title: Have preferences of girls changed almost 3 years after the much debated start of the HPV vaccination program in The Netherlands? A discrete choice experiment.
abstract: OBJECTIVE
  To assess how girls' preferences have changed almost 3 years after the much debated start of the human papillomavirus (HPV) vaccination program.
  
  
  METHODS
  A discrete choice experiment (DCE) was conducted among girls aged 11-15 years who were invited, or were not yet invited, to get vaccinated. A panel latent class model was used to determine girls' preferences for vaccination based on five characteristics: degree of protection against cervical cancer; duration of protection; risk of mild side-effects; age of vaccination; and the number of required doses of the vaccine.
  
  
  RESULTS
  The response rate was 85% (500/592). Most girls preferred vaccination at age 14 years (instead of at age 9 years) and a 2-dose scheme (instead of the current 3-dose scheme). Girls were willing to trade-off 7% (CI: 3.2% to 10.8%) of the degree of protection to have 10% less risk of mild side-effects, and 4% (CI: 1.2% to 5.9%) to receive 2 doses instead of 3 doses. Latent class analyses showed that there was preference heterogeneity among girls, i.e., higher educated girls and HPV vaccinated girls had a higher probability to opt for HPV vaccination at a higher age than lower educated girls or non-vaccinated girls.
  
  
  CONCLUSIONS
  Three years after the start of HPV vaccination program the risk of mild side-effects and age at vaccination seem to have become less important. For the Dutch national immunization program, we recommend not to lower the current target age of 12 years. A 2-dose scheme may result in a higher uptake and we recommend that if this scheme is introduced, it needs to receive adequate publicity.
authors.affiliation: Department of Public Health, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, the Netherlands.
authors.forename: Robine
authors.initials: R
authors.lastname: Hofman
authors.affiliation: Department of Public Health, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, the Netherlands.
authors.forename: Esther W
authors.initials: EW
authors.lastname: de Bekker-Grob
authors.affiliation: Department of Public Health, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, the Netherlands; Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.
authors.forename: Jan Hendrik
authors.initials: JH
authors.lastname: Richardus
authors.affiliation: Department of Public Health, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, the Netherlands.
authors.forename: Harry J
authors.initials: HJ
authors.lastname: de Koning
authors.affiliation: Department of Public Health, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, the Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: van Ballegooijen
authors.affiliation: Department of Public Health, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, the Netherlands.
authors.forename: Ida J
authors.initials: IJ
authors.lastname: Korfage
mesh_terms: D000293:Adolescent; D000367:Age Factors; D052685:Alphapapillomavirus / Q000276:immunology; D002648:Child; D002755:Choice Behavior; D004334:Drug Administration Schedule; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs; D009426:Netherlands; D030361:Papillomavirus Infections / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D014611:Vaccination / Q000523:psychology*
chemical_list: D053918:Papillomavirus Vaccines