From non school-based, co-payment to school-based, free Human Papillomavirus vaccination in Flanders (Belgium): A retrospective cohort study describing vaccination coverage, age-specific coverage and socio-economic inequalities. Issue 39 (22nd September 2015)

• Record Type: Journal Article
• Authors: Lefevere, Eva; Theeten, Heidi; Hens, Niel; De Smet, Frank; Top, Geert; Van Damme, Pierre
• Is Part Of: Vaccine. Volume 33:Issue 39(2015)
• Page Start: 5188
• Page End: 5195
• Publication Date: 2015-09-22
• Subjects: Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2015.07.088
• Languages: English
• ISSNs: 0264-410X

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <p id="spar0005">School-based, free HPV vaccination for girls in the first year of secondary school was introduced in Flanders (Belgium) in 2010. Before that, non school-based, co-payment vaccination for girls aged 12–18 was in place. We compared vaccination coverage, age-specific coverage and socio-economic inequalities in coverage – 3 important parameters contributing to the effectiveness of the vaccination programs – under both vaccination systems.</p> <p id="spar0010">We used retrospective administrative data from different sources. Our sample consisted of all female members of the National Alliance of Christian Mutualities born in 1995, 1996, 1998 or 1999 (<italic>N</italic> = 66, 664). For each vaccination system we described the cumulative proportion HPV vaccination initiation and completion over time. We used life table analysis to calculate age-specific rates of HPV vaccination initiation and completion. Analyses were done separately for higher income and low income groups.</p> <p id="spar0015">Under non school-based, co-payment vaccination the proportions HPV vaccination initiation and completion slowly rose over time. By age 17, the proportion HPV vaccination initiation/completion was 0.75 (95% CI 0.74–076)/0.66 (95% CI 0.65–0.67). The median age at vaccination initiation/completion was 14.4 years (95% CI 14.4–14.5)/15.4 years (95% CI 15.3–15.4). Socio-economic inequalities in coverage widened over time and with age. Under school-based, free vaccination rates of HPV vaccination initiation were substantially higher. By age 14, the proportion HPV vaccination initiation/completion was 0.90 (95% CI 0.90–0.90)/0.87 (95% CI 0.87–0.88). The median age at vaccination initiation/completion was 12.7 years (95% CI 12.7–12.7)/13.3 years (95% CI 13.3–13.3). Socio-economic inequalities in coverage and in age-specific coverage were substantially smaller.</p> </sec> </abstract>