Have preferences of girls changed almost 3 years after the much debated start of the HPV vaccination program in The Netherlands? A discrete choice experiment

PLoS One. 2014 Aug 19;9(8):e104772. doi: 10.1371/journal.pone.0104772. eCollection 2014.

Abstract

Objectives: To assess how girls' preferences have changed almost 3 years after the much debated start of the human papillomavirus (HPV) vaccination program.

Methods: A discrete choice experiment (DCE) was conducted among girls aged 11-15 years who were invited, or were not yet invited, to get vaccinated. A panel latent class model was used to determine girls' preferences for vaccination based on five characteristics: degree of protection against cervical cancer; duration of protection; risk of mild side-effects; age of vaccination; and the number of required doses of the vaccine.

Results: The response rate was 85% (500/592). Most girls preferred vaccination at age 14 years (instead of at age 9 years) and a 2-dose scheme (instead of the current 3-dose scheme). Girls were willing to trade-off 7% (CI: 3.2% to 10.8%) of the degree of protection to have 10% less risk of mild side-effects, and 4% (CI: 1.2% to 5.9%) to receive 2 doses instead of 3 doses. Latent class analyses showed that there was preference heterogeneity among girls, i.e., higher educated girls and HPV vaccinated girls had a higher probability to opt for HPV vaccination at a higher age than lower educated girls or non-vaccinated girls.

Conclusions: Three years after the start of HPV vaccination program the risk of mild side-effects and age at vaccination seem to have become less important. For the Dutch national immunization program, we recommend not to lower the current target age of 12 years. A 2-dose scheme may result in a higher uptake and we recommend that if this scheme is introduced, it needs to receive adequate publicity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Alphapapillomavirus / immunology
  • Child
  • Choice Behavior*
  • Drug Administration Schedule
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Immunization Programs*
  • Netherlands
  • Papillomavirus Infections / immunology
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Infections / virology
  • Papillomavirus Vaccines / administration & dosage*
  • Risk Factors
  • Surveys and Questionnaires
  • Uterine Cervical Neoplasms / immunology
  • Uterine Cervical Neoplasms / prevention & control*
  • Uterine Cervical Neoplasms / virology
  • Vaccination / psychology*

Substances

  • Papillomavirus Vaccines

Grants and funding

This study was funded by the Dutch Cancer Society (no. EMCR 2009-4561). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.