Introduction: HPV infection is the most common sexually transmitted infection worldwide. It is notably responsible in France for nearly 30 000 precancerous lesions of the cervix and 6 300 new cancers, approximately half ...
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Introduction: HPV infection is the most common sexually transmitted infection worldwide. It is notably responsible in France for nearly 30 000 precancerous lesions of the cervix and 6 300 new cancers, approximately half of which are cervical cancers with a median age of diagnosis of 53 years old and 1 100 deaths each year. More than 25% of all HPV-induced cancers occur in men, with an estimate of around 1 800 new cases of HPV-induced cancer each year in France. Vaccination against HPV, recommended from 11 to 14 years old, with the possibility of vaccination to 19 years old, has been available since 2007 for young girls and 2021 for young boys in France. However, French vaccination uptake remains insufficient and below national objectives with only 47,8% of young girls and 12,8% of young boys aged 15 having received one dose of the vaccine. The main objective of this study was to quantify the determinants of HPV vaccine hesitancy declared by parents among young girls and boys aged 11 to 17 in the counties of Gironde and Landes in 2023. The secondary objectives were to evaluate the vaccination uptake rate of young girls and boys aged 11 to 17 in the counties of Gironde and Landes in 2023, and to describe the factors associated with this vaccination. Method: we conducted an observational, descriptive, transversal, multicenter study based on a questionnaire in general medical practices in Gironde and Landes. The source population was parents (father or mother) having, at the time of filling in the questionnaire, at least one child, girl or boy, aged 11 to 17, living in Gironde or Landes. Results: 162 questionnaires were analyzed in our study, 66 of which came from Gironde (40,7%) and 96 from Landes (59,3%). 93 girls (57,4%) and 69 boys (42,6%) were included. The main barriers to vaccination found in our study were, for all sexes combined, the absence of an offer of the vaccine (14,7%), the lack of sufficient medical knowledge about the vaccine (10,5%), the fear of the side effects (10,0%), then the lack of knowledge and information on possible diseases caused by HPV (8,9%) and mistrust of the pharmaceutical industry (8,9%). Thereby, 63,4% of girls and 44,9% of boys aged 11 to 17 in our study were vaccinated against HPV. Among girls, if the mother answered our questionnaire, the parent’s very favorable opinion about vaccination in general and about HPV vaccine campaign in high schools, the parent’s knowledge of the risk of severe disease due to HPV and of the extension of HPV vaccination for boys, and the offer of vaccination by the attending doctor, were statistically associated with higher vaccination rates. Among boys, if the family lived in an urban area, parent’s favorable opinion about the HPV vaccine campaign in high schools and parent’s knowledge about the extension of HPV vaccination for boys were statistically associated with higher vaccination rates. Conclusion: many determinants of HPV vaccine hesitancy have been identified and still persist in our society. Better dissemination of information about the vaccine to the population, its real side effects, about HPV infection and its risks, by attending doctors and public authorities seem to be a priority to improve vaccination uptake in France. The national HPV vaccine campaign in high schools will help reduce social inequalities regarding access to healthcare.
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