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Contribution title Evolution of the HPV vaccination coverage in Switzerland, 2008-2016
Authors
  1. Phung Lang Institut für Epidemiologie, Biostatistik und Prävention der Universität Zürich Presenter
  2. Philipp Sinniger Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich
  3. Anne Spaar Bundesamt für Gesundheit
  4. Rita Born Federal Office of Public Health
  5. Christoph Hatz Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich
Form of presentation Poster
Topic
  • Public health
Abstract Introduction
In 2008, the Swiss Federal Office of Public Health (FOPH) officially included the human papillomavirus (HPV) vaccination for girls and young women into the immunization schedule. In 2012, the recommendation changed from the 3- to the 2-dose series. This study examines the evolution of HPV vaccine coverage between 2008 and 2016, with focus on the completion rates of recommended dosing intervals for both vaccination schedules.

Method
HPV vaccination data for 16-year old girls from the Swiss National Vaccination Coverage Survey (SNVCS) 2008-16 were analyzed. Completion rate (defined using the recommendations from the FOPH for 2- and 3- dose series) was calculated based on the date of birth and dates of the administered HPV vaccine doses. Cases with missing date of birth or dates of administered HPV vaccine doses were not included in the evaluation.

Results
HPV vaccine uptake has increased between 2008 and 2016. Compared to the HPV vaccine coverage based on the number of doses administered, completion rates based on recommended dosing intervals for both series were only 21.0% (95% CI 17.4%-24.5%) instead of 27.0% (95% CI 22.8%-31.1%) during the survey period 2008-10 (n=3,488), 45.5% (95% CI 43.3%-47.8%) instead of 52.8% (95% CI 50.5%-55.0%) in 2011-13 (n=3,777) and 47.7% (95% CI 45.4%-50.0%) instead of 55.3% (95% CI 53.1%-57.6%) in 2014-16 (n=3,354). After the change in recommendation from the 3- to the 2-dose series in 2012, the proportion of the completed 2-dose series of all completed series increased from 0.6% (95% CI 0.3%-0.9%) in 2011-13 to 47.7% (95% CI 40.8%-54.6%) in 2014-16. Cantons with HPV vaccination programs in the schools 2014-16 had a completion rate of 50.6% (95% CI 47.8%-53.5%) for both series compared to 37.2% (95% CI 34.1%-40.3%) in cantons without this service.

Conclusion
The FOPH recommendation to change from a 3- to a 2-dose schedule for HPV vaccination is well accepted and explains the significant decline in the completion rate of the 3-dose series (from 45.3% (95% CI 43.0%-47.5%) to 25.0% (95% CI 21.5%-28.4%)). The numbers of completed 2-dose series had increased significantly, although the overall completion rate had not. The completion rate may be further increased, in particular through school vaccination programs.