Abstract 61: Factors Related to Human Papillomavirus Vaccine Uptake and Acceptability in Manizales, Colombia, 2017-2019: A Population-Based Study of the 2003, 2004 and 2005 Birth Cohorts.
Authors: Cárdenas-Garzón Karen , Agudelo Maria Cecilia , Tovar-Aguirre Olga Lucia , Franco Sandra , Valverde Kelly Paola , Arias Nelson , Gonzalez Difariney , Montoya Nilton E. , Arbelaez Maria Patricia , Garces-Palacio Isabel Cristina , Louie Karly , Beddows Simon , Sanchez Gloria 
Published: July 2021

Abstract
Purpose: The first 2 rounds (2012-2013) of the Colombian school-based HPV vaccination program attained 80% coverage of nine-year-old girls. After a psychogenic event in 2014 in a town of the Caribbean region, vaccination fell nationwide to 20% in 2016. We identified factors associated to decreasing coverage of the HPV vaccination program in Manizales, Colombia.
Methods: Structured questionnaires based on the HPV health belief model (HBM) were used in a population-based survey (September 2017-February 2019) to privately interview girls from birth cohorts of 2003, 2004 and 2005 and their parents. Vaccination coverage (at least one dose) was defined by the Expanded Program of Immunization Registry, HPV 6/11/16/18 serology and parents and girls self-report. Multivariable adjusted Prevalence Ratios (aPR) and 95% confidence intervals were estimated using complementary log-log regression to identify sociodemographic factors associated to coverage and changes in HBM constructs scores associated to acceptability of the HPV vaccine.
Results: 1.287 of 1.299 eligible girls and their parents completed the survey, 99% were school-registered and 97% urban area residents. The vaccine coverage was 93.4% (394/422), 84% (356/424), and 63% (279/441) for the 2003, 2004, and 2005 birth cohorts, respectively. High educational level in parents was associated with decreased HPV vaccine coverage (aPR 0.80, 95%CI 0.66-0.95). The perceived benefits increased (aPR 1.22, 95%CI 1.18-1.27 for parents; aPR 1.25, 95%CI 1.21-1.29 for girls) meanwhile, the perceived barriers (negative recommendation by family/friends, news about vaccine adverse events and health system and school barriers) decreased (aPR 0.73 95%CI 0.69-0.77 for parents; aPR 0.84 95%CI 0.79-0.88 for girls) the acceptability of HPV vaccine. Birth year (2005) and high socioeconomic status were also associated with decrease acceptability.
Conclusion: Perceived barriers were associated to decreased acceptability and coverage of vaccination in the first 3 rounds of the national HPV vaccination program in Manizales, Colombia.
Citation Format: Karen Cárdenas-Garzón, Maria Cecilia Agudelo, Olga Lucia Tovar-Aguirre, Sandra Franco, Kelly Paola Valverde, Nelson Arias, Difariney Gonzalez, Nilton E. Montoya, Maria Patricia Arbelaez, Isabel Cristina Garces-Palacio, Karly Louie, Simon Beddows, Gloria Sanchez. Factors Related to Human Papillomavirus Vaccine Uptake and Acceptability in Manizales, Colombia, 2017-2019: A Population-Based Study of the 2003, 2004 and 2005 Birth Cohorts. [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 61.