PIN133 A GEOSTATISTICAL ALGORITHM TO BETTER IDENTIFY CONTEXTUAL AND CLINICAL FACTORS ASSOCIATED TO HPV VACCINE COVERAGE IN FRANCE

Abstract

Large disparities of the Human Papillomavirus (HPV) vaccine coverage rates (VCR) are observed over the French territory. The study aims at identifying clinical and contextual factors explaining such variations using geostatistical algorithms which will be adapted to HPV vaccination in France. Understanding which community-level or individual-level factors are associated with HPV vaccination is a key aspect for designing targeted programs toward VCR improvement. At the community level, the HPV VCR were crossed over the French territory with a large number of data gathered in sociological, economic, clinical, political and behavioral categories for the year 2016. It includes agglomerated and geolocalized web and social network data. The analysis was driven in a spatially varying way in order to determine geographical areas which are homogeneous in regard to the observed correlations. In each geographical area, a factor analysis was performed to reduce redundant information. The study shows that HPV VCR spatial variations in France cannot be fully explained by a unique model. Rural areas were more influenced by political and sociological factors (especially socio-professional categories and education level), while urban areas were preferentially associated with economic and migration related factors. Two secondary geographical areas were determined: Ile-de-France and 10 North Eastern departments. Discriminating them was contributing to a better characterization of the VCR variations. The Ile-de-France was showing even more economic factors impact than the urban area as a whole, and the North Eastern departments located in the urban area were showing very high level of VCR despite a poor economic situation. Our geostatistical modeling approach leads to a better comprehension of the HPV VCR disparities. That is the first time that such innovative method is applied to identify factors influencing HPV VCR. Using this model, future localized vaccination programs should be targeted in specific sub-populations of interest.