Factors associated with seasonal influenza and HPV vaccination uptake among different ethnic groups in Arab and Jewish society in Israel

Abstract Background Parents in the Arab population of Israel are known to be “pro-vaccination” and vaccinate their children at higher rates than the Jewish population, specifically against human papilloma virus (HPV) and seasonal influenza. Objectives This study seeks to identify and compare variables associated with mothers’ uptake of two vaccinations, influenza and HPV, among different subgroups in Arab and Jewish society in Israel. Methods A cross-sectional study of the entire spectrum of the Israeli population was conducted using a stratified sample of Jewish mothers (n = 159) and Arab mothers (n = 534) from different subgroups: Muslim, Christian, Druse and Northern Bedouins. From March 30, 2019 through October 20, 2019, questionnaires were distributed manually to eighth grade pupils (13–14 years old) who had younger siblings in second (7–8 years old) or third (8–9 years old) grades. Results Arab mothers exhibited a higher rate of uptake for both vaccinations (p < .0001, HPV – 90%; influenza – 62%) than Jewish mothers (p = 0.0014, HPV – 46%; influenza – 34%). Furthermore, results showed that HPV vaccination uptake is significantly higher than seasonal influenza vaccination uptake in both populations. Examination of the different ethnic subgroups revealed differences in vaccination uptake. For both vaccinations, the Northern Bedouins exhibited the highest uptake rate of all the Arab subgroups (74%), followed by the Druse (74%) and Muslim groups (60%). The Christian Arab group exhibited the lowest uptake rate (46%). Moreover, the uptake rate among secular Jewish mothers was lower than in any of the Arab groups (38%), though higher than among religious/traditional Jewish mothers, who exhibited the lowest uptake rate (26%). A comparison of the variables associated with mothers’ vaccination uptake revealed differences between the ethnic subgroups. Moreover, the findings of the multiple logistic regression revealed the following to be the most significant factors in Arab mothers’ intake of both vaccinations: school-located vaccination and mothers’ perceived risk and perceived trust in the system and in the family physician. These variables are manifested differently in the different ethnic groups. Conclusions This research shows that all Arabs cannot be lumped together as one monolithic group in that they exhibit major differences according to religion, education and access to information. Ranking of variables associated with uptake of the two vaccines can provide decision-makers an empirical basis for tailoring appropriate and specific interventions to each subgroup to achieve the highest vaccine uptake rate possible. Media campaigns targeting the Arab population should be segmented to appeal to the various sub-groups according to their viewpoints, needs and health literacy.

Download Full-text

Knowledge, Attitude, and Barriers Influencing Seasonal Influenza Vaccination Uptake

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2020/7653745 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Mazin A. Barry ◽

Khalid I. Aljammaz ◽

Abdulaziz A. Alrashed

Keyword(s):

Saudi Arabia ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Seasonal Influenza ◽

