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Human papillomavirus vaccination of girls in the German model region Saarland: Insurance data-based analysis and identification of starting points for improving vaccination rates
In Germany, the incidence of cervical cancer, a disease caused by human papillomaviruses (HPV), is higher than in neighboring European countries. HPV vaccination has been recommended for girls since 2007. However, it continues to be significantly less well received than other childhood vaccines, so...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439211/ https://www.ncbi.nlm.nih.gov/pubmed/36054196 http://dx.doi.org/10.1371/journal.pone.0273332 |
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author | Sternjakob-Marthaler, Anna Berkó-Göttel, Barbara Rissland, Jürgen Schöpe, Jakob Taurian, Emeline Müller, Hanna Weber, Gero Lohse, Stefan Lamberty, Thomas Holleczek, Bernd Stoffel, Harry Hauptmann, Gunter Giesen, Martin Firk, Christiane Schanzenbach, Alexandra Brandt, Florian Hohmann, Heike Werthner, Quirin Selzer, Dominik Lehr, Thorsten Wagenpfeil, Stefan Smola, Sigrun |
author_facet | Sternjakob-Marthaler, Anna Berkó-Göttel, Barbara Rissland, Jürgen Schöpe, Jakob Taurian, Emeline Müller, Hanna Weber, Gero Lohse, Stefan Lamberty, Thomas Holleczek, Bernd Stoffel, Harry Hauptmann, Gunter Giesen, Martin Firk, Christiane Schanzenbach, Alexandra Brandt, Florian Hohmann, Heike Werthner, Quirin Selzer, Dominik Lehr, Thorsten Wagenpfeil, Stefan Smola, Sigrun |
author_sort | Sternjakob-Marthaler, Anna |
collection | PubMed |
description | In Germany, the incidence of cervical cancer, a disease caused by human papillomaviruses (HPV), is higher than in neighboring European countries. HPV vaccination has been recommended for girls since 2007. However, it continues to be significantly less well received than other childhood vaccines, so its potential for cancer prevention is not fully realized. To find new starting points for improving vaccination rates, we analyzed pseudonymized routine billing data from statutory health insurers in the PRÄZIS study (prevention of cervical carcinoma and its precursors in women in Saarland) in the federal state Saarland serving as a model region. We show that lowering the HPV vaccination age to 9 years led to more completed HPV vaccinations already in 2015. Since then, HPV vaccination rates and the proportion of 9- to 11-year-old girls among HPV-vaccinated females have steadily increased. However, HPV vaccination rates among 15-year-old girls in Saarland remained well below 50% in 2019. Pediatricians vaccinated the most girls overall, with a particularly high proportion at the recommended vaccination age of 9–14 years, while gynecologists provided more HPV catch-up vaccinations among 15-17-year-old girls, and general practitioners compensated for HPV vaccination in Saarland communities with fewer pediatricians or gynecologists. We also provide evidence for a significant association between attendance at the children´s medical check-ups “U11” or “J1” and HPV vaccination. In particular, participation in HPV vaccination is high on the day of U11. However, obstacles are that U11 is currently not financed by all statutory health insurers and there is a lack of invitation procedures for both U11 and J1, resulting in significantly lower participation rates than for the earlier U8 or U9 screenings, which are conducted exclusively with invitations and reminders. Based on our data, we propose to restructure U11 and J1 screening in Germany, with mandatory funding for U11 and organized invitations for HPV vaccination at U11 or J1 for both boys and girls. |
format | Online Article Text |
