ArticleBMJ open2019
What school-level and area-level factors influenced HPV and MenACWY vaccine coverage in England in 2016/2017? An ecological study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Barriers and enablers to vaccination in the ultra-orthodox Jewish population: a systematic review.Frontiers in public health · 2023Pooled it
- Improving School Vaccinations for Adolescents With Intellectual and Developmental Disabilities: A Person-Centred Approach.Journal of advanced nursing · 2026Review
- Inequalities in adolescent HPV, Td/IPV and MenACWY vaccination coverage by socio-economic status: an ecological study, England, 2017 to 2024.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026Article
- Invasive meningococcal disease in adolescents in Europe and select geographies: Disease burden, unmet medical need, and optimizing prevention.Human vaccines & immunotherapeutics · 2025Review
- Article
- Beyond Averages: Unpacking Disparities in School-Based Vaccination Coverage in Eastern Sydney: An Ecological Analysis.Vaccines · 2024Article
- Acceptability of human papillomavirus vaccination in the United Kingdom: a systematic review of the literature on uptake of, and barriers and facilitators to HPV vaccination.Therapeutic advances in vaccines and immunotherapy · 2024Review
- Measuring school level attributable risk to support school-based HPV vaccination programs.BMC public health · 2022Article
- Cervical cancer screening, treatment and prophylaxis in Brazil: Current and future perspectives for cervical cancer elimination.Frontiers in medicine · 2022Review
- School-Level Variation in Coverage of Co-Administered dTpa and HPV Dose 1 in Three Australian States.Vaccines · 2021Article
- Surveillance optimisation to detect poliovirus in the pre-eradication era: a modelling study of England and Wales.Epidemiology and infection · 2020Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo describe school-level and area-level factors that influence coverage of the school-delivered human papillomavirus (HPV) and meningococcal A, C, W and Y (MenACWY) programmes among adolescents.
designEcological study. SETTING AND
participantsAggregated 2016/2017 data from year 9 pupils were received from 1407 schools for HPV and 1432 schools for MenACWY. The unit of analysis was the school. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcome measures were percentage point (pp) difference in vaccine coverage by schools' religious affiliation, school type, urban/rural, single sex/mixed and region. A subanalysis of mixed-sex, state-funded secondary schools also included deprivation, proportion of population from black and ethnic minorities, and school size.
resultsMuslim and Jewish schools had significantly lower coverage than schools of no religious character for HPV (24.0 (95% CI -38.2 to -9.8) and 20.5 (95% CI -30.7 to -10.4) pp lower, respectively) but not for MenACWY. Independent, special schools and pupil referral units had increasingly lower vaccine coverage compared with state-funded secondary schools for both HPV and MenACWY. For both vaccines, coverage was 2 pp higher in rural schools than in urban schools and lowest in London. Compared with mixed schools, HPV coverage was higher in male-only (3.7 pp, 95% CI 0.2 to 7.2) and female-only (4.8 pp, 95% CI 2 to 7.6) schools. In the subanalysis, schools located in least deprived areas had the highest coverage for both vaccines (3.8 (95% CI 0.9 to 6.8) and 10.4 (95% CI 7.0 to 13.8) pp for HPV and MenACWY, respectively), and the smallest schools had the lowest coverage (-10.4 (95% CI -14.1 to -6.8) and -7.9 (95% CI -12 to -3.8) for HPV and MenACWY, respectively).
conclusionsTailored approaches are required to improve HPV vaccine coverage in Muslim and Jewish schools. In addition, better ways of reaching pupils in smaller specialist schools are needed.
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