What school-level and area-level factors influenced HPV and MenACWY vaccine coverage in England in 2016/2017? An ecological study.
epidemiology
infection control
public health
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
11 07 2019
11 07 2019
Historique:
entrez:
14
7
2019
pubmed:
14
7
2019
medline:
24
7
2020
Statut:
epublish
Résumé
To describe school-level and area-level factors that influence coverage of the school-delivered human papillomavirus (HPV) and meningococcal A, C, W and Y (MenACWY) programmes among adolescents. Ecological study. Aggregated 2016/2017 data from year 9 pupils were received from 1407 schools for HPV and 1432 schools for MenACWY. The unit of analysis was the school. Outcome measures were percentage point (pp) difference in vaccine coverage by schools' religious affiliation, school type, urban/rural, single sex/mixed and region. A subanalysis of mixed-sex, state-funded secondary schools also included deprivation, proportion of population from black and ethnic minorities, and school size. Muslim and Jewish schools had significantly lower coverage than schools of no religious character for HPV (24.0 (95% CI -38.2 to -9.8) and 20.5 (95% CI -30.7 to -10.4) pp lower, respectively) but not for MenACWY. Independent, special schools and pupil referral units had increasingly lower vaccine coverage compared with state-funded secondary schools for both HPV and MenACWY. For both vaccines, coverage was 2 pp higher in rural schools than in urban schools and lowest in London. Compared with mixed schools, HPV coverage was higher in male-only (3.7 pp, 95% CI 0.2 to 7.2) and female-only (4.8 pp, 95% CI 2 to 7.6) schools. In the subanalysis, schools located in least deprived areas had the highest coverage for both vaccines (3.8 (95% CI 0.9 to 6.8) and 10.4 (95% CI 7.0 to 13.8) pp for HPV and MenACWY, respectively), and the smallest schools had the lowest coverage (-10.4 (95% CI -14.1 to -6.8) and -7.9 (95% CI -12 to -3.8) for HPV and MenACWY, respectively). Tailored approaches are required to improve HPV vaccine coverage in Muslim and Jewish schools. In addition, better ways of reaching pupils in smaller specialist schools are needed.
Identifiants
pubmed: 31300506
pii: bmjopen-2019-029087
doi: 10.1136/bmjopen-2019-029087
pmc: PMC6629380
doi:
Substances chimiques
Meningococcal Vaccines
0
Papillomavirus Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e029087Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Vaccine. 2018 May 31;36(23):3231-3238
pubmed: 29716775
Vaccine. 2018 Oct 29;36(45):6726-6735
pubmed: 30266484
Epidemiol Infect. 2018 Jan;146(2):197-206
pubmed: 29239285
Vaccine. 2006 Apr 12;24(16):3087-94
pubmed: 16500736
Vaccine. 2015 Feb 4;33(6):759-70
pubmed: 25556592
J Epidemiol Community Health. 2014 Jan;68(1):57-63
pubmed: 23986492
Vaccine. 2015 May 21;33(22):2620-8
pubmed: 25835576
Int J Epidemiol. 2013 Jun;42(3):896-908
pubmed: 23620381
J Public Health (Oxf). 2012 Dec;34(4):498-504
pubmed: 22711912
Vaccine. 2012 May 21;30(24):3546-56
pubmed: 22480928
PLoS One. 2016 Mar 14;11(3):e0149857
pubmed: 26974977
Vaccine. 2011 Apr 12;29(17):3192-6
pubmed: 21354481
J Public Health (Oxf). 2014 Mar;36(1):36-45
pubmed: 23620542