title: HPV vaccination coverage among women aged 18-20 years in Germany three years after recommendation of HPV vaccination for adolescent girls: results from a cross-sectional survey.
abstract: OBJECTIVE
  Routine immunization of adolescent girls aged 12-17 y against human papillomavirus (HPV) was recommended in Germany in March 2007. We aimed to assess HPV-vaccine uptake and knowledge about post-vaccination cervical cancer screening and condom use in women aged 18-20 years, three years after adoption of HPV-vaccination into the routine vaccination schedule.
  
  
  RESULTS
  Overall 2,001 females participated in our study. Of these, 49% reported receipt of a complete three-dose course of HPV-vaccines; 11% received 1 or 2 doses. Living in East Germany, high educational status, and interest in health-related issues were independently associated with HPV-vaccination. Misconceptions among survey-participants were rare: Only 8% believed that HPV-vaccination would obviate the need for cervical screening and 1% that condom use would be dispensible after vaccination.
  
  
  METHODS
  In 2010, a nationwide cross-sectional telephone-survey was performed among randomly-selected women aged 18-20 years living in Germany. Telephone interviews were conducted by a large professional market research institute as part of a daily omnibus survey.
  
  
  CONCLUSIONS
  HPV-vaccination coverage is low in Germany. The results indicate that there is an urgent need for the implementation of a coordinated adolescent vaccination program to facilitate access to vaccination, including balanced information tailored to this age group. Otherwise, the HPV-vaccination effort will fall short of reaching its maximum public health benefit.
authors.affiliation: Immunisation Unit; Department for Infectious Disease Epidemiology; Robert Koch Institute (RKI); Berlin, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Deleré
authors.forename: Merle M
authors.initials: MM
authors.lastname: Böhmer
authors.forename: Dietmar
authors.initials: D
authors.lastname: Walter
authors.forename: Ole
authors.initials: O
authors.lastname: Wichmann
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D012725:Sexual Behavior / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000209:etiology / Q000517:prevention & control*; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Germany; HPV; cross-sectional survey; telephone interview; vaccine uptake