id | pubmed-9439211 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-94392112022-09-03 Human papillomavirus vaccination of girls in the German model region Saarland: Insurance data-based analysis and identification of starting points for improving vaccination rates Sternjakob-Marthaler, Anna Berkó-Göttel, Barbara Rissland, Jürgen Schöpe, Jakob Taurian, Emeline Müller, Hanna Weber, Gero Lohse, Stefan Lamberty, Thomas Holleczek, Bernd Stoffel, Harry Hauptmann, Gunter Giesen, Martin Firk, Christiane Schanzenbach, Alexandra Brandt, Florian Hohmann, Heike Werthner, Quirin Selzer, Dominik Lehr, Thorsten Wagenpfeil, Stefan Smola, Sigrun PLoS One Research Article In Germany, the incidence of cervical cancer, a disease caused by human papillomaviruses (HPV), is higher than in neighboring European countries. HPV vaccination has been recommended for girls since 2007. However, it continues to be significantly less well received than other childhood vaccines, so its potential for cancer prevention is not fully realized. To find new starting points for improving vaccination rates, we analyzed pseudonymized routine billing data from statutory health insurers in the PRÄZIS study (prevention of cervical carcinoma and its precursors in women in Saarland) in the federal state Saarland serving as a model region. We show that lowering the HPV vaccination age to 9 years led to more completed HPV vaccinations already in 2015. Since then, HPV vaccination rates and the proportion of 9- to 11-year-old girls among HPV-vaccinated females have steadily increased. However, HPV vaccination rates among 15-year-old girls in Saarland remained well below 50% in 2019. Pediatricians vaccinated the most girls overall, with a particularly high proportion at the recommended vaccination age of 9–14 years, while gynecologists provided more HPV catch-up vaccinations among 15-17-year-old girls, and general practitioners compensated for HPV vaccination in Saarland communities with fewer pediatricians or gynecologists. We also provide evidence for a significant association between attendance at the children´s medical check-ups “U11” or “J1” and HPV vaccination. In particular, participation in HPV vaccination is high on the day of U11. However, obstacles are that U11 is currently not financed by all statutory health insurers and there is a lack of invitation procedures for both U11 and J1, resulting in significantly lower participation rates than for the earlier U8 or U9 screenings, which are conducted exclusively with invitations and reminders. Based on our data, we propose to restructure U11 and J1 screening in Germany, with mandatory funding for U11 and organized invitations for HPV vaccination at U11 or J1 for both boys and girls. Public Library of Science 2022-09-02 /pmc/articles/PMC9439211/ /pubmed/36054196 http://dx.doi.org/10.1371/journal.pone.0273332 Text en © 2022 Sternjakob-Marthaler et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Sternjakob-Marthaler, Anna Berkó-Göttel, Barbara Rissland, Jürgen Schöpe, Jakob Taurian, Emeline Müller, Hanna Weber, Gero Lohse, Stefan Lamberty, Thomas Holleczek, Bernd Stoffel, Harry Hauptmann, Gunter Giesen, Martin Firk, Christiane Schanzenbach, Alexandra Brandt, Florian Hohmann, Heike Werthner, Quirin Selzer, Dominik Lehr, Thorsten Wagenpfeil, Stefan Smola, Sigrun Human papillomavirus vaccination of girls in the German model region Saarland: Insurance data-based analysis and identification of starting points for improving vaccination rates |
title | Human papillomavirus vaccination of girls in the German model region Saarland: Insurance data-based analysis and identification of starting points for improving vaccination rates |
title_full | Human papillomavirus vaccination of girls in the German model region Saarland: Insurance data-based analysis and identification of starting points for improving vaccination rates |
title_fullStr | Human papillomavirus vaccination of girls in the German model region Saarland: Insurance data-based analysis and identification of starting points for improving vaccination rates |
title_full_unstemmed | Human papillomavirus vaccination of girls in the German model region Saarland: Insurance data-based analysis and identification of starting points for improving vaccination rates |
title_short | Human papillomavirus vaccination of girls in the German model region Saarland: Insurance data-based analysis and identification of starting points for improving vaccination rates |
title_sort | human papillomavirus vaccination of girls in the german model region saarland: insurance data-based analysis and identification of starting points for improving vaccination rates |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439211/ https://www.ncbi.nlm.nih.gov/pubmed/36054196 http://dx.doi.org/10.1371/journal.pone.0273332 |
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