G497(P) Human papilloma virus vaccination coverage rates in ‘looked after’ young women – another marker of health disadvantage?

Abstract

Aims Vaccination of young women against human papilloma virus (HPV) has important health benefits, not least in reducing lifetime cervical cancer risk. Young women who are ‘looked after’ are a vulnerable group, known to face disadvantage in several areas, including in relation to their health. Are we able to achieve HPV coverage rates in this group comparable to the general population in order to safeguard their future health? We set out to study this in our own Health Board area. Methods We studied young women aged 12–18 years, ‘looked after’ by three Local Authorities co-terminus with our Health Board’s geographical area, who by virtue of their age should have received a 3 dose HPV vaccination course. We compared vaccination coverage in this group, using their recorded vaccination status on the All Wales Child Health Database, with a cohort of young women who were not ‘looked after’, and who had completed academic year 9 and were resident in the same Health Board area, using NPHS Wales ‘COVER’ data. We statistically analysed differences observed. We established that ethical approval was not required to undertake this study. Results Of 2555 young women who had completed year 9 and who were not ‘looked after’, 2308 had completed a 3 dose HPV vaccination course (90.3%). Of the 157 eligible young women ‘looked after’, 131 had received a comparable 3 dose vaccination course (83.4%). The difference was statistically significant (X2 7.763, p 0.005). Conclusion Our study of young women who should have completed a 3 dose HPV vaccination course highlights that those ‘looked after’ were significantly less likely to be vaccinated. We have identified yet another area of health disadvantage for this group which could have important consequences for their future health. Action is required to address this and our own recommendations will be discussed, in addition to what we see as the possible reasons for this difference. We suggest that HPV vaccination coverage rates in young women ‘looked after’ should be reviewed across the United Kingdom by those health professionals who work with this vulnerable group.