Institut national de santé publique du Québec, Québec, Canada.
Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; VITAM-Centre de recherche en santé durable, Québec, Canada.
Vaccine. 2024 Jul 11;42(18):3768-3773. doi: 10.1016/j.vaccine.2024.04.089. Epub 2024 May 6.
Vaccination coverage against human papillomavirus (HPV) in school-based programs in Quebec, Canada, is suboptimal despite more than a decade of introduction. Three interventions to improve HPV vaccine acceptability and coverage in school-based programs were developed, implemented as part of a multicomponent strategy and evaluated.
Sixty-four (64) schools were recruited, of which 32 received the interventions (pilot schools), and 32 received usual vaccination activities (control schools). Two approaches were used to assess the impact of the interventions. Pre-post questionnaires were completed by parents in both pilot and control schools. Quantitative analyses of vaccination coverage using the Quebec immunization registry were conducted.
Participating parents (n = 989 in the pre-intervention survey and n = 772 in the post-intervention one) were generally aware of HPV and HPV vaccination. Most parents were confident about vaccination, had little or no hesitation and had decided to have their child vaccinated. Parents in the pilot schools were less concerned about vaccine safety than those in the control schools after the interventions. Parents in the pilot schools were also more likely to have decided to have their child vaccinated. A statistically significant difference of 7.4 % in HPV vaccine coverage between pilot and control schools was observed (82.9 % vs 75.5 %, p <0.0001).
Although school-based programs offer equitable access to vaccination and minimize access barriers, it remains crucial to identify effective interventions to improve vaccine uptake further and reach the WHO cervical cancer elimination goal. Our multicomponent strategy appears to have positively impacted HPV vaccine acceptability and coverage and could be adapted to other contexts where vaccination is delivered in school-based programs.
尽管加拿大魁北克省的学校计划已经实施了十多年，但针对人乳头瘤病毒（HPV）的疫苗接种覆盖率仍不理想。为了提高 HPV 疫苗在学校计划中的可接受性和覆盖率，开发并实施了三种干预措施，作为多组分策略的一部分进行了评估。
招募了 64 所学校，其中 32 所接受了干预措施（试点学校），32 所接受了常规疫苗接种活动（对照学校）。使用两种方法评估干预措施的影响。在试点和对照学校中，家长都完成了疫苗接种前后的问卷调查。利用魁北克免疫登记处对疫苗接种覆盖率进行了定量分析。
参与的家长（干预前调查 989 人，干预后调查 772 人）普遍了解 HPV 和 HPV 疫苗接种。大多数家长对疫苗接种有信心，几乎没有或没有犹豫，并决定为孩子接种疫苗。干预后，试点学校的家长比对照学校的家长对疫苗安全性的担忧更少。试点学校的家长更有可能决定为孩子接种疫苗。试点学校和对照学校之间 HPV 疫苗覆盖率存在统计学显著差异（82.9%比 75.5%，p<0.0001），差异为 7.4%。
尽管学校计划提供了公平的疫苗接种机会，并最大限度地减少了接种障碍，但仍需要确定有效的干预措施，以进一步提高疫苗接种率，实现世界卫生组织消除宫颈癌的目标。我们的多组分策略似乎对 HPV 疫苗的可接受性和覆盖率产生了积极影响，并可适用于其他在学校计划中进行疫苗接种的环境。