Well Being ◽

Influenza Viruses ◽

Vaccine Uptake ◽

Severe Illness ◽

Seasonal Influenza Vaccination ◽

Vaccination Uptake

Background. Seasonal influenza is an acute respiratory infection caused by influenza viruses that are highly contagious and circulate in all parts of the world. It gives rise to an estimated 3 to 5 million cases of severe illness and about 250,000 to 500,000 deaths globally each year. Influenza tends to cause epidemics with serious illness and death among high-risk groups such as children aged 5 years and younger, pregnant women, elderly ≥65 years of age, and with chronic medical conditions. According to the Centers for Disease Prevention and Control (CDC), all people who are 6 months old and above are recommended to receive the seasonal influenza vaccine annually. Despite the fact that influenza vaccine is readily available, and the severity of the disease is known to adversely affect the individual’s quality of life and well-being, vaccination uptake rates are still low, contributing to the increased burden of the disease worldwide. Objectives. To measure the influenza vaccine uptake among residents of Riyadh Province, Saudi Arabia, that determines their attitude, knowledge, and beliefs regarding the vaccine. Methods. A cross-sectional study was conducted using a self-administered structured questionnaire distributed online targeting residents of Riyadh Province, Saudi Arabia, from 1st of August 2019 till 30th of September 2019. Participants were selected through volunteer sampling. The questionnaire included demographic data including age, gender, occupation, education level, marital status, and comorbidities. It also included questions regarding knowledge, attitude, and beliefs regarding influenza vaccine. After collection of data, statistical analyses were conducted by using Statistical Package for Social Sciences (SPSS) version 19.0. A P value of <0.05 was considered statistically significant. Results. Our study included 503 participants, with age ranging from 18 to 65 years old and 324 (64%) were females. 100 participants (19.9%) had comorbid conditions, and 223 (44.3%) have been vaccinated against influenza in the past. A large portion of participants (41.2%) were familiar with seasonal influenza vaccination from the media. The knowledge part of the questionnaire showed that 302 (60%) participants knew how often they should receive the vaccine and 313 (62.2%) participants knew that the vaccine is provided freely in all of Saudi Arabia. In terms of belief and attitude, 371 participants (73.8%) thought they were susceptible to the disease and 365 (73.8%) believed that influenza vaccine is beneficial, while 446 participants (88.7%) thought that the general public need more knowledge and awareness on the scientific facts of influenza vaccine. Regarding barriers, 295 participants (58.6%) wanted to avoid vaccines and 252 (50.1%) were concerned about the vaccine’s adverse effects. Participants with frequent health checkups and those who had previous knowledge on the availability of the vaccine for free were more likely to be vaccinated. Vaccinated participants (44.3%) were asked if they were willing to take the vaccine again when it is due, 158 (70.9%) answered yes. Those who elicited symptomatic reaction to the vaccine (26.0%) were less inclined to take it again P = 0.035 . Conclusion. We concluded that there is a low influenza vaccine uptake rate among our study population, considering that the barriers most commonly chosen by participants are solvable with health education and campaigns oriented towards delivering facts about the vaccine and dispelling misinformation; such measures are highly recommended and are postulated to carry a great benefit that should target common misconceptions identified in this study.

Download Full-text

The role of health determinants in the influenza vaccination uptake among older adults (65+): a scope review

Aging Clinical and Experimental Research ◽

10.1007/s40520-021-01793-3 ◽

2021 ◽

Author(s):

Regina Roller-Wirnsberger ◽

Sonja Lindner ◽

Lea Kolosovski ◽

Elisabeth Platzer ◽

Peter Dovjak ◽

...

Keyword(s):

Older Adults ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Seasonal Influenza ◽

Vaccine Uptake ◽

Health Determinants ◽

Bibliographic Databases ◽

Factors Affecting ◽

Vaccination Uptake

Abstract Background Although the burden of influenza infection is the highest in older adults, vaccination coverage remains low, despite this age group being more vulnerable than others. Aims Given the current pandemic of SARS-CoV-2, it was the aim of this scope review to update knowledge on factors affecting seasonal influenza vaccine uptake among older adults to strengthen prevention approaches in the context of an overall burden of infectious diseases. Methods We searched bibliographic databases from 2012 to 2019. All studies reviewed one or more social determinant of health listed by WHO, or factors affecting the decision-making process whether to accept influenza vaccine or not. Results Overall, 44 studies were included, 41 determinants were extracted and summarized into six categories. Older age and constitutional factors including multiple chronic diseases as well as preventive lifestyle and frequent routine healthcare utilization positively affected vaccination uptake (VU). Living and working conditions are also researched determinants of influenza vaccine uptake. A small number of studies explored the role of social inclusion and system-based interventions. Discussion and conclusions This scope review provides a comprehensive overview on factors affecting seasonal influenza vaccination uptake among older citizens. The review also clearly shows gaps for evidence on system-based level or political strategies to improve vaccination uptake.

Download Full-text

Nurses’ and teachers’ perceived barriers and facilitators to the uptake of the Human Papilloma Virus (HPV) vaccination program in Iquitos, Peru: A qualitative study

PLoS ONE ◽

10.1371/journal.pone.0255218 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0255218

Author(s):

Anna Clavé Llavall ◽

Gilles de Wildt ◽

Graciela Meza ◽

Jasmine Tattsbridge ◽

Laura Jones

Keyword(s):

