Abstract
ObjectivesThe objectives were to measure uptake of and factors associated with human papillomavirus (HPV) vaccination initiation and to determine whether HPV vaccination reduced the uptake of cervical cancer screening.MethodsWe conducted a cross-sectional survey in a random sample of Swiss women aged 18–49 years in 2014 (N = 3588).ResultsVaccination initiation was 69.3% and full coverage (three doses) 54.1% for 18–20-year olds, respectively, 42.4% and 33.9% for 21–24-year olds. Women with ≥ 10 lifetime sexual partners were less likely to have received any HPV vaccination than women with ≤ 2 partners (18–20 years OR 0.2, 21–24 years OR 0.5). Amongst 1000 unvaccinated women (18–24 years), reasons for not having initiated vaccination were lack of information (22.5%) and fear of vaccine side effects (18.1%). Vaccination status was not associated with adherence to cervical cancer screening recommendations (OR 1.3). 95.4% of all vaccinated participants knew about the continued need for screening.ConclusionsOur data suggest that HPV vaccination is not associated with reduced uptake of cervical cancer screening. This study provides information that can be used to improve HPV vaccination uptake in Switzerland.
Highlights
The aim of human papillomavirus (HPV) vaccination programs is to reduce the incidence of cervical cancer and other HPV-associated cancers (Barr and Sings 2008)
Our data suggest that HPV vaccination is not associated with reduced uptake of cervical cancer
This study provides information that can be used to improve HPV vaccination uptake in Switzerland
Summary
The aim of human papillomavirus (HPV) vaccination programs is to reduce the incidence of cervical cancer and other HPV-associated cancers (Barr and Sings 2008). In Switzerland, HPV vaccination was included in the National Vaccination Plan in 2007 for 11- to 26-year-old women (Bundesamt fur Gesundheit and EKIF 2008). The recommended age for primary HPV vaccination in Switzerland is 11–14 years. The Swiss National Vaccination Coverage Survey routinely collects HPV vaccination coverage in 16-year olds (Bundesamt fur Gesundheit 2008). The cost of HPV vaccination is fully covered by health insurance for vaccinations administered within public health vaccination programs (Bundesamt fur Gesundheit 2010a, b). Health insurance covers Papanicolaou (Pap) screening, the other main measure to control cervical cancer. The Swiss Gynecological Society recommends Pap screening from age 21 or from the start of sexual activity every 2 years. In 30- to 70-year-old women, screening should be performed every 3 years assuming that the last three screening test results were normal. Thereafter, screening is only continued in case of continued sexual activity or previous abnormal screening results (Gynecologie Suisse, Kommission Qualitatssicherung 2012)
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