School-based HPV Vaccination: Variation in Inter-school Vaccine Uptake not Influenced by the Introduction of a New Information Brochure

Switzerland, with an adolescent HPV vaccination coverage at 59%, remains far from reaching the crucial swiss national goal of 80% coverage. Our objective was to implement a new information brochure in schools to increase HPV vaccination uptake. We designed a public health quality project. A new information brochure was produced and was distributed to a test group of 9th grade students from the Canton of Vaud, in Switzerland during the 2019-2020 school year. Vaccine uptake of the test group was compared to those of all other students in 2019-2020 and of students in the same schools in 2017-2018. 12,143 electronic records were analyzed. 713 students were enrolled in 6 schools where the new brochure was distributed. Median age was 13 years (IQR 12-13), and 6,031 (49.7%) were female. Vaccine uptake was 52% (6,299/12,143). The new brochure did not result in increased uptake. Age ≥ 13 years (aOR 1.39, 95% CI 1.22-1.58) was significantly associated with uptake. Uptake increased between 2017-2018 (51%, 3,216/6,307) and 2019-2020 (52.8%, 3,083/5,836, p=0.04) due to increased acceptance among boys. The only determinant of uptake in 2019-2020 was uptake in the same schools in 2017-2018. The introduction of a new information brochure was insufficient to increase HPV vaccination coverage. More innovative strategies are needed.