Dema Emily, Osman Roeann, Soldan Kate, Field Nigel, Sonnenberg Pam
University College London Institute for Global Health, London, UK
UK Health Security Agency, London, UK.
J Epidemiol Community Health. 2025 Apr 10;79(5):388-396. doi: 10.1136/jech-2024-222488.
Uptake of human papillomavirus (HPV) vaccination is generally high in high-income countries with school-based vaccination programmes; however, lower uptake in certain population subgroups could continue pre-immunisation inequalities in cervical cancer.
Six electronic databases were searched for quantitative articles published between 1 September 2006 and 20 February 2023, which were representative of the general population, with individual-level data on routine school-based vaccination (with >50% coverage) and sociodemographic measures. Titles, abstracts and full-text articles were screened for eligibility criteria and assessed for bias. A second independent reviewer randomly screened 20% of articles at each stage. A narrative synthesis summarised findings.
24 studies based in eight countries (Australia, Belgium, Canada, New Zealand, Norway, Sweden, Switzerland, UK) were included. Studies reported vaccination uptake by individual-level and area-level socioeconomic status (SES), parental education, religion, ethnicity and/or country of birth. 19 studies reported that more than 70% were vaccinated (range: 50.7%-93.0%). Minority ethnic groups and migrants were more likely to have lower vaccination uptake than White groups and non-migrants (11/11 studies). Lower SES was also associated with lower uptake of vaccination (11/17 studies). Associations with other sociodemographic characteristics, such as parental education and religion, were less clear.
Even in high-income countries with high coverage school-based vaccination programmes, inequalities are seen. The totality of available evidence suggests girls from lower SES and minority ethnic groups tend to be less likely to be vaccinated. Findings could inform targeted approaches to mop-up vaccination and cervical cancer screening amidst changing HPV epidemiology in a vaccine era.
CRD42023399648.
在实施基于学校的疫苗接种计划的高收入国家，人乳头瘤病毒（HPV）疫苗的接种率总体较高；然而，某些人群亚组的较低接种率可能会延续宫颈癌免疫接种前的不平等现象。
检索了六个电子数据库，查找2006年9月1日至2023年2月20日期间发表的定量文章，这些文章代表一般人群，包含基于学校常规疫苗接种（覆盖率>50%）的个体层面数据和社会人口学指标。对文章标题、摘要和全文进行筛选，以确定是否符合纳入标准，并评估偏倚情况。第二位独立评审员在每个阶段随机筛选20%的文章。采用叙述性综合分析总结研究结果。
纳入了来自八个国家（澳大利亚、比利时、加拿大、新西兰、挪威、瑞典、瑞士、英国）的24项研究。这些研究报告了按个体层面和地区层面社会经济地位（SES）、父母教育程度、宗教、种族和/或出生国家划分的疫苗接种情况。19项研究报告称，超过70%的人接种了疫苗（范围：50.7%-93.0%）。少数族裔群体和移民比白人组和非移民更有可能接种率较低（11/11项研究）。较低的SES也与较低的疫苗接种率相关（11/17项研究）。与其他社会人口学特征（如父母教育程度和宗教）的关联不太明确。
即使在实施高覆盖率基于学校的疫苗接种计划的高收入国家，也存在不平等现象。现有证据表明，社会经济地位较低的女孩和少数族裔群体往往接种疫苗的可能性较小。这些发现可为疫苗时代HPV流行病学变化背景下的查漏补种疫苗和宫颈癌筛查的针对性方法提供参考。
CRD42023399648。
