The Influence of Socioeconomic Factors on Human Papillomavirus Vaccination Among Adolescent Girls in France

Introduction - Our study aimed to explore the socioeconomic factors associated with vaccination against human papillomavirus (HPV) infections among adolescent girls in France, taking into account both individual characteristics and those related to their living environment. Methods - We conducted a retrospective study of girls born between 1997 and 1999 and retrieved HPV vaccine reimbursement data available in the Inter-Regime Consumption Datamart (DCIR) of the national health insurance system. The variable of interest was the initiation of vaccination with at least one dose of the vaccine before age 17. The association with individual variables and characteristics of the municipality of residence was explored using a multilevel Poisson regression model. Results - Among the 1,051,656 girls included in the study, 35% had initiated vaccination before the age of 17. Individual variables associated with vaccination were year of birth, health insurance scheme, CMU-C status, and the number of medical visits during the 2011–2016 period. At the municipal level, vaccination was associated with the social disadvantage index, the size of the urban area, the immigrant rate, and access to gynecologists. Overall, the prevalence of HPV vaccination decreased as the level of social disadvantage in the municipality of residence increased, but this association varied by department. Conclusion - This study highlighted social and regional inequalities related to HPV vaccination. It calls for strengthening efforts to promote and improve access to this vaccination in the most disadvantaged areas and for developing public health policies to reduce these inequalities.

Author(s): Blondel Clara, Barret Anne-Sophie, Pelat Camille, Lucas Etienne, Fonteneau Laure, Lévy-Bruhl Daniel

Publishing year: 2019

Pages: 441-450

Weekly Epidemiological Bulletin, 2019, n° 22-23, p. 441-450

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