Cervical Cancer ◽

Community Education ◽

Ecological Model ◽

Hpv Vaccination ◽

Barriers And Facilitators ◽

Vaccine Uptake ◽

Vaccination Program ◽

Papilloma Virus ◽

Vaccination Uptake ◽

Depth Interviews

Globally, over 300,000 women die of cervical cancer annually. Given that human papillomavirus vaccines are highly effective in the primary prevention of cervical cancer, it is important to explore the barriers and facilitators to vaccination uptake in areas where the burden of disease remains high. This study, informed by the socio-ecological model, aimed to qualitatively explore vaccination uptake via in-depth interviews with eleven nurses and ten teachers involved in vaccine delivery in Iquitos, Peru. The results highlighted that vaccine uptake was influenced by multiple factors including individuals’ knowledge and attitudes, community beliefs, geography, and policy level variables. Findings suggested that professionals were informed and supportive of the HPV vaccination program but perceived that parents were uninformed about the vaccine. There is a need for community education programs, for a revision of the process of obtaining parental consent, for improved communication between professionals and for involvement of grassroots staff in policy making.

Download Full-text

The role of health determinants in the influenza vaccination uptake among older adults (65+): a scope review

10.21203/rs.3.rs-84732/v1 ◽

2020 ◽

Author(s):

Regina Roller-Wirnsberger ◽

Sonja Lindner ◽

Lea Kolosovski ◽

Elisabeth Platzer ◽

Peter Dovjak ◽

...

Keyword(s):

Older Adults ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Seasonal Influenza ◽

Vaccine Uptake ◽

Health Determinants ◽

Bibliographic Databases ◽

Factors Affecting ◽

Vaccination Uptake

Abstract Background: Although the burden of influenza infection is the highest in older adults, vaccination coverage remains low, despite this age group being more vulnerable than others. Aims: Given the current pandemic of SARS-CoV-2, it was the aim of this scope review to update knowledge on factors affecting seasonal influenza vaccine uptake among older adults in order to strengthen prevention approaches in the context of an overall burden of infectious diseases.Methods: We searched bibliographic databases from 2012 to 2019. All studies reviewed one or more social determinant of health listed by WHO, or factors affecting the decision-making process whether to accept influenza vaccine or not.Results: Overall, 44 studies were included, 41 determinants were extracted and summarized into six categories. Older age and constitutional factors including multiple chronic diseases as well as preventive lifestyle and frequent routine healthcare utilization positively affected vaccination uptake (VU). Living and working conditions are also researched determinants of influenza vaccine uptake. A small number of studies explored the role of social inclusion and system-based interventions. Discussion and Conclusions: This scope review provides a comprehensive overview on factors affecting seasonal influenza vaccination uptake among older citizens. The review also clearly shows gaps for evidence on system-based level or political strategies to improve vaccination uptake.

Download Full-text

Longitudinal uptake of the human papillomavirus vaccine among gay, bisexual and other men who have sex with men in British Columbia, Canada 2012–2019

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054871 ◽

2021 ◽

pp. sextrans-2020-054871

Author(s):

Jatinder Khatra ◽

Jordan Mitchell Sang ◽

Clara Wang ◽

Nicanor Bacani ◽

Nathan John Lachowsky ◽

...

Keyword(s):

British Columbia ◽

Human Papillomavirus ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Mixed Effects ◽

