Peter R Hansen1, Matthias Schmidtblaicher2, Noel T Brewer3. 1. Department of Economics, University of North Carolina at Chapel Hill, United States; Department of Finance, Copenhagen Business School, Denmark. Electronic address: hansen@unc.edu. 2. Department of Economics, European University Institute, Florence, Italy; QuantCo, Inc, United States. 3. Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, United States.
Abstract
BACKGROUND: Immunization programs' resilience to shocks is central to their success, but little empirical evidence documents resilience in action. We sought to characterize the decline of HPV vaccination in Denmark after negative media coverage and recovery during a national information campaign. METHODS: We conducted a population-based retrospective cohort study of all girls born in Denmark from 1997 to 2006 (N = 328,779), aged 12-15. The outcome measure was HPV vaccine uptake (first dose), as reported to the Danish national health registry from 2009 to 2019, when HPV vaccine was freely available to girls in primary care clinics in Denmark. Events that created 4 natural time periods for study were HPV vaccine reaching the uptake of other vaccines in the national program (2009), some negative media coverage of HPV vaccination (2013), extensive negative media coverage (2015), and a national information campaign about the vaccine's safety and effectiveness (2017-2019). RESULTS: In the period with some negative media coverage, HPV vaccine uptake fell to 83.6% (95% CI:78.0%-89.7%) of baseline uptake. In the period with extensive negative media coverage, uptake fell even further to 49.6% (95% CI:44.5%-55.2%) of baseline uptake. After the information campaign, HPV vaccine uptake recovered to its baseline level (109.2%, 95% CI:90.1%-132.4%) due in part to catch-up doses. Despite the recovery, an estimated 26,000 fewer girls initiated the vaccine than if uptake had not declined. CONCLUSIONS: The experience in Denmark offers one of the first opportunities to document how a nation grappled with negative media coverage of HPV vaccination and the steadying impact of action by national authorities.
BACKGROUND: Immunization programs' resilience to shocks is central to their success, but little empirical evidence documents resilience in action. We sought to characterize the decline of HPV vaccination in Denmark after negative media coverage and recovery during a national information campaign. METHODS: We conducted a population-based retrospective cohort study of all girls born in Denmark from 1997 to 2006 (N = 328,779), aged 12-15. The outcome measure was HPV vaccine uptake (first dose), as reported to the Danish national health registry from 2009 to 2019, when HPV vaccine was freely available to girls in primary care clinics in Denmark. Events that created 4 natural time periods for study were HPV vaccine reaching the uptake of other vaccines in the national program (2009), some negative media coverage of HPV vaccination (2013), extensive negative media coverage (2015), and a national information campaign about the vaccine's safety and effectiveness (2017-2019). RESULTS: In the period with some negative media coverage, HPV vaccine uptake fell to 83.6% (95% CI:78.0%-89.7%) of baseline uptake. In the period with extensive negative media coverage, uptake fell even further to 49.6% (95% CI:44.5%-55.2%) of baseline uptake. After the information campaign, HPV vaccine uptake recovered to its baseline level (109.2%, 95% CI:90.1%-132.4%) due in part to catch-up doses. Despite the recovery, an estimated 26,000 fewer girls initiated the vaccine than if uptake had not declined. CONCLUSIONS: The experience in Denmark offers one of the first opportunities to document how a nation grappled with negative media coverage of HPV vaccination and the steadying impact of action by national authorities.
Authors: Tatjana Gazibara; Lau Caspar Thygesen; Maria Holst Algren; Janne Schurmann Tolstrup Journal: J Gen Intern Med Date: 2020-04-27 Impact factor: 5.128
Authors: Kalyani Sonawane; Yueh-Yun Lin; Haluk Damgacioglu; Yenan Zhu; Maria E Fernandez; Jane R Montealegre; Cecilia Ganduglia Cazaban; Ruosha Li; David R Lairson; Ying Lin; Anna R Giuliano; Ashish A Deshmukh Journal: JAMA Netw Open Date: 2021-09-01