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Highest Vaccine Uptake after School-Based Delivery - A County-Level Evaluation of the Implementation Strategies for HPV Catch-Up Vaccination in Sweden.
Rehn, Moa; Uhnoo, Ingrid; Kühlmann-Berenzon, Sharon; Wallensten, Anders; Sparén, Pär; Netterlid, Eva.
Afiliación
  • Rehn M; Department of Monitoring and Evaluation, Public Health Agency of Sweden, Solna, Sweden.
  • Uhnoo I; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
  • Kühlmann-Berenzon S; Department of Monitoring and Evaluation, Public Health Agency of Sweden, Solna, Sweden.
  • Wallensten A; Department of Monitoring and Evaluation, Public Health Agency of Sweden, Solna, Sweden.
  • Sparén P; Department of Monitoring and Evaluation, Public Health Agency of Sweden, Solna, Sweden.
  • Netterlid E; Section for Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
PLoS One ; 11(3): e0149857, 2016.
Article en En | MEDLINE | ID: mdl-26974977
BACKGROUND: The Swedish school-based vaccination programme offers HPV vaccine to girls born ≥1999 in 5-6th grade. In 2012, all counties introduced free-of-charge catch-up vaccination campaigns targeting girls born 1993-1998. Varying vaccine uptake in the catch-up group by December 2012 suggested that some implementation strategies were more successful than others. In order to inform future vaccination campaigns, we assessed the impact of different implementation strategies on the county-level catch-up vaccine uptake. METHODS: We conducted an ecological study including all Swedish counties (n = 21), asking regional health offices about the information channels they used and where vaccination of the catch-up target group took place in their counties. The uptake of ≥1 dose by 30 September 2014 was estimated using data from the voluntary national vaccination register. We investigated associations between counties' catch-up vaccine uptake, information channels and vaccination settings by calculating incidence rate ratios (IRR) and 95% confidence intervals (CI), using negative binomial regression models. RESULTS: County level catch-up vaccine uptake varied between 49-84%. All counties offered vaccination through primary health care settings. Apart from this eight (34%) also offered the vaccine in some of their schools, four (19%) in all their schools, and two (10%) in other health care centres. The information channels most frequently used were: information at the national on-line health care consulting web-page (100%), letter/invitations (90%), and advertisement (81%). Counties offering vaccination to girls in all schools and counties offering vaccination in some of their schools, reached higher vaccine uptake compared to counties not offering vaccination in any of their schools (all schools adjusted IRR: 1.3, 95% CI: 1.1-1.5, some schools adjusted IRR: 1.2, 95% CI: 1.1-1.3). CONCLUSION: Counties offering HPV vaccination to catch-up groups in schools reached the highest vaccine uptake. No information channel explained differences in county-level vaccine uptake. Our findings suggest that catch-up vaccination outside the national vaccination program can reach a high uptake at the population level if it is implemented primarily with an organized delivery (e.g. in schools).
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Instituciones Académicas / Sistema de Registros / Vacunación / Atención a la Salud / Vacunas contra Papillomavirus Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude / Implementation_research Límite: Adolescent / Adult / Female / Humans País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2016 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Instituciones Académicas / Sistema de Registros / Vacunación / Atención a la Salud / Vacunas contra Papillomavirus Tipo de estudio: Prognostic_studies Aspecto: Determinantes_sociais_saude / Implementation_research Límite: Adolescent / Adult / Female / Humans País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2016 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos