Impact of new consent procedures on uptake of the schools-based Human Papillomavirus (HPV) vaccination programme

Harriet Fisher*, Matthew Hickman, Joanne Ferrie, Karen Evans, Michael Bell, Julie Yates, Marion Roderick, Rosy Reynolds, John MacLeod, Suzanne Audrey

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Background: Local policy change initiating new consent procedures was introduced during 2017/18 for the Human Papillomavirus (HPV) vaccination programme year in two local authorities in the south west of England. This study aims to assess impact on uptake and inequalities.
Methods: Publicly available aggregate and individual-level routine data were retrieved for the programme years 2015/16 to 2018/19. Statistical analyses were undertaken to show: (i) change in uptake in intervention local authorities in comparison to matched local authorities in England, and; (ii) change in uptake overall, and by local authority, school type, ethnicity and deprivation.

Results: Aggregate data showed uptake in Local Authority One increased from 76.3% to 82.5% in the post-intervention period (risk difference: 6.2% p=0.17), with a difference-in-differences effect of 11.5% (p=0.03). There was no evidence for a difference-in-differences effect in Local Authority Two (p=0.76). Individual-level data showed overall uptake increased post-intervention (risk difference: +1.1%, p=0.05), and for young women attending school in Local Authority One (risk difference: 2.3%, p<0.01). No strong evidence for change by school category, ethnic group, and deprivation.

Conclusion: Implementation of new consent procedures can improve and overcome trends for decreasing uptake among matched local authorities. However, no evidence for reduction in inequalities was found.
Original languageEnglish
Article numberfdaa164
Number of pages8
JournalJournal of Public Health
Publication statusPublished - 26 Sep 2020


  • HPV vaccination programme
  • adolescents
  • consent
  • policy
  • quasi experimental study design


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