Recommendations regarding HPV vaccination for young adolescent woman have been in place since 2007 in Belgium, and since 2010, HPV vaccines have been offered free-of-charge through a school-based system to all girls in the 1st or 2nd year of secondary school in Belgium. The recommendations were thoroughly discussed and updated in 2017, and led to specific recommendations for boys, MSM, and immunocompromised patients. The opportunity was taken also to update information on safety and long term data for the bivalent, quadrivalent and nonavalent HPV vaccine as well as data on HPV vaccination in women 27 to 45 years of age and women with pre-existing HPV infection.
In 2012-2013 vaccination coverage in the recommended free-of-charge age group was assessed in Flanders and the Walloon region of Belgium. The coverage for the 3rd dose of HPV vaccination was 29% in the Walloon region, 36% for Capital Region of Brussels and 83% in the Flemish region.
In 2016, the HPV vaccination coverage was measured again in girls (born in 2000) living in Flanders who were eligible for a free of charge 3-dose HPV vaccination scheme four years before.
The 2016 survey was done using WHO’s Expanded Program on Immunization two-stage cluster sampling technique. Parents of 488 adolescent girls were interviewed at home and vaccination documents were copied after consent was given. Apart from vaccination status and socio-demographic data, parents were also asked to complete a general questionnaire on vaccine confidence/hesitancy. Vaccination data were checked against the electronic Flemish vaccination registry (Vaccinnet) and still missing data, were retrieved from the GP, pediatrician and School Health Service.
Vaccination coverage (95%CI) for the 1st, 2nd and 3rd dose was respectively 92.3% (89.7-94.8%), 92.2% (89.6-94.8%) and 89.5% (86.5-92.4%). When classified according to the current 2- or previous 3-dose recommended schedule, the coverage for being correctly vaccinated increased to 91%. Of these vaccines, 89% were administered through the school health system. Factors associated with incomplete or non-vaccination were living in a larger city, having a lower family income and having a mother or a father of non-Belgian origin. Confidence in vaccination was high.
The HPV vaccination program of girls seems consolidated in Flanders but not in the other Belgian Regions. However, care should be taken to maintain the confidence in this vaccine in Flanders as different stories on alleged side effects are currently circulating on social media.
Vandermeulen C, Hoppenbrouwers K, Roelants M, Theeten H, Van Damme P, Breackman T, Blaizot S, Maertens K. Studie van de vaccinatiegraad in Vlaanderen, 2016. Rapport Vlaamse Gemeenschap. https://www.zorg-en-gezondheid.be/sites/default/files/atoms/files/Vaccinatiegraadstudie%202016.pdf
Vemeeren A, Miermans MC, Swennen B. Evolution de 2008 à 2013 des couvertures vaccinales en Fédération Walonie-Bruxelles, Provac, Bruxelles 2014.