You are here

  • Home
  • Archive
  • Volume 5, Issue 5
  • Do parental education and income matter? A nationwide register-based study on HPV vaccine uptake in the school-based immunisation programme in Norway

Article Text

Article menu
XML
Public health
Research
Do parental education and income matter? A nationwide register-based study on HPV vaccine uptake in the school-based immunisation programme in Norway
  1. Berit Feiring1,
  2. Ida Laake1,
  3. Tor Molden1,
  4. Inger Cappelen2,
  5. Siri E Håberg3,
  6. Per Magnus3,
  7. Ólöf Anna Steingrímsdóttir4,
  8. Bjørn Heine Strand4,
  9. Jeanette Stålcrantz1,
  10. Lill Trogstad1
  1. 1Department of Vaccines, Norwegian Institute of Public Health, Oslo, Norway
  2. 2Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
  3. 3Institute Management and Staff, Norwegian Institute of Public Health, Oslo, Norway
  4. 4Department of Health Statistics, Norwegian Institute of Public Health, Oslo, Norway
  1. Correspondence to Berit Feiring; berit.feiring{at}fhi.no

Abstract

Objective Vaccine against human papillomavirus (HPV) has been offered free of charge to all 12-year-old girls in Norway since 2009. Nevertheless, the uptake of HPV vaccine is lower than for other childhood vaccines. The aim of this study was to examine whether parental education and income are associated with initiation and completion of HPV vaccination.

Design Nationwide register-based study.

Setting Publicly funded childhood immunisation programme in Norway.

Participants 91 405 girls born between 1997 and 1999 and registered in the Norwegian Central Population Registry were offered HPV vaccine during the first 3 programme years. Of these, 84 139 had complete information on all variables and were included in the study.

Measurements Information on HPV-vaccination status was obtained from the Norwegian Immunisation Registry. Data on socioeconomic factors were extracted from Statistics Norway. Risk differences (RDs) and CIs were estimated with Poisson regression.

Results In the study sample, 78.3% received at least one dose of HPV vaccine and 73.6% received all three doses. High maternal education was significantly associated with lower probability of initiating HPV vaccination (multivariable RD=−5.5% (95% CI −7.0% to −4.0%) for highest compared with lowest education level). In contrast, high maternal income was significantly associated with higher probability of initiating vaccination (multivariable RD=10.1% (95% CI 9.0% to 11.3%) for highest compared with lowest quintile). Paternal education and income showed similar, but weaker, associations. The negative association between education and initiation was only seen for incomes below the median value.

Conclusions In spite of the presumably equal access to HPV vaccine in Norway, we found socioeconomic disparities in vaccine uptake. More studies are needed to explain the underlying factors responsible for the observed socioeconomic differences. Insight into these factors is necessary to target information and increase vaccination coverage to ultimately reduce HPV-related disease across socioeconomic barriers.

  • EPIDEMIOLOGY
  • PREVENTIVE MEDICINE
  • PUBLIC HEALTH

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2014-006422

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Supplementary materials

    • Supplementary Data

      This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.