Factors associated with HPV vaccine uptake in teenage girls: A systematic review
Highlights
► Systematic review of factors associated with HPV vaccine uptake not intention. ► 25 included studies of variable quality, most at moderate risk of bias. ► Uptake associated with health insurance, older age, better knowledge, positive attitudes. ► In US, African American girls less likely to initiated or complete 3 dose series. ► More studies needed about series completion and factors linked to high uptake rates.
Section snippets
Background
Human papillomavirus (HPV) is a sexually transmitted infection that is a necessary (but insufficient) cause of 99% of all cervical cancer cases [1]. Two HPV vaccines are available, Cervarix® and Gardasil® [2], [3], which are the first vaccines directed at the prevention of (cervical) cancer [4]. Cervarix®, a bivalent HPV vaccine, targets types 16 and 18, responsible for nearly 70% of all cervical cancer cases, while Gardasil®, a quadrivalent vaccine, also targets types 6 and 11, which cause
Search strategies
Medline, Medline in process, Embase and CINAHL were searched by two researchers from 2006 to the 7th of March 2011. The search terms were papillomavirus infections, human papillomavirus or HPV AND vaccines or papillomavirus vaccines AND adolescent, child or girl* AND accept*, aware*, attitude*, belief*, behave*, decision, decide, intent*, know*, perceived*, percept*, risk*, sever*, uptake*, effectiveness, coverage, vaccination, mass vaccination, decision making or perception. The reference
Results
The search resulted in 66 potentially eligible abstracts which were assessed against the inclusion criteria by obtaining the full-text article. We identified 33 relevant articles representing 25 unique studies, after multiple publications from the same study were identified (Fig. 1).
Discussion
To our knowledge this is the first systematic review of factors influencing actual HPV vaccine uptake, since previous systematic reviews have primarily focused on vaccine acceptability and intention to vaccinate, not actual uptake [11], [12], [46]. This review confirms the findings of these previous reviews identifying a range of important predictors to vaccination including: the vaccinated girl's race or ethnicity, age, health insurance status, previous vaccination history, and knowledge about
Conclusions
The aims of this systematic review were to evaluate factors associated with the success of HPV vaccination programs for (pre-)adolescent girls in increasing vaccine coverage in this population. Important factors influencing initiation and completion of the HPV vaccination series included race/ethnicity, girls’ age, parental and adolescent knowledge about HPV and vaccination and healthcare utilization. However, the quality of the included studies limits the conclusions we can make about the
Acknowledgments
Annette Braunack-Mayer, Helen Marshall and Maureen Watson are investigators on an Australian Research Council Linkage Grant Project (LP100200007) known as Health Bridges, which is investigating intersectoral collaboration and the school-based HPV immunization program, and Rebecca Tooher is the project manager on this grant. We would like to acknowledge the helpful comments provided by the other Health Bridges investigators: Maree O’Keefe, Rachel Skinner, Kirsten McKaffrey, Teresa Burgess, and
References (69)
- et al.
Efficacy, duration of immunity and cross protection after HPV vaccination: a review of the evidence
Vaccine
(2009) - et al.
Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women
Lancet
(2009) - et al.
Voluntary school-based human papillomavirus vaccination: an efficient and acceptable model for achieving high vaccine coverage in adolescents
Journal of Adolescent Health
(2010) - et al.
A systematic review of measures used in studies of human papillomavirus (HPV) vaccine acceptability
Vaccine
(2010) - et al.
Predictors of HPV vaccine acceptability: a theory-informed, systematic review
Preventive Medicine
(2007) - et al.
Factors associated with initiation and completion of human papillomavirus vaccine series among young women enrolled in Medicaid
Journal of Adolescent Health
(2010) - et al.
Patient and clinic factors associated with adolescent human papillomavirus vaccine utilization within a university-based health system
Vaccine
(2010) - et al.
Human papillomavirus and cervical cancer: Gardasil vaccination status and knowledge amongst a nationally representative sample of Australian secondary school students
Vaccine
(2010) - et al.
Understanding the reasons why mothers do or do not have their adolescent daughters vaccinated against human papillomavirus
Annals of Epidemiology
(2009) - et al.
Parental response to human papillomavirus vaccine availability: uptake and intentions
Journal of Adolescent Health
(2009)