From non school-based, co-payment to school-based, free Human Papillomavirus vaccination in Flanders (Belgium): A retrospective cohort study describing vaccination coverage, age-specific coverage and socio-economic inequalities

Lefevere, Eva; Theeten, Heidi; Hens, Niel; Smet, Frank De; Top, Geert; Damme, Pierre Van

doi:10.1016/j.vaccine.2015.07.088

Cited by 18 publications

(14 citation statements)

References 17 publications

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“…Vaccines can be delivered outside of health clinics, for instance in schools, pharmacies, community centres, hospitals or at home. For example, Belgium offered school-based vaccination against human papillomavirus (HPV), which increased rates of vaccination initiation/completion and lowered inequalities based on socioeconomic factors [30].…”

Section: From Data To Actionmentioning

confidence: 99%

Towards equity in immunisation

Boyce

Gudorf²,

Kat

et al. 2019

Eurosurveillance

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In the World Health Organization (WHO) European Region, differences in uptake rates of routine childhood immunisation persist within and among countries, with rates even falling in some areas. There has been a tendency among national programmes, policymakers and the media in recent years to attribute missed vaccinations to faltering demand or refusal among parents. However, evidence shows that the reasons for suboptimal coverage are multifactorial and include the social determinants of health. At the midpoint in the implementation of the European Vaccine Action Plan 2015–2020 (EVAP), national immunisation programmes should be aware that inequity may be a factor affecting their progress towards the EVAP immunisation targets. Social determinants of health, such as individual and household income and education, impact immunisation uptake as well as general health outcomes – even in high-income countries. One way to ensure optimal coverage is to make inequities in immunisation uptake visible by disaggregating immunisation coverage data and linking them with already available data sources of social determinants. This can serve as a starting point to identify and eliminate underlying structural causes of suboptimal uptake. The WHO Regional Office for Europe encourages countries to make the equitable delivery of vaccination a priority.

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Section: From Data To Actionmentioning

confidence: 99%

Towards equity in immunisation

Boyce

Gudorf²,

Kat

et al. 2019

Eurosurveillance

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“…3 Countries as disparate as Sweden, Rwanda, Bhutan, and Australia have implemented school-based vaccination programs, with reported 3-dose HPV coverage rates ranging from 69% to 90%. [4][5][6][7][8][9][10] Although aspects of school-located HPV vaccination certainly vary across and within countries, most international SLV programs share several common structural features. [4][5][6][7][8][9][10] National immunization programs are often heavily involved in planning and supervising programs.…”

Section: International Experience With School-located Hpv Vaccinationmentioning

confidence: 99%

Can School-Located Vaccination Have a Major Impact on Human Papillomavirus Vaccination Rates in the United States?

Kempe

Allison

Daley

2018

Academic Pediatrics

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School-local vaccination (SLV) has been a highly effective method of increasing rates of human papillomavirus (HPV) vaccination in many countries internationally in which vaccines are purchased by national, regional, or local public health authorities and offered free of charge within schools. However, the effectiveness of SLV for increasing HPV vaccination rates in the United States is likely to be substantially limited due to a number of identified barriers, the most significant of which is with the need to bill for vaccines among adolescents not covered under the Vaccines for Children Program. HPV vaccination within school-based health centers (SBHCs) has been much more effective than SLV, but SBHCs exist in only 2% of schools in the United States. The opportunity gap between the United States and other countries will remain unless reimbursement issues related to HPV delivery in schools can be addressed in a sustainable manner or SBHCs become much more common.

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“…A study conducted in the same province five years post vaccination program implementation showed a 1% combined prevalence of HPV6/11/16/18 DNA in 17-19 year-old sexually active girls. 26 Such a low circulation of the 4 HPV types included in the 4vHPV vaccine support the hypothesis that environmental exposure had very little, if any, impact on antibody persistence.…”

Section: Post First Dosementioning

confidence: 78%

“…24,25 However, these findings may not be easily extrapolated to our source studies in which vaccination was initiated at a younger age, in a free-ofcharge school-based program that has been shown to minimize socioeconomic inequalities on vaccination course completion. 26 The relative titers across types are the same for the 9-10 year old pre-adolescents not yet sexually active and 13-18-years-old adolescents, an age group in which we cannot rule out sexual activity. 27,28 This observation suggests that adolescents vaccinated with one dose of vaccine are not getting significant boosting from viruses shed by their sex partners.…”

Section: Post First Dosementioning

confidence: 92%

Long intervals between two doses of HPV vaccines and magnitude of the immune response: a post hoc analysis of two clinical trials

Gîlca

Sauvageau

Panicker

et al. 2019

Human Vaccines & Immunotherapeutics

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The objective of this analysis was to compare the anti-HPV GMTs and their distribution after a 6-month or a 3-8-y interval between two HPV vaccine doses. The results from two clinical trials, conducted by the same team in the same region, with serological assays performed at the same laboratory using the same ELISA methodology were compared. In the first study, 173 9-10-y-old girls and boys received two doses of 9vHPV vaccine at a 6-month interval; in the second study, 31 girls vaccinated with one dose of 4vHPV at the age of 9-14 y received a dose of 9vHPV 3-8 y later (mean 5.4 y). In both studies, blood samples were collected before and 1 month post second dose. Despite large differences in the time since the first dose, all subjects (100%) were seropositive to the common 4 HPV types (6, 11, 16 and 18) to both vaccines, with comparable GMTs and titer distributions before the second dose. One month post second dose, the GMTs increased 40-91-fold for those with a 6-month interval between doses and 60-82-fold for those with a 3-8-y interval. Titer distributions after the booster dose were comparable in the two studies. These results indicate that 2-dose HPV vaccination schedules with an interval of several years could be used for pre-adolescents. Intervals longer than 6 months may facilitate logistics for immunization programs and could be useful during periods of vaccine shortage or as a transition while the effectiveness of a one-dose schedule is being evaluated.

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From non school-based, co-payment to school-based, free Human Papillomavirus vaccination in Flanders (Belgium): A retrospective cohort study describing vaccination coverage, age-specific coverage and socio-economic inequalities

Cited by 18 publications

References 17 publications

Towards equity in immunisation

Towards equity in immunisation

Can School-Located Vaccination Have a Major Impact on Human Papillomavirus Vaccination Rates in the United States?

Long intervals between two doses of HPV vaccines and magnitude of the immune response: a post hoc analysis of two clinical trials

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