title: Factors associated with HPV vaccine uptake in teenage girls: a systematic review.
abstract: BACKGROUND
  Since 2006 Human papillomavirus (HPV) vaccination has become available to adolescent girls and women in an increasing number of countries, to protect against the virus causing cervical cancer. The vaccine series is offered in three doses over 6 months, and this study aimed to identify factors associated with initiation and/or completion of the 3 dose series in (pre-) adolescent girls. Previous studies have considered intention to vaccinate rather than actual vaccination uptake.
  
  
  METHODS
  A systematic search of Medline, Medline in process, Embase and CINAHL, from 2006 to March 2011 for articles related to HPV-vaccine uptake among adolescent girls and factors potentially associated with uptake yielded 25 studies.
  
  
  RESULTS
  The majority of studies were surveys or retrospective reviews of data, only 5 studies reported data on program completion. Most were conducted in the United States (20/25). Higher vaccine uptake was associated with having health insurance, of older age, receipt of childhood vaccines, a higher vaccine related knowledge, more healthcare utilization, having a healthcare provider as a source of information and positive vaccine attitudes. In US settings, African American girls were less likely to have either initiated or completed the three dose vaccination series.
  
  
  CONCLUSIONS
  HPV vaccination programs should focus on narrowing disparities in vaccine receipt in ethnic and racial groups and on providing correct information by a reliable source, e.g. healthcare providers. School-based vaccination programs have a high vaccine uptake. More studies are required to determine actual vaccine course completion and factors related to high uptake and completion, and information from a broader range of developed and developing settings is needed.
authors.affiliation: Discipline of Public Health, School of Population Health and Clinical Practice, The University of Adelaide, Adelaide, Australia. S.J.M.kessels@student.ru.nl
authors.forename: Sharon J M
authors.initials: SJ
authors.lastname: Kessels
authors.forename: Helen S
authors.initials: HS
authors.lastname: Marshall
authors.forename: Maureen
authors.initials: M
authors.lastname: Watson
authors.forename: Annette J
authors.initials: AJ
authors.lastname: Braunack-Mayer
authors.forename: Rob
authors.initials: R
authors.lastname: Reuzel
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Tooher
mesh_terms: D000293:Adolescent; D002648:Child; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines