Human papillomavirus vaccine uptake, knowledge and attitude among 10th grade students in Berlin, Germany, 2010

Abstract

IntroductionPersisting human papillomavirus (HPV) infections, especially with HPV high-risk types 16 or 18, are prerequisites for cervical precancer and cancer. At the end of 2006 a quadrivalent HPV-vaccine became available in Germany providing protection against the HPV-types 6, 11, 16, and 18. The primary vaccination series consists of 3 separate doses administered at 0, 2, and 6 mo. If an alternate vaccination schedule is necessary, the second dose should be administered at least one month after the first and the third at least 3 mo after the second dose. The primary vaccination series should be completed within a 1-y period, according to the German summary of product characteristics (SPC). In 2007, a bivalent vaccine was approved for immunisation against HPV-types 16 and 18. For this vaccine, the German SPC recommends a vaccination schedule of 0, 1, 6 mo. HPV vaccination is free of charge in Germany. In clinical trials, the HPV-vaccines demonstrated > 90% efficacy against HPV 16-and 18-related Purpose: since March 2007, the standing committee on Vaccination (sTIKO) recommends HpV vaccination for all 12-17 y-old females in Germany. In the absence of an immunization register, we aimed at assessing HpV-vaccination coverage and knowledge among students in Berlin, the largest city in Germany, to identify factors influencing HpV-vaccine uptake.Results: Between september and December 2010, 442 students completed the questionnaire (mean age 15.1; range 14-19). In total 281/442 (63.6%) students specified HpV correctly as a sexually transmitted infection. Of 238 participating girls, 161 (67.6%) provided their vaccination records. among these, 66 (41.0%) had received the recommended three HpVvaccine doses. Reasons for being HpV-unvaccinated were reported by 65 girls: Dissuasion from parents (40.2%), dissuasion from their physician (18.5%), and concerns about side-effects (30.8%) (multiple choices possible). The odds of being vaccinated increased with age [Odds Ratio (OR) 2.19, 95% confidence Interval (cI) 1.16, 4.15] and decreased with negative attitude toward vaccinations (OR = 0.33, 95% cI 0.13, 0.84).Methods: self-administered questionnaires were distributed to 10th grade school students in 14 participating schools in Berlin to assess socio-demographic characteristics, knowledge, and statements on vaccinations. Vaccination records were reviewed. Multivariable statistical methods were applied to identify independent predictors for HpV-vaccine uptake among female participants.Conclusions: HpV-vaccine uptake was low among school girls in Berlin. Both, physicians and parents were influential regarding their HpV-vaccination decision even though personal perceptions played an important role as well. school programs could be beneficial to improve knowledge related to HpV and vaccines, and to offer low-barrier access to HpV vaccination.Human papillomavirus vaccine uptake, knowledge and attitude among 10th grade students in Berlin, Germany, 2010 In Germany, a structured program for the evaluation and assessment of the impact...

HPV vaccine uptake after introduction of the vaccine in Germany

“…6 Previously conducted coverage studies from Germany, which were mainly based on survey data, have shown heterogeneous results, depending on the considered age group, region, and study population. [3][4][5]7 Direct comparability of our results with those studies is hampered by different aspects. First of all, an estimation of the vaccination coverage rather than the vaccine uptake was not possible in the context of the present study due to the limited study period (only the year 2008), for which the data was available.…”

“…6 Vaccination record review (n = 161) including females aged 14-19 y showed an HPV vaccination coverage with all three recommended doses of 41% in the federal state of Berlin. 7 To our knowledge, no comprehensive and nationwide information on the uptake or coverage of HPV vaccination in Germany is available to date. Administrative claims data from health insurances has been shown to be a useful source of data for the monitoring of vaccination coverage or the uptake of newly In Germany, vaccination against human papilloma virus (hPV) has been recommended by the German standing Vaccination committee (sTIKO) for girls aged 12-17 years since March 2007.…”

Impfstatus und Determinanten der Impfung gegen humane Papillomviren (HPV) bei Mädchen in Deutschland

“…Bislang liegen für Deutschland keine ausreichenden Erkenntnisse vor, wie hoch die Impfquote ist und in welcher Weise die Inanspruchnahme mit soziodemografischen und versorgungsstrukturellen Faktoren zusammenhängt. Lokale Erhebungen lassen vermuten, dass Bildung und soziales Umfeld einen Einfluss auf die Inanspruchnahme der HPV-Impfung haben [6][7][8]. Für elterliche Impfentscheidungen insgesamt ist bekannt, dass Ärztinnen und Ärzte die Schlüsselfiguren darstellen [9].…”

“…Mädchen scheinen überwiegend über den Zusammenhang zwischen HPV und Krebs und über die Möglichkeit der Impfung informiert zu sein; allerdings ist der Mehrheit der Befragten die hohe Wahrscheinlichkeit für eine Infektion nicht bewusst [8,27,28]. Immerhin fast 20 % der im Auftrag der BZgA im Jahr 2012 befragten jungen Frauen kannten die HPV-Impfung nicht oder hatten keine Meinung zur Bedeutung der Impfung [5].…”

Dr Google

“…13,[15][16][17][18][19] Deterrent factors influencing personal decision-making in relation to HPV vaccination have been identified and analyzed and have highlighted, in particular, concerns surrounding vaccine effectiveness and an over-perception of the risk of side effects. [20][21][22] In the analysis of current opposition trends to systematic vaccination, arguments pertaining to the subjective and/or emotional realms allowing for a greater possibility of manipulation, rather than those of scientific evidence, were found. ReseARcH PAPeR 3 times or more.…”