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

Abstract

Objective: To assess the feasibility and acceptability of delivering a human papillomavirus (HPV) vaccine to adolescent girls.

Design: Prospective cohort study.

Setting: 36 secondary schools in two primary care trusts in Greater Manchester, United Kingdom.

Participants: 2817 schoolgirls in year 8 (12 and 13 year olds).

Intervention: Delivery of the bivalent vaccine at 0, 1, and 6 months over one school year.

Main outcome measures: Vaccine uptake for doses 1 and 2 of a three dose schedule.

Results: Vaccine uptake was 70.6% (1989/2817) for the first dose and 68.5% (1930/2817) for the second dose. Uptake was significantly lower in schools with a higher proportion of ethnic minority girls (P<0.001 for trend) or higher proportion of girls entitled to free school meals (P=0.029 for trend). The main reason for parents' refusal of vaccination was insufficient information about the vaccine and its long term safety. Maintaining the vaccine schedule was challenging as 16.3% (dose 1) and 23.6% (dose 2) of girls missed their vaccination day and had to be offered alternative appointments. No serious adverse events were reported.

Conclusion: Delivery of the first two doses of HPV vaccine to adolescent schoolgirls is encouraging, but the success of the vaccination programme depends on high coverage for the third dose.