Estimated acceptance of HPV vaccination among Italian women aged 18-26 years.

In Italy vaccination against human papillomavirus (HPV) was introduced in the national immunization programme in 2007; the primary target for this vaccination is 11-year-old females, whereas vaccination for older age groups is still a matter of debate. This project was carried out in the period 2007-2009 to estimate the acceptance rate among 18-26-year-old, to whom free-of-charge vaccination was actively offered. Socio-demographic factors associated with acceptance were also investigated. A sample of 1159 women was randomly selected from resident population lists of 10 Local Health Units in 6 of Italy's 21 Regions; 1032 women were deemed eligible for the study. Of the eligible women, 580 received at least one vaccine dose for an acceptance rate of 56.2% and 542 received all three vaccine doses (52.6%). The acceptance rate was significantly higher for: residents of northern and central Italy (OR(adj)=2.22, 95%CI 1.64-3.01 and OR(adj)=1.77, 95%CI, 1.20-2.61 respectively), compared to southern Italy; women with a high educational level (OR(adj)=1.41; 95%CI: 1.02-1.93); and students (OR(adj)=1.64; 95%CI: 1.13-2.37). The low immunization rate highlights the difficulties of reaching young adult women, although the current coverage rates observed in the primary target population of HPV vaccination campaign (64%) emphasize that achieving high coverage rates is challenging also in younger age groups. Our results suggest that it would be premature to extend the active free-of-charge offer of HPV vaccination to older women and that efforts should be focused on the priority target, considering that the objective of 95% coverage established for this age group is still far from being attained.