Role of ethnicity in human papillomavirus vaccination uptake: a cross-sectional study of girls from ethnic minority groups attending London schools

OBJECTIVES Research suggests that girls from ethnic minority groups are less likely to receive the human papillomavirus (HPV) vaccination than white British girls; however, the specific ethnic minority groups that have lower uptake have not been identified. This study aimed to examine the relationship between school-level uptake and ethnicity as well as uptake and other ethnicity-related factors, to understand which specific groups are less likely to receive the vaccination. METHODS Aggregated uptake rates from 195 schools were obtained for each of the three recommended vaccine doses from 2008 to 2010. Census data at the lower super output area (LSOA) level for the postcode of each school were also obtained, describing the ethnic breakdown of the resident population (ethnicity, language spoken, religion, proficiency in English and duration of residency in the UK). These were used as proxy measures of the ethnic make-up of the schools. The most prevalent non-majority group for each ethnicity and ethnicity-related factor was assigned to each school. Analyses explored differences in uptake by ethnicity and ethnicity-related factors. RESULTS No significant differences in vaccination uptake were found by ethnicity or ethnicity-related factors, although descriptive differences were apparent. Schools in areas where black ethnicities were the most prevalent non-white British ethnicities had consistently low rates of uptake for all doses. Schools in areas where some Asian ethnicities were the most prevalent non-white British ethnicities had consistently high rates of uptake for all doses. There was evidence of variability in mean uptake rates for ethnicities within 'black' and 'Asian' ethnic groups. CONCLUSIONS Future research would benefit from focusing on specific ethnicities rather than broad ethnic categories. Replication of this study with a larger sample and using complete individual-level data, collected on a national level, would provide a clearer indication of where ethnic differences in HPV vaccination uptake exist.