HPV vaccination: French girls and women aged 14–23 years: relationship to mothers’ uptake of Pap smears

Vaccine
Volume 31, Issue 45, Pages 5147-5296 (25 October 2013)
http://www.sciencedirect.com/science/journal/0264410X/31/45

HPV vaccination among French girls and women aged 14–23 years and the relationship with their mothers’ uptake of Pap smear screening: A study in general practice
Original Research Article
Pages 5243-5249
D. Lutringer-Magnin, C. Cropet, G. Barone, G. Canat, J. Kalecinski, Y. Leocmach, P. Vanhems, F. Chauvin, C. Lasset

Abstract
Introduction
HPV vaccination is recommended in France for girls aged 14 and for those aged 15–23 before sexual debut or who have become sexually active within the previous year. The first aim was to describe vaccination practice among 14–23-year-old girls visiting a general practitioner. A second objective was to investigate factors associated with starting vaccination among girls aged 14–18, in particular the regular practice of Pap-smear screening (PSS) by their mothers.

Methods
A cross-sectional study was conducted from June to August 2009. A total of 87 general practitioners from the large Rhône-Alpes region contributed data on 502 girls/women who came for consultation.

Results
231 (46.0%) of these girls/women had begun the process of HPV vaccination (68.2%, 56.9% and 18.7% of the 14–16, 17–20 and 21–23-year-olds respectively) of whom 139 (60.2%) had received all three doses. 92 girls/women (39.8%) had received only one or two doses at the time of study. However, in 71 (77.2%) cases, the gap between the last dose received and the time of study was within the between-dose interval recommended in the vaccination schedule. GPs reported that 16 (11.5%) had mentioned side effects following injections. Having a mother who practised regular PSS (Odds Ratio 6.2 [1.5–25.8]), having never lived with a partner (4.6 [1.6–13.5]) and vaccination against hepatitis B (3.2 [1.6–6.1]) were found to be independently correlated with the initiation of HPV vaccination among girls/women aged 14–18 years.

Conclusion
Two years after the start of the programme, only half of girls/women aged 14–23 years had begun the process of HPV vaccination. HPV vaccination status was correlated with PSS in the mother, family status and hepatitis B vaccination. Such information may help to better target girls who are less likely to be vaccinated.