HPV vaccination coverage in French girls attending middle and high schools: a declarative cross sectional study in the department of Cote d'Or

Objectives: To assess human papillomavirus prophylactic vaccine coverage among a representative population of French girls, aged 14 years and above, attending middle and high schools, and to determine factors associated with the initiation and completion of the vaccination protocol. Study design: This cross-sectional study, designed with cluster sampling, was conducted from October 2010 to May 2011, in 29 schools in the department of Cote d'Or, France. The schools were randomized according to their status (public or private) and location (rural or urban). Two classes per level were then included. All analyses were stratified on age. Results: 948 questionnaires were collected (87.9% participation). Mean age was 15.2 years (SD = 1.3), ranging between 14 and 19. Only 31.7% of 14-year-old girls and 61.4% of girls aged 15 and above initiated vaccination (one dose), and 7.8% of 14-year-old girls and 48.5% of girls aged 15 and above completed it (three doses). An urban school location and a physician's recommendation were independently associated with vaccination initiation in girls aged 14. In girls aged 15 and above, the parents' socioeconomic status, the family composition and a recommendation by a physician were independently associated with vaccination initiation. Once vaccination had been initiated, girls who attended private school, who belonged to families with higher outcomes, who lived with a single parent or who smoked were less likely to complete the vaccination protocol. Conclusion: HPV prophylactic vaccine coverage in girls attending school in Cote d'Or appears to be low. Physicians play a major role in vaccine acceptance. (C) 2013 Elsevier Ireland Ltd. All rights reserved.