Uptake of HPV Vaccine in Adolescent Girls Is "˜Encouraging'

Research: Uptake of first two doses of human papillomavirus vaccine by adolescent schoolgirls in Manchester: prospective cohort study BMJ Online First

Editorial: HPV vaccination in the UK BMJ Online First

Newswise — Seven in ten girls are likely to be vaccinated against the human papillomavirus (HPV) when a £100m national UK vaccination programme comes into effect in the autumn, according to a fast tracked study published on bmj.com today.

The Manchester-based pilot study is the first to look at whether the vaccine will be accepted by enough parents to ensure the success of a national UK immunisation programme, and how easy it is to deliver such a programme to adolescent girls.

The vaccination prevents two types of HPV that are sexually transmitted and associated with about 70% of cervical cancers. From September 2008, all schoolgirls in the UK aged between 12 and 13 years old (Year 8) will be offered the vaccination.

In February 2007, two Primary Care Trusts (PCTs) in Manchester agreed to take part in a study led by researchers from the University of Manchester. Each PCT was responsible for delivering the vaccine to all secondary schools in its catchment area.

The HPV vaccine was offered to 2 817 girls aged between 12 and 13 years old attending 36 secondary schools. Parents were fully informed about the study and were invited to information evenings. They were asked to give their consent for vaccination or, if they refused, to give their reasons. The researchers report the number of girls who received the first two doses of the vaccine. In order for the vaccine to be fully effective three doses are needed at 0, 1 and 6 months. In total, 1 989 (70.6%) received the first dose and 1 930 the second (68.5%).

The authors found that delivery of the vaccination was challenging, partly because doses needed to be delivered at the start of the academic year when schools were busy, but also because a significant proportion of girls missed the appointment times for their first and second doses (16.3% and 23.6% respectively), and therefore had to be offered alternative times.

They also noted that the main reason given by parents for refusing to allow vaccination was insufficient information about the vaccine and its long term safety (36%). Only a few parents mentioned the age for vaccination (10%) or the vaccine's possible effect on adolescent sexual behaviour (3%).

The researchers conclude: "These are encouraging results for the forthcoming national HPV vaccine programme but the final criterion for success will be the proportion of girls who receive all three vaccine doses."

In the wake of the measles, mumps, and rubella (MMR) vaccine debate, more needs to be done to restore public confidence in immunisation, say Jo Waller and Jane Wardle from Cancer Research UK, in an accompanying editorial.

20% of parents in the study refused the vaccine giving no reason. More work is therefore needed to understand the motives for refusal and the practical barriers to providing consent, they conclude.

Click here to view full article: http://press.psprings.co.uk/bmj/april/HPV.pdf

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