Effectiveness of a School- and Primary Care–Based HPV Vaccination Intervention

• DOI: 10.1001/jamanetworkopen.2024.11938
• Publication Date: 2024-05-23T15:33:33Z
• Authors: Nathalie Thilly; Morgane Michel; Maïa Simon; Aurélie Bocquier; Amandine Gagneux-...; Aurélie Gauchet; Serge Gilberg; Anne-Sophie Le Du...; Sébastien Bruel; Judith E. Mueller; Bruno Giraudeau; Karine Chevreul; ; Nelly Agrinier; Isabelle Adam; Stéphanie Bonnay; Estelle Fall; Céline Pulcini; Marie Ecollan; Dragos-Paul Hagiu; Josselin Le Bel; Henri Partouche; Juliette Pinot; Louise Rossignol; Arthur Tron; Minghui Zuo; Gaëlle Vareilles; Julie Bros; Catherine Juneau; Marion Branchereau; Elisabeth Botelho...; Géraldine Jambon; Florian Jeanleboeuf; Julie Kalecinski; Christine Lasset; Laetitia Marie Di...; Jonathan Sicsic; Jocelyn Raude; Sandra Chyderiotis; Damien Oudin-Dogl...; Josée Dussault; Anne-Sophie Barret; Isabelle Bonmarin; Daniel Levy-Bruhl; Clémence Castagnet; Mélanie Simony; Julien Ailloud; Olivier Epaulard; Emily Darlington; Mabrouk Nekaa
• Keywords: HPV vaccines

Importance The human papillomavirus (HPV) vaccine is safe and effective, yet vaccination coverage remains below public health objectives in many countries. Objective To examine the effectiveness of a 3-component intervention on HPV among adolescents aged 11 to 14 years 2 months after ended, each component being applied alone or combination. Design, Setting, Participants A cluster randomized trial with incomplete factorial design (PrevHPV) was conducted between July 1, 2021, April 30, 2022, French municipalities receiving 0, 2, 3 components intervention. Randomization stratified by school district municipalities’ socioeconomic level. Analyses were carried out 11- 14-year-old living all participating municipalities, regardless what had been implemented. Intervention PrevHPV components: (1) educating motivating middle schools, along their parents; (2) training general practitioners (GPs) up-to-date information motivational interviewing techniques; (3) free at school. Main Outcomes Measures primary outcome (≥1 dose) ended based national reimbursement database data collected during groups implement at-school vaccination. Results total 91 comprising 30 739 (15 876 boys 863 girls) included analyzed. Half lowest quintiles access GPs poor more than two-thirds municipalities. Thirty-eight 61 schools (62.3%) implemented actions 26 45 (57.8%) least 1 trained GP. median increased 4.0 percentage points (IQR, 2.0-7.3 points) 14.2 9.1-17.3 months. At-school significantly (5.50 [95% CI, 3.13-7.88 points]) while no effect observed for adolescents’ education motivation (−0.08 −2.54 2.39 GPs’ (−1.46 −3.44 0.53 points]). Subgroup analyses found significant interaction GPs, higher when (8.62 5.37-11.86 points] vs 2.13 −1.25 5.50 points]; P = .007 interaction). Conclusions Relevance In this trial, within context late COVID-19 pandemic period limited GP participation, coverage. did not show motivation, although it may be time has elapsed Trial Registration ClinicalTrials.gov Identifier: NCT04945655