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

Karen Canfell; Sam Egger; Louiza S Velentzis; Jessica Darlington Brown; Dianne L O'Connell; Emily Banks; Freddy Sitas

doi:10.1016/j.vaccine.2015.01.024

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

Vaccine. 2015 May 11;33(20):2387-94. doi: 10.1016/j.vaccine.2015.01.024. Epub 2015 Apr 3.

Authors

Karen Canfell¹, Sam Egger², Louiza S Velentzis², Jessica Darlington Brown³, Dianne L O'Connell⁴, Emily Banks⁵, Freddy Sitas⁶

Affiliations

¹ Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia; Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia. Electronic address: k.canfell@unsw.edu.au.
² Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia.
³ Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia; Lowy Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia.
⁴ Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; School of Public Health, University of Sydney, Sydney, NSW, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
⁵ National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
⁶ Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia; School of Public Health, University of Sydney, Sydney, NSW, Australia; School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.

PMID: 25843203
DOI: 10.1016/j.vaccine.2015.01.024

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: Cervical smears; HPV vaccine; Inequality; Sexual behaviour; Socioeconomic status.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Australia
Female
Health Knowledge, Attitudes, Practice*
Humans
Mass Vaccination*
National Health Programs / statistics & numerical data*
New South Wales
Papanicolaou Test
Papillomavirus Vaccines / administration & dosage*
Patient Acceptance of Health Care*
Sexual Behavior
Sexually Transmitted Diseases / epidemiology
Socioeconomic Factors
Surveys and Questionnaires
Young Adult

Substances

Papillomavirus Vaccines