Introduction
Methods
Participants and recruitment
Statistical analyses
Results
Response rate, demographic characteristics and sexual behavior
HPV vaccination coverage and reasons for not being vaccinated
N
| Percentage, median | 95% CI or SD (%) | |
---|---|---|---|
Number of HPV vaccine doses | 2363 | ||
0 dose | 46.6% | 41.6–51.6 | |
1 dose | 5.4% | 3.6–8.0 | |
2 doses | 4.7% | 3.3–6.6 | |
3 doses | 41.3% | 36.4–46.3 | |
Vaccinated, number of doses unknown | 2.2% | 1.6–2.9 | |
HPV vaccination initiated, by language region | 2363 | ||
French | 68.1% | 60.6–74.8 | |
German | 47.4% | 41.1–53.9 | |
Italian | 63.3% | 51.6–73.6 | |
Age at first HPV vaccine dose | 1243 | ||
11–14 years | 39.8% | 32.7–47.5 | |
15–19 years | 54.4% | 47.2–61.4 | |
≥ 20 years | 5.8% | 4.1–8.1 | |
Median | 15 years | ||
Vaccine type(s) received | 826 | ||
Quadrivalent | 95.0% | 81.7–97.0 | |
Bivalent | 3.5% | 2.1–5.9 | |
Quadrivalent and bivalent | 1.5% | 0.4–4.9 | |
Timing of vaccination at age 11–14 years in relation to first sexual intercourse | 470 | ||
Before first sexual intercourse | 97.2% | 94.7–98.5 | |
Same year | 2.3% | 1.2–4.3 | |
After first sexual intercourse | 0.5% | 0.1–3.5 | |
Timing of catch-up vaccination at age 15–19 years in relation to first sexual intercourse | 716 | ||
Before first sexual intercourse | 49.7% | 42.4–56.9 | |
Same year | 19.1% | 14.3–25.1 | |
After first sexual intercourse | 31.2% | 25.6–37.4 |
18–20 yearsa
| 21–24 yearsb
| 18–24 years (combined) | ||||
---|---|---|---|---|---|---|
% | 95% CI | % | 95% CI | % | 95% CI | |
Not (sufficiently) informed about HPV vaccination | 16.9 | 8.9–29.7 | 24.7 | 18.3–32.3 | 22.5 | 17.2–28.9 |
Fear of vaccine side effects | 30.3 | 16.8–48.3 | 13.5 | 8.8–20.2 | 18.1 | 12.5–25.5 |
Had already one or more sexual partners | 3.6 | 1.7–7.4 | 21.2 | 14.4–30.0 | 16.4 | 11.3–23.2 |
Opposed to vaccination in general | 20.7 | 10.5–36.9 | 11.5 | 7.0–18.3 | 14.0 | 9.3–20.5 |
HPV vaccination is for younger girls/too oldc
| 0.6 | 0.2–2.1 | 15.9 | 9.7–25.1 | 11.7 | 7.1–18.8 |
No time or forgotten | 11.6 | 7.2–18.1 | 10.1 | 7.4–13.6 | 10.5 | 8.1–13.5 |
Physician advised against vaccination | 5.4 | 2.9–9.8 | 8.0 | 5.5–11.6 | 7.3 | 5.3–10.0 |
Friends/family advised against vaccination | 12.0 | 6.1–22.3 | 3.4 | 2.2–5.3 | 5.8 | 3.7–8.8 |
Thinks vaccine does not work | 4.9 | 2.7–8.6 | 3.1 | 1.9–4.9 | 3.6 | 2.5–5.1 |
Would rather rely on cervical cancer screening than vaccination | 2.1 | 7.9–5.5 | 3.4 | 2.1–5.5 | 3.1 | 2.0–4.7 |
Other reasons | 14.9 | 9.8–22.2 | 13.8 | 10.5–18.0 | 14.1 | 11.2–17.6 |
Refusal or do not know | 4.0 | 2.2–7.1 | 3.7 | 2.3–5.8 | 3.8 | 2.6–5.4 |
Factors associated with HPV vaccination
18–20 years | 21–24 years | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
N
yes/N
obs
a
| Weighted proportion % | Univariable model | Multivariable model |
N
yes/N
obs
| Weighted proportion % | Univariable model | Multivariable model | |||||
OR | 95% CI | OR | 95% CI | OR | 95% CI | OR | 95% CI | |||||
Language region | ||||||||||||
