level of health care workers on routine immunization is high. Their knowledge and perception of under-utilized and future vaccines were however low. There is, therefore, need for more training and retraining of health care workers on the vaccines.

scholarly journals Introduction of human papillomavirus (HPV) vaccination in Belgium, 2007-2008

2009 ◽  
Vol 14 (46) ◽  
Author(s):  
C Simoens ◽  
M Sabbe ◽  
P Van Damme ◽  
P Beutels ◽  
M Arbyn
Keyword(s):  
Human Papillomavirus ◽  
Secondary School ◽  
Hpv Vaccine ◽  
Vaccine Coverage ◽  
Hpv Vaccination ◽  
Target Population ◽  
Hepatitis B Vaccination ◽  
First Year ◽  
Vaccine Introduction ◽  
School Based

This paper documents the progress of human papillomavirus (HPV) vaccine introduction in Belgium. Information on vaccine use is based on sales statistics and reimbursement claims. From November 2007 to November 2008, the National Institute for Health and Disability Insurance reimbursed the HPV vaccine for girls aged between 12-15 years. In December 2008, the age limit was extended to include girls up to the age of 18. In November 2008, the total number of HPV vaccines sold exceeded 530,000 doses. The number of vaccines reimbursed in Belgium, for the period November 2007-November 2008, corresponds to the amount required to fully vaccinate 44% of all girls aged between 12-15 years. However, the trend was decreasing over the last 10 months. By the current reimbursement policy, we can expect that maximum half of the target population can be reached. In Flanders (one of the three Communities in Belgium), the intention is to start, from September 2010, with a free school-based HPV immunisation for girls in the first year of secondary school (12 years of age), complemented with vaccination by a physician of choice. This strategy ensures a higher HPV vaccine coverage which is expected to be as high as the current coverage in the hepatitis B vaccination programme (approximately 80%) offered to boys and girls in the same age group and under the same circumstances.

scholarly journals 18. Association Between State-level Voting Patterns and Prior Receipt of the HPV Vaccine, an Analysis Using Data from the Behavioral Risk Factor Surveillance System 2016 – 2018

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S31-S32
Author(s):  
Maria A Corcorran ◽  
Ethan Valinetz ◽  
Abir Hussein ◽  
Alyson J Littman ◽  
Stephen E Hawes
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccine ◽  
Surveillance System ◽  
Vaccine Coverage ◽  
Strong Association ◽  
Hpv Vaccination ◽  
State Level ◽  
Vaccine Uptake ◽  
Behavioral Risk ◽  
Pharyngeal Cancer

Abstract Background Human papillomavirus (HPV) is the main cause of cervical, anal and oro-pharyngeal cancer worldwide. The HPV vaccine can prevent over 90% of HPV-related malignancies but vaccination rates in the United State (US) vary significantly by region. In this study, we assessed whether state-level politics is associated with receipt of HPV vaccination in the US, and if the association is modified by sex and age. Methods This study analyzed data from the Center for Disease Control and Prevention’s (CDC) Behavioral Risk Factors Surveillance System (BRFSS) survey. Persons ages 18 to 36 years of age, who lived in 17 states that included the supplementary “Adult Human Papillomavirus (HPV)” module questionnaire in 2016, 2017 or 2018, were included. We compared self-reported receipt of HPV vaccination among persons living in Republican versus Democratic states, based on state electoral college votes in the 2016 US presidential election. Mantel-Haenszel stratified analysis was used to estimate prevalence ratios and to assess for effect modification and control for confounding. Results Overall, 36,334 survey respondents were included in the analysis, 22.7% of whom reported prior receipt of the HPV vaccine, 28.1% in Democratic states and 20.4% in Republican states. When adjusted for race, living in a Democratic state was associated with a higher prevalence of prior receipt of the HPV vaccine in comparison to living in a Republican state. This association was strongest for men less than 26 years of age (PR 1.77, 95% CI: 1.58, 1.98) but remained significant for men ages 26 – 36 years (PR 1.51, 95% CI: 1.24, 1.85), women less than 26 years of age (PR 1.20, 95% CI: 1.13, 1.27), and women ages 26 – 36 years (PR 1.69, 95% CI: 1.57, 1.83). Conclusion Overall HPV vaccine coverage was low in adults 18–36 years of age. The strong association between state-level voting patterns and prior receipt of the HPV vaccine suggests that HPV vaccine coverage is lower in Republican states when compared to Democratic states. Further public health efforts are needed to promote HPV vaccine uptake among young men and women, particularly in Republican voting states. Disclosures All Authors: No reported disclosures

scholarly journals Do parental education and income matter? A nationwide register-based study on HPV vaccine uptake in the school-based immunisation programme in Norway

