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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/19759

Title: From non school-based, co-payment to school-based, free Human Papillomavirus vaccination in Flanders (Belgium): A retrospective cohort study describing vaccination coverage, age-specific coverage and socio-economic inequalities
Authors: Lefevere, Eva
Theeten, Heidi
Hens, Niel
De Smet, Frank
Top, Geert
Van Damme, Pierre
Issue Date: 2015
Publisher: ELSEVIER SCI LTD
Citation: VACCINE, 33 (39), p. 5188-5195
Abstract: School-based, free HPV vaccination for girls in the first year of secondary school was introduced in Flanders (Belgium) in 2010. Before that, non school-based, co-payment vaccination for girls aged 12-18 was in place. We compared vaccination coverage, age-specific coverage and socio-economic inequalities in coverage -3 important parameters contributing to the effectiveness of the vaccination programs - under both vaccination systems. We used retrospective administrative data from different sources. Our sample consisted of all female members of the National Alliance of Christian Mutualities born in 1995, 1996, 1998 or 1999 (N=66,664). For each vaccination system we described the cumulative proportion HPV vaccination initiation and completion overtime. We used life table analysis to calculate age-specific rates of HPV vaccination initiation and completion. Analyses were done separately for higher income and low income groups. Under non school-based, co-payment vaccination the proportions HPV vaccination initiation and completion slowly rose over time. By age 17, the proportion HPV vaccination initiation/completion was 0.75 (95% CI 0.74-076)/0.66 (95% CI 0.65-0.67). The median age at vaccination initiation/completion was 14.4 years (95% CI 14.4-14.5)/15.4 years (95% CI 15.3-15.4). Socio-economic inequalities in coverage widened over time and with age. Under school-based, free vaccination rates of HPV vaccination initiation were substantially higher. By age 14,the proportion HPV vaccination initiation/completion was 0.90 (95% CI 0.90-0.90)/0.87(95% CI 0.87-0.88). The median age at vaccination initiation/completion was 12.7 years (95% CI 12.7-12.7)/13.3 years (95% CI 13.3-13.3). Socio-economic inequalities in coverage and in age-specific coverage were substantially smaller. (C) 2015 Published by Elsevier Ltd.
Notes: [Lefevere, Eva] Univ Antwerp, Herman Deleeck Ctr Social Policy, B-2000 Antwerp, Belgium. [Theeten, Heidi; Van Damme, Pierre] Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, CEV, B-2610 Antwerp, Belgium. [Hens, Niel] Hasselt Univ, Ctr Stat CenStat, B-3590 Diepenbeek, Belgium. [Hens, Niel] Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, Ctr Hlth Econ Res & Modelling Infect Dis CHERMID, B-2610 Antwerp, Belgium. [De Smet, Frank] Natl Alliance Christian Mutual, B-1031 Brussels, Belgium. [De Smet, Frank] Katholieke Univ Leuven, Dept Publ Hlth & Primary Care, Environm & Hlth, B-3000 Leuven, Belgium. [Top, Geert] Agcy Care & Hlth Infect Dis Control & Vaccinat, B-1030 Brussels, Belgium.
URI: http://hdl.handle.net/1942/19759
DOI: 10.1016/j.vaccine.2015.07.088
ISI #: 000361862900023
ISSN: 0264-410X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2016
Appears in Collections: Research publications

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