Vaccine Uptake ◽

Transmitted Infection ◽

Vaccination Uptake ◽

Gay Community ◽

Sex With Men

ObjectivesIn 2015, a publicly funded human papillomavirus (HPV) vaccination programme was implemented for gay, bisexual and other men who have sex with men (gbMSM) up to age 26 years in British Columbia, Canada. We assessed trends and correlates of HPV vaccine uptake from 2012 to 2019 in a cohort of gbMSM in Vancouver.MethodsWe recruited sexually active gbMSM aged ≥16 years using respondent-driven sampling from February 2012 to February 2015 and followed them until July 2019. We evaluated self-reported HPV vaccine trends using mixed-effects logistic regression and identified factors associated with uptake using multivariable mixed-effects Poisson regression.ResultsA total of 719 participants were recruited and completed the baseline visit, of whom 549 were unvaccinated with at least one follow-up visit. The median age was 33 years and 23% were living with HIV. HPV vaccination increased from 4% in 2012 to 28% in 2019 (p<0.001) among gbMSM >26 years, and from 9% in 2012 to 20% in 2017 (p<0.001) among gbMSM ≤26 years. Vaccination uptake increased after September 2015, following vaccination policy expansion (adjusted rate ratio (aRR)=1.82, 95% CI 1.06 to 3.12). In multivariable models, increased vaccination was associated with age ≤26 years vs ≥45 years (aRR=3.90; 95% CI 1.75 to 8.70), age 27–44 vs ≥45 years (aRR=2.86; 95% CI 1.46 to 5.62), involvement in gay community sports teams (aRR=2.31; 95% CI 1.15 to 4.64) and other groups (aRR=1.71; 95% CI 1.04 to 2.79), awareness of HIV-postexposure prophylaxis (aRR=5.50; 95% CI 1.31 to 23.09), recent sexually transmitted infection testing (aRR=2.72; 95% CI 1.60 to 4.60) and recent sex-work (aRR=2.59; 95% CI 1.08 to 6.19).ConclusionsAlthough we observed increases in HPV vaccination uptake from 2012, by 2019 HPV vaccination still remained below 30% among gbMSM in Vancouver, BC. Additional interventions are needed to increase vaccine uptake.

Download Full-text

A Rapid Systematic Review of Factors Influencing COVID-19 Vaccination Uptake in Minority Ethnic Groups in the UK

Vaccines ◽

10.3390/vaccines9101121 ◽

2021 ◽

Vol 9 (10) ◽

pp. 1121

Author(s):

Atiya Kamal ◽

Ava Hodson ◽

Julia M. Pearce

Keyword(s):

Ethnic Groups ◽

Grey Literature ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Vaccination Uptake ◽

Factors Influencing ◽

Minority Ethnic Groups ◽

Reported Data ◽

The Uk ◽

Minority Ethnic

COVID-19 has disproportionately affected minority ethnic groups in the United Kingdom. To maximise the effectiveness of the vaccination programme, it is important to understand and address disparities in vaccine uptake. The aim of this review was to identify factors influencing COVID-19 vaccination uptake between minority ethnic groups in the UK. A search was undertaken in peer-reviewed databases, polling websites and grey literature from January 2020–May 2021. Studies were included if they reported data on vaccine uptake or the reasons for or against accepting the COVID-19 vaccination for minority ethnic groups in the UK. Twenty-one papers met the inclusion criteria, all of which were rated as either good or moderate quality. Ethnic minority status was associated with higher vaccine hesitancy and lower vaccine uptake compared with White British groups. Barriers included pre-existing mistrust of formal services, lack of information about the vaccine’s safety, misinformation, inaccessible communications, and logistical issues. Facilitators included inclusive communications which address vaccine concerns via trusted communicators and increased visibility of minority ethnic groups in the media. Community engagement to address the concerns and informational needs of minority ethnic groups using trusted and collaborative community and healthcare networks is likely to increase vaccine equity and uptake.

Download Full-text

Factors associated with HPV vaccination uptake in Central Uganda

East African Journal of Science, Technology and Innovation ◽

10.37425/eajsti.v1i4.185 ◽

2020 ◽

Vol 1 (4) ◽

Author(s):

Alone Isabirye ◽

JohnBosco Asiimwe ◽

Martin Mbonye

Keyword(s):

