Socioeconomic Predictors of Human Papillomavirus Vaccination Among Girls in the Danish Childhood Immunization Program

Abstract Purpose In 2009, human papillomavirus (HPV) vaccination was introduced in the Danish national childhood immunization program targeting all 12-year-old girls. Previous findings suggest that 10%–13% of girls born in 1996–1997 have not initiated vaccination despite free access. This study aims...

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Bibliographic Details
Published in:Journal of adolescent health 2015-04, Vol.56 (4), p.402-407
Main Authors: Slåttelid Schreiber, Selma Marie, Juul, Kirsten Egebjerg, Ph.D, Dehlendorff, Christian, Ph.D, Kjær, Susanne Krüger, M.D., Dr. Med. Sci
Format: Article
Language:English
Subjects:
Adolescent
Cancer
Child
Childhood
Denmark
Denmark - epidemiology
Educational Status
Emigrants and Immigrants - statistics & numerical data
Female
Females
Human papillomavirus
Humans
Immigrants
Immunization Programs - statistics & numerical data
Income - statistics & numerical data
Logistic Models
Low Income Groups
Mothers
Papillomavirus Infections - prevention & control
Papillomavirus Vaccines - therapeutic use
Patient Acceptance of Health Care - statistics & numerical data
Pediatrics
Social Inequality
Socioeconomic Factors
Socioeconomic status
Vaccination
Vaccine coverage
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Summary:Abstract Purpose In 2009, human papillomavirus (HPV) vaccination was introduced in the Danish national childhood immunization program targeting all 12-year-old girls. Previous findings suggest that 10%–13% of girls born in 1996–1997 have not initiated vaccination despite free access. This study aims to identify socioeconomic predictors of initiation and completion of HPV vaccination. Methods Girls born in 1996–1997 and their guardians were identified through the Danish Civil Registration System. Information on socioeconomic variables and HPV vaccination status was obtained by linkage to Statistics Denmark and the Danish National Health Insurance Service Register. Through logistic regression, we examined associations between socioeconomic variables and HPV vaccine initiation (N = 65,926) and completion (N = 61,162). Results Girls with immigrant ethnicity (odds ratio [OR] = .49; 95% confidence interval [CI], .42–.57) had lower HPV vaccine initiation than Danish girls. Girls of mothers with basic education (OR = .75; 95% CI, .69–.82) or low disposable income (OR = .67; 95% CI, .61–.73) had decreased initiation compared with girls of mothers with higher education/income. Girls of unemployed mothers (OR = .75; 95% CI, .69–.82) or mothers being unmarried (OR = .70; 95% CI, .65–.76) had lower initiation than girls of employed or married mothers. Finally, vaccine initiation varied depending on place of residence. The predictors of HPV vaccine completion were similar to those of initiation. Conclusions We found social inequality in the initiation and completion of HPV vaccination despite free access. As socioeconomic risk factors identified for cervical cancer also are associated with decreased HPV vaccination, social inequalities in cervical cancer have the potential to increase.
ISSN:1054-139X
1879-1972
DOI:10.1016/j.jadohealth.2014.12.008