Secondary analyses to test the impact on inequalities and uptake of the schools-based human papillomavirus (HPV) vaccination programme by stage of implementation of a new consent policy in the south-west of England.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
07 07 2021
Historique:
entrez: 8 7 2021
pubmed: 9 7 2021
medline: 5 8 2021
Statut: epublish

Résumé

To test the impact on inequalities and uptake of the schools-based human papillomavirus (HPV) vaccination programme by stage of implementation of a new policy providing additional opportunities to consent. Two local authorities in the south-west of England. Young women (n=7129) routinely eligible for HPV vaccination aged 12-13 years during the intervention period (2017/2018 to 2018/2019 programme years). Local policy change that included additional opportunities to provide consent (parental verbal consent and adolescent self-consent). Secondary analyses of cross-sectional intervention data were undertaken to examine uptake by: (1) receipt of parental written consent forms and; (2) percentage of unvaccinated young women by stage of implementation. During the intervention period, 6341 (89.0%) eligible young women initiated the HPV vaccination series. Parental written consent forms were less likely to be returned where young women attended alternative education provider settings (p<0.001), belonged to non-white British ethnic groups (p<0.01) or more deprived quintiles (p<0.001). Implementation of parental verbal consent and adolescent self-consent reduced the percentage of unvaccinated young women from 21.3% to 16.5% (risk difference: 4.8%). The effect was greater for young women belonging to the most deprived compared with the least deprived quintile (risk difference: 7.4% vs 2.3%, p<0.001), and for young women classified as Unknown ethnic category compared with white British young women (6.7% vs 4.2%, p<0.001). No difference was found for non-white British young women (5.4%, p<0.21). Local policy change to consent procedures that allowed parents to consent verbally and adolescents to self-consent overcame some of the barriers to vaccination of young women belonging to families less likely to respond to paper-based methods of gaining consent and at greater risk of developing cervical cancer. 49 086 105.

Identifiants

pubmed: 34233969
pii: bmjopen-2020-044980
doi: 10.1136/bmjopen-2020-044980
pmc: PMC8264897
doi:

Substances chimiques

Papillomavirus Vaccines 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e044980

Subventions

Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/T027150/1
Pays : United Kingdom
Organisme : Department of Health
ID : PB-PG-0416-20013
Pays : United Kingdom

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Harriet Fisher (H)

Bristol Medical School, University of Bristol, Bristol, UK Harriet.Fisher@bristol.ac.uk.

Karen Evans (K)

Sirona Care and Health CIC, Kingswood, South Gloucestershire, UK.

Rosy Reynolds (R)

Bristol Medical School, University of Bristol, Bristol, UK.

Julie Yates (J)

Screening and Immunisations South West, Public Health England, London, UK.

Marion Roderick (M)

Department of Paediatric Immunology & Infectious Diseases, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, Bristol, UK.

Jo Ferrie (J)

Screening and Immunisations South West, Public Health England, London, UK.

John Macleod (J)

Bristol Medical School, University of Bristol, Bristol, UK.
Bristol Biomedical Research Centre and NIHR CLAHRC West, University of Bristol, Bristol, UK.

Matthew Hickman (M)

Bristol Medical School, University of Bristol, Bristol, UK.

Suzanne Audrey (S)

Bristol Medical School, University of Bristol, Bristol, UK.

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Classifications MeSH