Birth Order ◽

Rural Areas ◽

Hpv Vaccination ◽

Wealth Index ◽

Vaccine Uptake ◽

Cross Sectional Survey ◽

Targeted Interventions ◽

Hpv Knowledge ◽

Vaccination Uptake ◽

Factors Associated

The burden of cervical cancer in Uganda is high yet uptake of HPV vaccination is low. Identification of child and mother factors associated with HPV vaccination are important for targeted interventions however, this problem has not been well investigated. The aim of the study was to determine the prevalence of HPV vaccine uptake and associated factors among the10 to 17-year-old girls in Central Uganda four years after rolling out the vaccine in the country. The cross-sectional survey was done in Wakiso and Nakasongola districts in Central Uganda. A total of 503 girls participated in the study. Logistic regression analyses were done to establish the relationship between vaccination status and socio-demographic characteristics of the girls and their mothers. HPV vaccination uptake was generally low (39.4%) in central Uganda and significantly associated with; mothers’ education attainment, HPV knowledge, mothers’ age, religion, wealth index, type of residence, birth order and schooling status. There were reduced odds of HPV vaccination among Pentecostal girls [OR=0.44; (95% CI: 0.21-0.90), p=0.025)] and rural dwelling girls [OR=0.24 (95% CI: 0.16-0.37), P=0.016)]. The likelihood of vaccination was higher among girls; of birth order three [OR=2.45 (95% CI: 1.25-4.82), P=0.029)], who were schooling [OR=2.73 (95% CI: 1.12-6.63), P=0.027)], with high wealth index [OR= 2.31 (95% CI: 1.12-4.76), P=0.024)], living with mothers with high HPV knowledge [OR= 2.26 (95% CI: 1.41-3.61), P=0.001)], and whose mothers were aged 30-39 years [OR= 2.44 (95% CI: 1.07-5.59), P=0.034)]. Both child and mother characteristics showed a marked impact on HPV vaccination. Strategies like creation of awareness should target girls: in rural areas, not schooling, with lower social economic status, living with women below 29 years, of lower birth orders, and living with less knowledgeable women; and involving religious leaders in programs should be embraced in order to achieve high vaccination uptake.

Download Full-text

OP151 Cost-Utility Of Gender-Neutral HPV Vaccination In Ireland

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462319001727 ◽

2019 ◽

Vol 35 (S1) ◽

pp. 34-34

Author(s):

Conor Teljeur ◽

Eamon O Murchu ◽

Patricia Harrington ◽

Mairin Ryan

Keyword(s):

Cost Effectiveness ◽

Uptake Rate ◽

Hpv Vaccination ◽

Cost Effective ◽

Cost Utility ◽

Vaccine Uptake ◽

Economic Evaluations ◽

Uptake Rates ◽

Gender Neutral ◽

The Cost

IntroductionA number of economic evaluations of gender-neutral human papillomavirus (HPV) vaccination have been published, generally finding that the cost-effectiveness is sensitive to the uptake rate in girls. In Ireland there is a girls-only program in place, but the initial high uptake rate (>85 percent) was substantially impacted by high profile negative publicity concerning perceived vaccine safety issues. Efforts to address perceived safety concerns have recently yielded a partial recovery in uptake rates. The aim of this study was to estimate the cost-utility of extending the program to include boys and explore the impact of fluctuating uptake rates.MethodsA previously published cost-utility model used in the United States of America and Norway was adapted to the Irish setting and populated with Irish epidemiological and cost data. Comparators included no vaccination, and girls-only and gender-neutral vaccination, both with either a 4-valent or 9-valent vaccine. Vaccination is at age 12 years and oropharyngeal and penile cancers were excluded in the base case analysis. Additional analyses were used to incorporate fluctuating uptake rates into the model.ResultsA 9-valent girls-only program dominated the existing girls-only 4-valent program. The incremental cost-effectiveness ratio (ICER) for a gender-neutral 9-valent program was EUR 50,823/quality-adjusted life year (QALY). Gender-neutral vaccination would be cost-effective at a willingness-to-pay threshold of EUR 45,000/QALY when the uptake rate is below 78 percent. The ICER decreased to between EUR 41,000 and EUR 42,000/QALY when the uptake rate was allowed to fluctuate across six to 12 yearly cycles.ConclusionsThe cost-effectiveness of gender-neutral HPV vaccination is highly sensitive to the assumed uptake rate in girls. Large fluctuations in HPV vaccine uptake rates have been observed in a number of countries in the last decade. Incorporating fluctuating uptake rates in the model shows that a gender-neutral program may be more cost-effective than when a stable uptake is assumed.

Download Full-text

Determinants of HPV-vaccination uptake and subgroups with a lower uptake in the Netherlands

BMC Public Health ◽

10.1186/s12889-021-11897-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

A. C. de Munter ◽

T. M. Schurink-van t Klooster ◽

A. van Lier ◽

R. Akkermans ◽

H. E. de Melker ◽

...

