Coverage of the English National human papillomavirus (HPV) Immunisation Programme among 12 to 17 year-old females by area-level deprivation score, England, 2008 to 2011

Eurosurveillance
Volume 19, Issue 2, 16 January 2014
http://www.eurosurveillance.org/Public/Articles/Archives.aspx?PublicationId=11678

Surveillance and outbreak reports
Coverage of the English National human papillomavirus (HPV) Immunisation Programme among 12 to 17 year-old females by area-level deprivation score, England, 2008 to 2011
A Hughes1, D Mesher1, J White2, K Soldan1
Public Health England, HIV and STI Department, London, United Kingdom
Public Health England, Immunisation, Hepatitis and Blood Safety Department, London, United Kingdom

Abstract
The English national human papillomavirus (HPV) immunisation programme has offered vaccination to girls aged 12 years at the start of each school year since September 2008. A catch-up programme has offered vaccination to girls up to 18 years. Delivery is predominantly school-based, with some general practitioner (GP)-based immunisation. The relationship between HPV immunisation coverage and deprivation (index of multiple deprivation, IMD) was assessed by geographical area (N=151) for each school year offered the HPV vaccine between 2008 to 2011 using the Spearman’s rank correlation coefficient, and compared to that for adequate cervical screening of women aged 25 to 49 years. Coverage at age 12 showed no significant association with IMD at the area-level (p=0.12). Within the catch-up years, there was some suggestion of higher deprivation being associated with lower coverage. This was not significant for girls offered immunisation under 16 years (in compulsory education) (p=0.09), but was more marked and statistically significant for older girls (p<0.0001). The proportion of women aged 25 to 49 years with an adequate cervical screen was negatively associated with deprivation (p<0.0001). School-based HPV immunisation delivery appears to be successfully reducing inequalities in cervical cancer control at area-level. However, the catch-up cohorts above the age of compulsory education may face increased inequality. Further investigation is needed into individual-level factors associated with coverage.