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276 Challenges of implementing human papillomavirus vaccination among women 15–40 year-old in a territory with low population density
  1. L Colomé Ceballos1,
  2. MJ Pla Farnós2,
  3. C Ceballos García3,
  4. M Rubio Del Caño1,
  5. JL Clua Espuny4,
  6. J Fernández Sáez5 and
  7. N Andrés Cubells1
  1. 1Hospital Verge de la Cinta de Tortosa, Obstetrics and Gyneacology, Tortosa, Spain
  2. 2Hospital Universitari de Bellvitge, Gyneacology Oncology, Hospitalet de Llobregat, Spain
  3. 3Hospital de la Santa Creu de Jesús, Geriatrics, Tortosa, Spain
  4. 4Institut Català de la Salut, UUDD Terres de l’Ebre, Tortosa, Spain
  5. 5Institut Català de la Salut, IDIAP Jordi Gol, Tortosa, Spain


Introduction/Background*The World Health Organization called for the elimination of cervical cancer as public health problem and targeted the HPV vaccination coverage rate at 90% by 2030. HPV vaccines have not been uniformly adopted for a large-scale use in both low and high-income countries, and face multiple barriers. The main aim of the study is to learn about HPV vaccination (PVV).

Methodology Multicentre, retrospective and community-based study of women cohort aged 15-40 years. The study territory (Terres de l’Ebre, south Catalonia) in divided in four regions and has a low population density (52 inh/Km2). The public health service is made up of four regions, a total of 11 primary care teams, and referring Gynaecology Services in each region. It offers systematic PVV to girls in school sixth grade (11-12 years old) since 2008 and opportunistic cervical cancer screening without systematic HPV determination. Information was collected from the government-run healthcare provider Catalonian Health Institute (ICS) in an anonymized fashion from computerized data base. Demographic, clinical, functional, cervical intraepithelial neoplasia, and pharmacological variables were included. The primary outcome was PVV. A statistical analysis was carried out on the total population of women with active medical history in the territory between 01/01/2020-31/12/2020.

Result(s)*23528 women were included with a mean age of 28.5±ds7.7 years. The 35-40 years old group was significantly higher (29.1%, p 0.001). 7.444 (31.6%) women were registered as PVV. The average dose number was 1.76±ds0.78. The mean age of the vaccinated people was significantly lower than the unvaccinated (20.0±ds5.3 vs 32±ds5.9, p <0.001). The PVV coverage showed significant differences by regions (30.5-41.1%, p <0.001), health primary care teams (28.2%-40.9%, p <0.001), and age groups: 85.7% in 15-19 y-group vs 7.4% in 35-40y-group, p <0.001, inside Terres de l’Ebre. The 35-40 years-old cohort is the group with the lowest PVV coverage (4.4%, p<0.001)

Disclosures The study protocol received ethics approval from the Ethical Committee Jordi Gol University Institute of Primary Care Research (Instituto Universitario de Investigación de Atención Primaria, IDIAP) code 21/064-P.

The data were obtained in an anonymized fashion provided by Information and Communication Technology Dept from the Minimum Basic Data Set at hospital discharge.

Conclusion*The study highlights women over 30 years-old as those at most risk because their low probability to PVV and/or systematic HPV determination. Population dispersion and demographic structure may play a role as barrier in healthcare infrastructure and the implementation PVV.

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