Effect of school-based HPV vaccine campaigns on inequalities in uptake in France: the PrevHPV trial

Josée Dussault (1) , A S Le Duc-Banaszuk (2) , Amandine Gagneux-Brunon (3, 4) , S Bruel (5) , Aurélie Gauchet (6) , A.S. Barret (7) , Jonathan Sicsic (8) , N Thilly (9) , Judith E. Mueller (1, 10, 11)

1 Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology
2 CRCDC Pays de la Loire - Centre Régional de Coordination des Dépistages des Cancers [Angers]
3 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
4 CIRI-GIMAP - Physiopathologie et biothérapies des infections muqueuses [CIRI]
5 UJM - Université Jean Monnet - Saint-Étienne
6 LIP-PC2S - Laboratoire Inter-universitaire de Psychologie : Personnalité, Cognition, Changement Social
7 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
8 UPCité - Université Paris Cité
9 APEMAC - Adaptation, mesure et évaluation en santé. Approches interdisciplinaires
10 EHESP - École des Hautes Études en Santé Publique [EHESP]
11 UR - Université de Rennes

BackgroundHPV vaccination is recommended in France for all adolescents aged 11-14. Coverage has increased over recent years but remains below 50% by age 15, with social disparities by area deprivation level, parental education and income. We analysed the effect of school-wide campaigns on adolescent vaccine uptake and related disparities.MethodsPrevHPV is a controlled cluster-randomised trial to assess the effectiveness and efficiency of a multi-component intervention targeting middle schools and general practitioners. Sixty-one French middle schools were randomised in a partial factorial design to one of six intervention arms, some of which included school-based vaccine campaigns combined with in-class education and motivation. We assessed HPV vaccine status using online questionnaires that were administered in class to pupils (aged 13-15 years) at baseline and after 5 months. Using linear regression, we explored the decomposed effect of campaigns on vaccine uptake and interactions of the effect with sociodemographic variables.ResultsIn total, 2639 adolescents provided complete vaccination data on both questionnaires, with a ≥ 1-dose coverage of 24% at baseline. Among previously unvaccinated pupils (N = 2017), 21% (7%) of girls (boys) in the control group reported receipt of first vaccine dose during the follow-up period, compared to 49% (33%) in arms with vaccine campaigns. Adjusting for baseline vaccine intention, vaccine campaigns increased the 5-month probability of a first dose by 25 (95% confidence interval: 19-31) percentage points compared to the control group. The effect of vaccine campaigns on student-reported vaccine uptake did not substantially vary by school area deprivation level, parental education level, or family multilingualism (compared to French monolingual family).ConclusionsSchool-based campaigns substantially increased vaccine coverage among all adolescents within a short time period. Yet, underlying disparities in HPV vaccination were unchanged.Key messages• School-based vaccine campaigns can quickly increase HPV vaccine uptake among adolescents.• Vaccination campaigns need tailored implementation strategies to eventually reduce social disparities in HPV vaccination.

Mots clés: Environmental and Occupational Health; Public Health

Domaines: Sciences du Vivant [q-bio]; Vaccinologie

Josée Dussault, A S Le Duc-Banaszuk, Amandine Gagneux-Brunon, S Bruel, Aurélie Gauchet, et al.. Effect of school-based HPV vaccine campaigns on inequalities in uptake in France: the PrevHPV trial. 16th European Public Health Conference 2023 Our Food, Our Health, Our Earth: A Sustainable Future for Humanity, Nov 2023, Dublin, Ireland. pp.ckad160.398, ⟨10.1093/eurpub/ckad160.398⟩. ⟨hal-04305327⟩