Vaccination coverage rates and predictors of HPV vaccination among eligible and non-eligible female adolescents at the Brazilian HPV vaccination public program

Alexandre Faisal-Cury,José Eluf-Neto,Maria Fernanda Tourinho,Renata Bertazzi Levy,Alexandre Grangeiro

doi:10.1186/s12889-020-08561-4

Alexandre Faisal-Cury, José Eluf-Neto + Show 3 more

Open Access

https://doi.org/10.1186/s12889-020-08561-4

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Abstract

BackgroundSince March 2014, the quadrivalent HPV vaccine has been incorporated into the Brazilian Unified Health Care System and began to be offered, without direct costs, for girls from 9 to 13 years of age. Older female adolescents would have the option to be vaccinated at private health care system being responsible for the payment of HPV vaccine. The present study aimed to evaluate the coverage rates and predictors of HPV vaccination in Brazil among two groups of female adolescents: eligible and non-eligible for the HPV vaccination public program.MethodsWe used data from the 2015 Brazilian National Adolescent School-Based Health Survey, which involved a probabilistic sample of 5404 female adolescents students at public and private schools. Using a questionnaire, we gathered information on sociodemographic characteristics, sexual behavior, and respondent perception of parental supervision and have been vaccinated for HPV. Age-specific vaccination rates were analyzed in girls aged 9 to 13 at the time of public vaccination (eligible for public policy), as well among those 14 to 17 years old not eligible by the Ministry of Health for vaccination. We used Poisson regression models to investigate associated factors.ResultsHPV vaccine coverage was 83.5 and 21.8% among eligible and non-eligible populations, respectively. In both populations, the chance of being vaccinated decreased with older age. In the eligible population there is a greater chance of being vaccinated among ethnic group “pardas” but not with other indicators of socioeconomic status. In the non-eligible population, there was a clear association between higher vaccine coverage and greater maternal education and living with the mother.ConclusionOur findings highlight the importance of public policies to minimize inequities in access to cancer prevention measures in vulnerable adolescents. A public policy of HPV vaccination for older female adolescents would increase coverage with possible reduction of HPV-related diseases in this group of women.

Highlights

Since March 2014, the quadrivalent human papillomavirus (HPV) vaccine has been incorporated into the Brazilian Unified Health Care System and began to be offered, without direct costs, for girls from 9 to 13 years of age
Since 2006, the HPV vaccine has been registered in Brazil and made available at private clinics and laboratories in the country, HPV vaccination being recommended for females between 9 and 26 years of age according to the vaccine producer
Vaccination rates among non-eligible population ranged from 32.4%, for the respondents whose mother had college degree to 11.5%, for those who lived with their father only (Table 1)

Summary

Introduction

Since March 2014, the quadrivalent HPV vaccine has been incorporated into the Brazilian Unified Health Care System and began to be offered, without direct costs, for girls from 9 to 13 years of age. In March 2014, the quadrivalent HPV vaccine was incorporated into the Brazilian Unified Health Care System and began to be offered, without direct costs, at primary care clinics, public schools, and private schools for girls from 9 to 13 years of age. Older female adolescents would have the option to be vaccinated at private health care system being responsible for the payment of HPV vaccine To reach this goal, mass campaigns aimed at the general population, health professionals, and adolescents were carried out by the Brazilian government. Studies have confirmed that vaccination against HPV is cost-effective in Brazil, especially if high vaccination coverage rates can be achieved [6]

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