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Table 2 HPV vaccination uptake among girls offered HPV vaccine during 2009–2014 (n = 177,387)

From: Time trends in HPV vaccination according to country background: a nationwide register-based study among girls in Norway

  HPV vaccine uptakea
n (%)
Univariable modelb Multivariable modelb,c
RD (95% CI) P-value RD (95% CI) P-value
Country backgroundd
 Norway 131,185 (82.6) 0 (Ref)   0 (Ref)  
 Western Europe 1544 (74.5) −8.1 (−10.1 to −6.2) <  0.001 −7.9 (−9.7 to −6.1) <  0.001
 Central- and Eastern Europe 3098 (79.7) −2.9 (−4.2 to − 1.7) <  0.001 −3.3 (−4.6 to − 2.1) <  0.001
 Middle East and North Africa 3079 (82.6) −0.1 (− 1.3 to 1.2) 0.91 0.8 (− 0.4 to 2.0) 0.20
 South-Asia 2925 (87.2) 4.5 (3.4 to 5.7) <  0.001 4.9 (3.8 to 5.9) <  0.001
 East−/South-East Asia 1987 (88.9) 6.2 (4.9 to 7.5) <  0.001 5.4 (4.3 to 6.6) <  0.001
 Sub-Saharan Africa 2130 (76.8) −5.9 (−7.4 to −4.3) <  0.001 −3.4 (− 5.0 to − 1.8) <  0.001
 America and Oceania 455 (76.5) −6.2 (−9.5 to − 2.7) <  0.001 − 5.5 (− 8.8 to − 2.2) 0.001
Year of birth (Programme year)e
 1997 (2009) 21,896 (72.5) 0 (Ref)   0 (Ref)  
 1998 (2010) 24,086 (81.1) 8.5 (7.9 to 9.2) <  0.001 8.6 (8.0 to 9.3) <  0.001
 1999 (2011) 25,136 (83.5) 11.0 (10.4 to 11.7) <  0.001 11.2 (10.5 to 11.8) <  0.001
 2000 (2012) 25,463 (84.6) 12.1 (11.5 to 12.8) <  0.001 12.4 (11.7 to 13.0) <  0.001
 2001 (2013) 25,104 (86.8) 14.3 (13.7 to 14.9) <  0.001 14.4 (13.8 to 15.1) <  0.001
 2002 (2014) 24,718 (87.3) 14.8 (14.1 to 15.4) < 0.001 15.1 (14.5 to 15.7) <  0.001
Parental education (years of schooling)
 Primary school/compulsory level 26,946 (82.0) 0 (Ref)   0 (Ref)  
 Upper secondary level 55,157 (82.7) 0.7 (0.2 to 1.2) 0.007 −0.1 (−0.6 to 0.4) 0.64
 Higher education, undergraduate level 52,132 (82.8) 0.8 (0.2 to 1.3) 0.004 −0.8 (−1.4 to − 0.3) 0.001
 Higher education, graduate level 12,168 (82.2) 0.2 (−0.6 to 0.9) 0.63 −1.6 (−2.3 to − 0.8) <  0.001
Household income quintile (NOK)
 1 (≤ 575,319) 27,687 (79.7) 0 (Ref)   0 (Ref)  
 2 (575320–811,300) 28,874 (81.5) 1.8 (1.2 to 2.4) <  0.001 1.4 (0.9 to 2.0) <  0.001
 3 (811301–988,227) 29,888 (83.7) 4.0 (3.4 to 4.5) <  0.001 3.7 (3.1 to 4.2) <  0.001
 4 (988228–1,251,798) 29,972 (83.8) 4.1 (3.5 to 4.6) <  0.001 4.2 (3.7 to 4.8) <  0.001
 5 (≥ 1,251,799) 29,982 (83.9) 4.1 (3.5 to 4.7) <  0.001 4.9 (4.3 to 5.5) <  0.001
Number of siblings
 0 6558 (80.0) 0 (Ref)   0 (Ref)  
 1 55,421 (83.7) 3.7 (2.8 to 4.6) <  0.001 2.9 (2.0 to 3.8) <  0.001
 2 52,142 (83.5) 3.5 (2.6 to 4.4) <  0.001 2.5 (1.7 to 3.4) <  0.001
 3 19,825 (80.7) 0.8 (−0.2 to 1.8) 0.13 0.4 (− 0.5 to 1.4) 0.37
  ≥ 4 12,457 (78.3) −1.7 (−2.8 to − 0.6) 0.002 −1.2 (− 2.3 to − 0.2) 0.02
Maternal age at time of daughter’s birth (years)
  ≤ 25 32,515 (83.5) 0 (Ref)   0 (Ref)  
 26–30 53,690 (83.6) 0.1 (−0.4 to 0.5) 0.81 −0.8 (−1.3 to − 0.4) <  0.001
 31–35 42,760 (82.3) − 1.2 (− 1.7 to − 0.7) <  0.001 −2.3 (− 2.8 to − 1.8) <  0.001
  > 35 17,438 (78.4) −5.1 (−5.8 to −4.5) <  0.001 −5.4 (−6.1 to −4.8) <  0.001
Region of residence
 Oslo 12,968 (81.6) 0 (Ref)   0 (Ref)  
 Eastern-Norway 37,721 (83.3) 1.7 (1.0 to 2.4) <  0.001 1.1 (0.4 to 1.8) 0.001
 Southern-Norway 28,671 (82.2) 0.6 (− 0.2 to 1.3) 0.13 0.1 (− 0.6 to 0.9) 0.69
 Western-Norway 32,551 (82.9) 1.2 (0.5 to 2.0) 0.001 0.4 (−0.3 to 1.1) 0.28
 Mid-Norway 20,321 (81.5) −0.2 (− 0.9 to 0.6) 0.68 − 0.6 (− 1.3 to 0.2 0.15
 Northern-Norway 14,171 (82.8) 1.2 (0.4 to 2.0) 0.005 0.7 (−0.1 to 1.5) 0.09
  1. HPV human papillomavirus, RD risk difference, CI confidence interval
  2. a Receipt of at least one dose of HPV vaccine
  3. b Risk differences are estimated with linear binomial regression
  4. c The model included country background, year of birth, parental education level, household income, number of siblings, maternal age at time of
  5. daughter’s birth, and region of residence
  6. d List of countries in each category is provided in the Supplementary table
  7. e Each programme year, the vaccine was offered to only one birth cohort