German | 314/404 | 64.2 | 1 | (Reference) | 1 | (Reference) | 303/531 | 36.2 | 1 | (Reference) | 1 | (Reference) |
French | 264/417 | 81.8 | 2.5 | 1.2–5.3 | 2.5 | 1.3–4.8 | 204/540 | 58.0 | 2.4 | 1.5–4.0 | 3.1 | 2.1–4.6 |
Italian | 136/216 | 73.7 | 1.6 | 0.7–3.5 | 1.6 | 0.7–3.8 | 125/256 | 55.5 | 2.2 | 1.1–4.5 | 2.5 | 1.1–5.7 |
Migratory background | ||||||||||||
No | 649/938 | 69.6 | 1 | (Reference) | 1 | (Reference) | 548/1136 | 44.1 | 1 | (Reference) | 1 | (Reference) |
Yes | 64/97 | 66.4 | 0.9 | 0.3–2.4 | 0.4 | 0.2–1.2 | 84/191 | 32.5 | 0.6 | 0.3–1.2 | 0.7 | 0.4–1.2 |
Education | ||||||||||||
Primary and lower secondary | 345/498 | 71.0 | 1 | (Reference) | 1 | (Reference) | 45/102 | 25.3 | 1 | (Reference) | 1 | (Reference) |
Upper secondary and post-secondary non-tertiary | 164/238 | 73.3 | 1.1 | 0.6–2.2 | 0.9 | 0.4–1.8 | 203/518 | 38.1 | 1.8 | 0.5–6.5 | 1.3 | 0.5–3.0 |
Undergraduate and post-graduate | 202/296 | 63.2 | 0.7 | 0.3–1.8 | 0.5 | 0.2–1.1 | 383/701 | 49.1 | 2.8 | 0.8–10.1 | 2.0 | 0.8–4.8 |
Household income (CHF) | ||||||||||||
< 5000 | 211/308 | 76.0 | 1 | (Reference) | 1 | (Reference) | 206/503 | 31.3 | 1 | (Reference) | 1 | (Reference) |
5000–8999 | 132/186 | 69.0 | 0.7 | 0.2–2.0 | 1.1 | 0.4–2.8 | 112/228 | 44.0 | 1.7 | 0.9–3.2 | 1.6 | 0.9–2.6 |
≥ 9000 | 184/256 | 67.7 | 0.7 | 0.3–1.6 | 1.0 | 0.5–2.1 | 185/343 | 52.1 | 2.4 | 1.3–4.3 | 2.4 | 1.5–3.8 |
Unknown | 157/243 | 63.4 | 0.5 | 0.2–1.3 | 0.9 | 0.5–1.8 | 94/178 | 41.1 | 1.5 | 0.8–3.1 | 1.7 | 0.9–3.0 |
Smoking | ||||||||||||
Yes or stopped | 210/302 | 75.3 | 1 | (Reference) | 1 | (Reference) | 217/542 | 33.6 | 1 | (Reference) | 1 | (Reference) |
Never | 503/733 | 67.5 | 0.7 | 0.4–1.3 | 0.8 | 0.4–1.5 | 414/782 | 49.8 | 2.0 | 1.2–3.2 | 1.6 | 1.0–2.5 |
Age at first sexual intercourse | ||||||||||||
< 18 years | 432/596 | 72.4 | 1 | (Reference) | 1 | (Reference) | 408/851 | 40.5 | 1 | (Reference) | 1 | (Reference) |
≥ 18 years | 282/440 | 65.5 | 0.7 | 0.3–1.5 | 0.7 | 0.3–1.5 | 224/476 | 46.0 | 1.3 | 0.8–1.9 | 0.8 | 0.5–1.3 |
Number of lifetime sexual partners | ||||||||||||
0–2 | 302/440 | 72.6 | 1 | (Reference) | 1 | (Reference) | 219/425 | 47.2 | 1 | (Reference) | 1 | (Reference) |
3–9 | 201/290 | 65.1 | 0.7 | 0.3–1.6 | 0.5 | 0.3–1.0 | 268/585 | 43.7 | 0.9 | 0.6–1.4 | 1.0 | 0.7–1.6 |
≥ 10 | 211/306 | 46.5 | 0.3 | 0.1–1.4 | 0.2 | 0.0–0.6 | 145/317 | 27.2 | 0.4 | 0.2–0.9 | 0.5 | 0.3–1.0 |
Cervical cancer screening | ||||||||||||
Yes | 319/480 | 61.8 | 1 | (Reference) | 1 | (Reference) | 93/205 | 43.6 | 1 | (Reference) | 1 | (Reference) |
No | 382/537 | 76.1 | 2.0 | 1.0–4.0 | 1.3 | 0.6–2.7 | 522/1078 | 42.4 | 1.0 | 0.6–1.6 | 1.1 | 0.6–1.9 |
Use of hormonal contraception | ||||||||||||
No | 116/175 | 62.5 | 1 | (Reference) | 1 | (Reference) | 129/309 | 34.2 | 1 | (Reference) | 1 | (Reference) |
Yes | 405/572 | 77.3 | 2.0 | 0.9–4.6 | 1.5 | 0.7–3.2 | 421/835 | 45.1 | 1.6 | 1.0–2.4 | 1.5 | 1.0–2.3 |
Not yet sexually experienced | 175/259 | 64.2 | 1.1 | 0.3–3.3 | 6.5 | 1.1–39.1 | 53/114 | 48.4 | 1.8 | 1.0–3.4 | 2.8 | 1.0–7.8 |