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Randomized Controlled Trial
. 2023 Nov;28(46):2300166.
doi: 10.2807/1560-7917.ES.2023.28.46.2300166.

Can physicians and schools mitigate social inequalities in human papillomavirus vaccine awareness, uptake and vaccination intention among adolescents? A cross-sectional study, France, 2021 to 2022

Hadrien Moffroid  1   2 , Damien Oudin Doglioni  1 , Sandra Chyderiotis  1 , Jonathan Sicsic  3 , Anne-Sophie Barret  4 , Jocelyn Raude  5 , Sebastien Bruel  6   7 , Aurelie Gauchet  8 , Morgane Michel  9   10 , Amandine Gagneux-Brunon  11   12 , Nathalie Thilly  13   14 , Judith E Mueller  1   5 ; PrevHPV Consortium  15
Affiliations
Randomized Controlled Trial

Can physicians and schools mitigate social inequalities in human papillomavirus vaccine awareness, uptake and vaccination intention among adolescents? A cross-sectional study, France, 2021 to 2022

Hadrien Moffroid et al. Euro Surveill. 2023 Nov.

Abstract

BackgroundIn France, human papillomavirus (HPV) vaccination coverage varies across socioeconomic levels.AimWe aimed at assessing HPV vaccine awareness, uptake and vaccination intention among adolescents in France.MethodsIn a cluster-randomised study, 13-15-year-old students in 61 French middle schools completed a web-based questionnaire. We used multivariable logistic regression to evaluate determinants of HPV vaccine awareness, self-reported uptake and vaccination intention among unvaccinated students and interaction terms to explore effects of visits to family physician and remembering school lessons on vaccination. The French deprivation index of school municipalities served as proxy for socioeconomic levels.ResultsAmong 6,992 participants, awareness was significantly associated with parental education (odds ratio (OR) = 0.82; 95% confidence interval (CI): 0.71-0.95), language spoken at home (OR = 0.59; 95% CI: 0.52-0.66) and deprivation level (OR = 0.57; 95% CI: 0.44-0.71), regardless of physician visit or school lessons. Vaccine uptake was associated with parental education without a recent physician visit (OR = 0.31; 95% CI: 0.16-0.59, vs OR = 0.64; 95% CI: 0.52-0.78 with a visit, interaction p = 0.045). Vaccination intention among unvaccinated was associated with deprivation level (moderate-low vs low) among students not remembering school lessons on vaccination (OR = 0.17; 95% CI: 0.05-0.62, vs OR = 0.93; 95% CI: 0.51-1.67 remembering school lessons, interaction p = 0.022). Parental education was associated with vaccination intention among students reporting a physician visit (OR = 0.41; 95% CI: 0.26-0.64 vs OR = 1.05; 95% CI: 0.50-2.20 without a visit, interaction p = 0.034).ConclusionOur results suggest that healthcare and school could promote vaccination and mitigate social inequalities in HPV vaccination coverage.

Keywords: France; HPV vaccination; acceptance; awareness; general practitioner; school-based initiatives; social inequalities; uptake.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Awareness of human papillomavirus vaccine among middle school students, France, 2021–22 (n = 6,992)
Figure 2
Figure 2
Uptake of human papillomavirus vaccine among middle school students aware of HPV vaccine and mitigation by physicians and school on vaccination, France, 2021–22 (n = 4,333)
Figure 3
Figure 3
Intention to get vaccinated against human papillomavirus among unvaccinated middle school students, by recent visit to a general practitioner and school lessons on vaccination, France, 2021–22 (n = 2,782)
Figure 4
Figure 4
Perceptions and knowledge on human papillomavirus vaccination among middle school students aware of human papillomavirus vaccination, by visit to the general practitioner and offer of a vaccine in last 12 months, France, 2021–22 (n = 4,333)
See this image and copyright information in PMC

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