Addressing HPV vaccination disparities among girls with mental illness

Girls with psychiatric or neurodevelopmental disorders are less likely than their peers to receive the HPV vaccine to prevent future cervical cancer, according to a new registry study published in 2011 by the Karolinska Institute in Sweden. The Lancet Public Health.

The study involved more than 115,000 girls enrolled in Sweden’s school-based human papillomavirus (HPV) vaccination programme, which offers the vaccine to all Swedish children and is administered by the school health service to prevent cervical cancer and other diseases.

Big Differences

When the researchers looked at the association between vaccination coverage and mental illness diagnosis or psychotropic medication use, they found significant differences.

Girls with a mental illness diagnosis were 11 percent less likely to receive the first HPV vaccine dose than girls their age who did not have such a diagnosis, and the difference was particularly pronounced among girls with autism and intellectual disabilities, who were more than 20 percent less likely to receive the vaccine.

Girls prescribed medications for mental illness were 7 percent less likely to get vaccinated, but the numbers varied widely by type of medication: Girls prescribed antipsychotics were 32 percent less likely to get vaccinated than girls of the same age who were not prescribed antipsychotics.

Ensuring health equity

“Our study highlights the need for targeted interventions to provide equitable healthcare to all children. All girls, regardless of their mental health condition, need to have equal access to life-saving vaccines.”

Kejia Fu, Postdoctoral Researcher, Institute of Environmental Medicine, Karolinska Institutet

In contrast, girls with a psychiatric diagnosis or illness who received their first dose of the vaccine were as likely as their peers to receive a second dose within a year of their first, and parental mental health status did not have a significant effect on daughters’ vaccination rates.

Finding the root cause

“To address this challenge, further research is needed to understand the underlying reasons why girls with psychiatric and neuropsychiatric disorders are less likely to take up the HPV vaccine,” said Karin Sundström, senior research scientist at the Centre for Cervical Cancer Elimination, Department of Clinical Sciences, Interventions and Technology, Karolinska Institutet.