Objectives: In Germany, vaccination against HPV infection has been recommended for girls aged 12-17 years since 2007. The aim of this paper was to provide an overview of the current status and determinants of HPV vaccination uptake in Germany.
Methods: Analyses included data from 14- to 17-year-old girls (n =1,337) of the German Health Interview and Examination Survey for Children and Adolescents - First Follow-up Survey (KiGGS Wave 1). Standardized telephone interviews included questions for girls on the number of HPV vaccine doses and visits to a gynecologist. Parents were asked about their socioeconomic status (SES) and the girls' participation in the J1 adolescent health check-up. Descriptive analyses of the HPV vaccination status with respect to social, demographic, and health-care utilization factors were performed. Factors associated with vaccination were identified and odds ratios (OR) were estimated by means of logistic regression analysis.
Results: The prevalence of vaccination with at least one HPV vaccine dose was 52.6% (95% confidence interval 48.5-56.6). Three-dose HPV vaccination coverage was 39.5% (35.3-43.9). Vaccine uptake increased with age, was higher in girls with middle and low SES compared with high SES, with residence in eastern Germany, in those who had already seen a gynecologist, and who participated in the J1. Multivariable logistic regression revealed a twofold increased chance of being vaccinated for girls with middle SES (OR 1.9) compared with high-SES girls and for those who had yet seen a gynecologist (OR 2.1).
Conclusions: School-based vaccination programs and multi-tier vaccination campaigns have led to high vaccination rates in some European and non-European countries. In Germany, however, such high vaccination rates have not been achieved. To fully realize the potential of HPV vaccinations to reduce HPV-related cancer incidence at the population level, vaccination coverage in Germany must be increased. In absence of school-based vaccination programs, medical doctors should use each visit to check and complete the girl's vaccination status.