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Analysis of institutional authors

Robles CCorresponding AuthorBruni LAuthorDe Sanjose SAuthorBosch FxAuthor

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January 11, 2021
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Article

Determinants of Human Papillomavirus Vaccine Uptake by Adult Women Attending Cervical Cancer Screening in 9 European Countries

Publicated to: American Journal Of Preventive Medicine. 60 (4): 478-487 - 2021-04-01 60(4), DOI: 10.1016/j.amepre.2020.08.032

Authors:

Robles, C; Bruni, L; Acera, A; Riera, JC; Prats, L; Poljak, M; Mlakar, J; Valencak, AO; Eriksson, T; Lehtinen, M; Louvanto, K; Hortlund, M; Dillner, J; Faber, MT; Munk, C; Kjaer, SK; Petry, KU; Denecke, A; Xu, L; Arbyn, M; Cadman, L; Cuzick, J; Dalstein, V; Clavel, C; de Sanjosé, S; Bosch, FX
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Affiliations

Atenció a la Salut Sexual i Reproductiva (ASSIR) SAP Cerdanyola-Ripollet, Institut Catala de la Salut, Barcelona, Spain - Author
Atenció a la Salut Sexual i Reproductiva (ASSIR) SAP Girones-Pla de l'Estany, Institut Catala de la Salut, Girona, Spain. - Author
Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain - Author
Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain. - Author
Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: crobles@idibell.cat. - Author
Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom. - Author
Centre Ginecològic Gine-3, Barcelona, Spain. - Author
Centre Hospitalier Universitaire (CHU) Reims, Université de Reims Champagne-Ardenne INSERM P3Cell and UMR-S 1250, SFR CAP-SANTE, Reims, France. - Author
Centro de Investigacion Biomedica en Red en Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain. - Author
Department of Gynecologic Oncology, Klinikum Wolfsburg, Wolfsburg, Germany. - Author
Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. - Author
Department of Health Science, University of Tampere, Tampere, Finland. - Author
Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden. - Author
Department of Obstetrics and Gynecology, University of Tampere, Tampere, Finland. - Author
Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain. - Author
Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. - Author
PATH, Seattle, Washington - Author
Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium. - Author
Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark - Author
Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark. - Author
Unitat de Suport a la Recerca Metropolitana Nord, IDIAP Jordi Gol, Barcelona, Spain. - Author
‎ Catalan Inst Oncol, IDIBELL, Canc Epidemiol Res Programme, Barcelona, Spain - Author
‎ Ctr Ginecol Gine 3, Barcelona, Spain - Author
‎ Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Barcelona, Spain - Author
‎ Danish Canc Soc, Res Ctr, Unit Virus Lifestyle & Genes, Copenhagen, Denmark - Author
‎ IDIAP Jordi Gol, Unitat Suport Recerca Metropolitana Nord, Barcelona, Spain - Author
‎ Inst Catala Salut, Atencio Salut Sexual & Reprod ASSIR SAP Cerdanyol, Barcelona, Spain - Author
‎ Inst Catala Salut, Atencio Salut Sexual & Reprod ASSIR SAP Girones P, Girona, Spain - Author
‎ Karolinska Inst, Dept Lab Med, Stockholm, Sweden - Author
‎ Klinikum Wolfsburg, