In Denmark, human papillomavirus
has been offered at age of 12 to girls born in 1996 and later. In this cohort study, we examined routine HPV vaccination
uptake in immigrants
from different countries and regions compared with native Danes, including the influence of socioeconomic characteristics and potential changes in uptake by birth cohort.
In nationwide registers, we identified all girls born in 1996–2003 (n = 260 251) and obtained information on country of origin, HPV vaccinations and parents’ income and employment. Vaccination
was defined as receiving ≥1 dose within 2 years after eligibility for routine vaccination
. Odds ratios (ORs) were estimated by logistic regression separately for birth cohorts 1996–2000 and 2001–2003.
Uptake in immigrants
varied by country and region of origin. Overall, immigrants
had lower uptake than native Danes, in birth cohorts 1996–2000 [79% vs. 93%, OR = 0.31; 95% confidence interval (CI), 0.29–0.34] and 2001–2003 (63% vs. 73%, OR = 0.60; 95% CI, 0.54–0.66). Descendants
had lower uptake than native Danes in cohorts 1996–2000 (89% vs. 93%, OR = 0.65; 95% CI, 0.60–0.68), but higher uptake in cohorts 2001–2003 (76% vs. 73%, OR = 1.15; 95% CI, 1.08–1.21). Most associations were attenuated, but not entirely explained, when adjusting for socioeconomic characteristics.
uptake varied by country and region. Most immigrants
had lower uptake than native Danes, and in most groups, this was not fully explained by socioeconomic differences. Patterns in descendants
were mixed. Interventions to increase uptake should be tailored to specific groups of immigrants