European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
Vaccine. 2011 Dec 6;29(52):9663-7. doi: 10.1016/j.vaccine.2011.10.021. Epub 2011 Oct 18.
Persistent infection with human papillomavirus (HPV) is a prerequisite for cervical cancer, which causes 175 yearly deaths and substantial morbidity in Denmark. In January 2009, HPV-vaccination for 12 year-old girls was introduced into the free-of-charge childhood vaccination programme. Due to concerns about potential poor compliance we determined the uptake and identified determinants for vaccination after the first year of the programme.
All vaccinations given within the vaccination programme are reported to a central register, which we linked to demographic information found in the Danish civil register. We calculated vaccination uptake and used Cox regression survival analysis to compare the uptake rates between demographic subgroups in the population, e.g. by number of siblings, age of mother (at the daughter's birth) and place of origin.
The uptake among the 33,838 eligible girls was 80%, 75% and 62% respectively for the three HPV-doses. All subgroups had uptake above 68% for the first HPV-vaccination. Girls with mothers younger or older than the reference group of 25-34 years had a lower uptake rate (adjHR 0.94, 95% CI 0.91-0.97 and adjHR 0.91, 95% CI 0.88-0.94 respectively). Girls with 5 or more siblings had lower uptake rate than girls without siblings (adjHR 0.79, 95% CI 0.71-0.87). Girls born in other EU/EFTA-countries had lower uptake rate than Danish-born girls with Danish-born parents (adjHR 0.74, 95% CI 0.67-0.82).
The introduction of routine HPV-vaccination in Denmark resulted in a relatively high uptake, indicating little reason for major concern about barriers towards the vaccination in Denmark. Population groups with reduced uptake were identified, but as they were small in number their effect on the overall vaccination coverage was marginal. Nonetheless, these groups should be targeted in future acceptance studies and vaccination awareness campaigns.
人乳头瘤病毒（HPV）的持续感染是宫颈癌的前提条件，这种疾病在丹麦每年导致 175 人死亡和大量发病。2009 年 1 月，为 12 岁女孩接种 HPV 疫苗被纳入免费儿童疫苗接种计划。由于担心潜在的低依从性，我们在该计划的第一年之后确定了接种率，并确定了接种的决定因素。
接种计划内接种的所有疫苗均向中央登记处报告，我们将该登记处与丹麦公民登记处的人口统计信息相关联。我们计算了接种率，并使用 Cox 回归生存分析比较了人口中不同人群的接种率，例如通过兄弟姐妹的数量、母亲（在女儿出生时）的年龄和原籍国。
在 33838 名符合条件的女孩中，三种 HPV 剂量的接种率分别为 80%、75%和 62%。所有亚组的第一剂 HPV 疫苗接种率均高于 68%。母亲年龄小于或大于 25-34 岁参考组的女孩接种率较低（调整后的 HR 0.94，95%CI 0.91-0.97 和调整后的 HR 0.91，95%CI 0.88-0.94）。有 5 个或更多兄弟姐妹的女孩接种率低于没有兄弟姐妹的女孩（调整后的 HR 0.79，95%CI 0.71-0.87）。出生在其他欧盟/欧洲自由贸易区国家的女孩接种率低于丹麦出生的父母为丹麦人的女孩（调整后的 HR 0.74，95%CI 0.67-0.82）。
在丹麦常规接种 HPV 疫苗的结果是相对较高的接种率，表明对丹麦疫苗接种的障碍几乎没有理由引起重大关注。确定了接种率较低的人群，但由于人数较少，对总体接种覆盖率的影响微乎其微。然而，在未来的接受研究和疫苗接种宣传活动中，应针对这些群体。
