Socioeconomic predictors of human papillomavirus vaccination in Danish men – A nationwide study

Background The quadrivalent human papillomavirus vaccine was licensed in Denmark in 2006. Unlike women, men are not offered human papillomavirus vaccination free of charge but can have it at their own expense. We investigated human papillomavirus vaccine uptake by men in Denmark and the socioeconomic factors that may predict human papillomavirus vaccination. Methods Using the Civil Registration System, we identified all boys and men aged 9–26 years in 2006–2013 and their mothers. By linkage to Statistics Denmark and the National Prescription Registry, we obtained information on socioeconomic variables and human papillomavirus vaccination during the study period. Using Cox regression, we examined the associations between socioeconomic variables and human papillomavirus vaccination. Results Between 2006 and 2013, 6253 (0.8%) males aged 9–26 years were vaccinated against human papillomavirus. The strongest predictor identified was ethnicity. Males who were immigrants (hazard ratio, 0.12; 95% confidence interval, 0.08–0.180) or sons of immigrant parents (hazard ratio, 0.13; 95% confidence interval, 0.10–0.17) were less likely to be vaccinated than Danish males. Additionally, sons of mothers who were unemployed, unmarried, had a low income, and basic education initiated human papillomavirus vaccination less frequently. Finally, sons of mothers who were physicians or nurses were more likely to be vaccinated than sons of other highly educated mothers. Conclusion We found low uptake, with social disparities in human papillomavirus vaccination of boys and young men in Denmark.
Highlights • In Denmark only women are included in the national HPV vaccination programme. • The uptake in men in Denmark is low especially among more socially disadvantaged. • Sons of heath care workers are more likely to be vaccinated than others.