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

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.