BMJ Open ◽  
2015 ◽  
Vol 5 (5) ◽  
pp. e006422-e006422 ◽  
Author(s):  
B. Feiring ◽  
I. Laake ◽  
T. Molden ◽  
I. Cappelen ◽  
S. E. Haberg ◽  
...  
Keyword(s):  
Hpv Vaccine ◽  
Parental Education ◽  
Immunisation Programme ◽  
Vaccine Uptake ◽  
School Based ◽  
Hpv Vaccine Uptake

scholarly journals Characteristics associated with COVID-19 vaccine uptake among adults in England (08 December to 17 May 2021)

2021 ◽  
Author(s):  
Elise Tessier ◽  
Yuma Rai ◽  
Eleanor Clarke ◽  
Anissa Lakhani ◽  
Camille Tsang ◽  
...  
Keyword(s):  
Vaccine Coverage ◽  
Care Home ◽  
Cross Sectional Study ◽  
Vaccine Uptake ◽  
Cross Sectional ◽  
Black African ◽  
National Immunisation ◽  
Tailored Interventions ◽  
Programme Design ◽  
African Caribbean

Objective: To determine characteristics associated with COVID-19 vaccine coverage among individuals aged 50 years and above in England since the beginning of the programme. Design: Observational cross-sectional study assessed by logistic regression and mean prevalence margins. Setting: COVID-19 vaccinations delivered in England from 08 December 2020 to 17 May 2021. Participants: 30,624,257/ 61,967,781 (49.4%) and 17,360,045/ 61,967,781 (28.1%) individuals in England were recorded as vaccinated in the National Immunisation Management System with a first dose and a second dose of a COVID-19 vaccine, respectively. Interventions: Vaccination status with COVID-19 vaccinations. Main Outcome Measures: Proportion, adjusted odds ratios and mean prevalence margins for individuals not vaccinated with dose 1 among those aged 50- 69 years old and dose 1 and 2 among those aged 70 years old and above. Results: Among individuals aged 50 years and above, Black/African/Caribbean ethnic group was the least likely of all ethnic groups to be vaccinated with dose 1 of the COVID-19 vaccine. However, among those aged 70 years and above, the odds of not having dose 2 was 5.53 (95% CI 5.42 to 5.63) and 5.36 (90% CI 5.29 to 5.43) greater among Pakistani and Black/African/Caribbean compared to White British ethnicity, respectively. The odds of not receiving dose 2 was 1.18 (95% CI 1.16 to 1.20) higher among individuals who lived in a care home compared to those who did not. This was the opposite to that observed for dose 1, where the odds of not being vaccinated was significantly higher among those not living in a care home (0.89 (95% CI 0.87 to 0.91)). Conclusions: We found that there are characteristics associated with low COVID-19 vaccine coverage. Inequalities, such as ethnicity are a major contributor to suboptimal coverage and tailored interventions are required to improve coverage and protect the population from SARS-CoV-2.

scholarly journals Healthcare Students' Flu Vaccine Uptake in the Last 5 Years and Future Vaccination Acceptance: Is There a Possible Association?

2020 ◽  
Vol 20 (2) ◽  
pp. e00474-e00474
Author(s):  
Paola Cella ◽  
Matteo D’Angelo ◽  
Giulia Dallagiacoma ◽  
Sandro Provenzano ◽  
Omar Enzo Santangelo ◽  
...  
Keyword(s):  
Regression Model ◽  
Vaccine Coverage ◽  
Multinomial Logistic Regression ◽  
Vaccine Uptake ◽  
Relative Risk Ratio ◽  
P Value ◽  
Cross Sectional ◽  
Healthcare Students ◽  
Flu Vaccination ◽  
Vaccination Acceptance

Background: Despite the free-of-charge offer of influenza vaccines to at-risk subgroups, vaccine coverage remains low and far from the target, probably due to the false myths and misperceptions. We aimed to explore the healthcare students’ vaccination behavior and beliefs to find any association between vaccination uptake during the last 5 years and future vaccination acceptance. Study design: A multicentre cross-sectional study. Methods: From Oct 2017 to Nov 2018, the Italian healthcare students from 14 different universities in 2017/2018 were enrolled, through an online and anonymous questionnaire previously validated. Absolute and relative frequencies were calculated and Pearson's Chi-square test was used. A multinomial logistic regression model was performed. Results are expressed as relative Risk Ratio (RR) with 95% Confidence Intervals (95% CI). The level of significance chosen was P-value <0.05. Results: A total of 3137 students were enrolled and 3131 questionnaires were analysed. 82.7% of the sample declared they had not received any flu vaccination during the last 5 years. Students who received flu vaccination 4 times or more during the last 5 years were more likely to do it again next year as well (95.1% vs 4.9%). The regression model showed that having received flu vaccination over the last 5 years was statistically associated with the intention of getting vaccinated during next season. Conclusions: Frequency of flu vaccination is predictive for future acceptance among healthcare students. This association could have both implications for the organization of vaccination campaigns and improve educational strategies for this category of students.

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