IntroductionPersisting human papillomavirus (HPV) infections, especially with HPV high-risk types 16 or 18, are prerequisites for cervical precancer and cancer. At the end of 2006 a quadrivalent HPV-vaccine became available in Germany providing protection against the HPV-types 6, 11, 16, and 18. The primary vaccination series consists of 3 separate doses administered at 0, 2, and 6 mo. If an alternate vaccination schedule is necessary, the second dose should be administered at least one month after the first and the third at least 3 mo after the second dose. The primary vaccination series should be completed within a 1-y period, according to the German summary of product characteristics (SPC). In 2007, a bivalent vaccine was approved for immunisation against HPV-types 16 and 18. For this vaccine, the German SPC recommends a vaccination schedule of 0, 1, 6 mo. HPV vaccination is free of charge in Germany. In clinical trials, the HPV-vaccines demonstrated > 90% efficacy against HPV 16-and 18-related Purpose: since March 2007, the standing committee on Vaccination (sTIKO) recommends HpV vaccination for all 12-17 y-old females in Germany. In the absence of an immunization register, we aimed at assessing HpV-vaccination coverage and knowledge among students in Berlin, the largest city in Germany, to identify factors influencing HpV-vaccine uptake.Results: Between september and December 2010, 442 students completed the questionnaire (mean age 15.1; range 14-19). In total 281/442 (63.6%) students specified HpV correctly as a sexually transmitted infection. Of 238 participating girls, 161 (67.6%) provided their vaccination records. among these, 66 (41.0%) had received the recommended three HpVvaccine doses. Reasons for being HpV-unvaccinated were reported by 65 girls: Dissuasion from parents (40.2%), dissuasion from their physician (18.5%), and concerns about side-effects (30.8%) (multiple choices possible). The odds of being vaccinated increased with age [Odds Ratio (OR) 2.19, 95% confidence Interval (cI) 1.16, 4.15] and decreased with negative attitude toward vaccinations (OR = 0.33, 95% cI 0.13, 0.84).Methods: self-administered questionnaires were distributed to 10th grade school students in 14 participating schools in Berlin to assess socio-demographic characteristics, knowledge, and statements on vaccinations. Vaccination records were reviewed. Multivariable statistical methods were applied to identify independent predictors for HpV-vaccine uptake among female participants.Conclusions: HpV-vaccine uptake was low among school girls in Berlin. Both, physicians and parents were influential regarding their HpV-vaccination decision even though personal perceptions played an important role as well. school programs could be beneficial to improve knowledge related to HpV and vaccines, and to offer low-barrier access to HpV vaccination.Human papillomavirus vaccine uptake, knowledge and attitude among 10th grade students in Berlin, Germany, 2010 In Germany, a structured program for the evaluation and assessment of the impact...