Keyword(s):

The Netherlands ◽

Hpv Vaccine ◽

Social Economic ◽

Hpv Vaccination ◽

Vaccine Uptake ◽

Birth Cohorts ◽

Immunization Program ◽

Vaccination Uptake ◽

Cultural Determinants ◽

Hpv Vaccine Uptake

Abstract Background In the Netherlands, the HPV-vaccine uptake was 52% during the 2009 catch-up campaign (birth cohorts 1993–1996). This increased to 61% in the regular immunization program (birth cohorts 2000–2001). However for birth cohorts 2003–2004 the uptake declined to 45.5%. With this study we aimed to gain insight into social, economic and cultural determinants that are associated with HPV-vaccination uptake and which subgroups with a lower HPV-vaccination uptake can be identified. In addition, we investigated whether the influence of these factors changed over time. Methods To study the determinants of HPV-vaccine uptake we performed a database study using different aggregation levels, i.e. individual level, postal code level and municipality level. All Dutch girls who were invited for HPV-vaccination through the National Immunization Program in the years 2012, 2014 and 2017 (i.e. birth cohorts 1999, 2001 and 2004, respectively) were included in the study population. We conducted multilevel logistic regression analyses to analyze the influence of the determinants on HPV-vaccination uptake, taking into account that the delivery of HPV-vaccine was nested within municipalities. Results Results showed that in particular having not received a MMR-vaccination, having one or two parents born in Morocco or Turkey, living in an area with lower socioeconomic status and higher municipal voting proportions for Christian political parties or populist parties with liberal-conservative views were associated with a lower HPV-vaccination uptake. Besides some changes in political preferences of the population and changes in the association between HPV uptake and urbanization level we found no clear determinants which could possibly explain the decrease in the HPV-vaccination uptake. Conclusions In this study we identified current social, economic and cultural determinants that are associated with HPV-vaccination uptake and which low-vaccination subgroups can be identified. However, no clear determinants were found which could explain the decrease in the HPV-vaccination uptake. Tailored information and/or consultation for groups that are associated with a lower HPV-vaccination uptake might help to increase the HPV-vaccination uptake in the future.

Download Full-text

Online vaccine-related information-seeking in mothers and HPV vaccine uptake in their daughters

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1254 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

F Dib ◽

P Mayaud ◽

L Longfier ◽

O Launay

Keyword(s):

Hpv Vaccine ◽

Internet Use ◽

Hpv Vaccination ◽

Vaccine Uptake ◽

Outcome Variable ◽

The Internet ◽

Sources Of Information ◽

Vaccination Uptake ◽

Related Information ◽

Online Sources

Abstract Background There is widespread concern about online vaccine misinformation. The aim of this study was to investigate the association between seeking vaccine-related information on the Internet and HPV vaccination uptake. Methods Data were obtained from the 2015, 2016, 2017 and 2018 Vaccinoscopie® studies, a pluriannual web-based survey conducted on a nationally representative quota sample of mothers to monitor the dynamics of vaccine coverage, perception and attitudes towards vaccination in France. Mothers of girls aged 14-15 years were asked to state all vaccinations reported on the vaccinal pages of their child's healthcare records. We computed univariate and multivariate logistic regression models, with the outcome variable “HPV vaccination” defined as equal to 1 if the daughter received at least one dose of HPV vaccine, and equal to 0 otherwise; and the dependant variable “Internet use” defined as equal to 1 if the mother responded “Internet” (alone or combined with other sources) to the question “When in doubt about a vaccine, what source(s) of information do you turn to to decide whether or not to have your child vaccinated?”, and equal to 0 otherwise. Results Over the 4 years, a total of 2038 mothers answered the self-administered online questionnaire. Overall, 96.1% declared their need to search for information, 23.9% of whom used the Internet as a source. Maternal Internet use was associated with lower HPV vaccination uptake in their daughters (Odds Ratio (OR)=0.49, 95%CI: 0.38-0.64). The association remained after adjusting for several potential confounders, including area of residence, household socio-professional category and income, maternal level of education, physician recommendation and use of other sources of information (adjusted OR = 0.68, 95%CI: 0.48-0.96). Conclusions Specific information campaigns are required to empower parents to better use online information and guide them to reputable sources when they seek information on vaccination. Key messages The findings of this study suggest that the use of online sources on information is negatively associated with HPV vaccination. Action is warranted to direct parents to use more correct online sources of information on vaccination.

Download Full-text