Abstract
The decision to introduce human papillomavirus (HPV) vaccination into the national immunisation programme in Spain was made in October 2007, recommending vaccination of girls aged between 11 and 14 years with three doses of HPV vaccine. All 19 regions of the country (17 Autonomous Communities and two Autonomous Cities) introduced HPV vaccination gradually into their immunisation programmes between November 2007 and the last school term of 2008. Eight regions administered the vaccine in healthcare centres and 11 in schools. In the first year of the introduction of HPV vaccination, coverage of the first and third doses was assessed, to determine the proportion of girls who did not complete the vaccination. On the basis of the available data, the Ministry of Health estimated that coverage for the first dose was 87.2% (range: 73.9–98.9%; 95% CI: 71.8 to 100) and 77.3% (range: 62.2–97.4%; 95% CI: 57.9 to 96.7) for the third dose. Higher uptake was observed when the vaccination was carried out in schools compared with healthcare centres, but the difference was not statistically significant. Negative messages in the media during implementation of the HPV vaccination programme may have had some influence on the attitudes of adolescent girls and/or their parents towards HPV vaccination and may be partly responsible for the observed vaccination dropout rate.
Highlights
Human papillomavirus (HPV) causes one of the commonest sexually transmitted infections and is the main cause of cervical cancer in the world
Regarding the venue of administration of the vaccines, coverage was 84.2% in regions that implemented the programme in schools and 70.1% for those that vaccinated in healthcare centres; the observed difference is not statistically significant
In 2009, coverage of other vaccines administered in adolescents in Spain was 74.1% and 82.7% [11]
Summary
Human papillomavirus (HPV) causes one of the commonest sexually transmitted infections and is the main cause of cervical cancer in the world. Spain has a national health system with universal access funded from general taxation [9] It is largely decentralised and the country’s 19 regions (17 Autonomous Communities and two Autonomous Cities) are responsible for the management and delivery of vaccination programmes. In February 2007 the Vaccines Board recommended the introduction of HPV vaccination This recommendation was approved by the Commission on Public Health in September and by the Interterritorial Council in October that year [10]. The Council decided to include HPV vaccination within the framework of the country’s cervical cancer prevention strategy It recommended that the vaccine be introduced before the end of 2010, for girls between the ages of 11 and 14 years, in accordance with requirements, priorities and logistics of regional vaccination programmes and the availability and supply of vaccines in each region. No specific target coverage was set as an objective of the programme
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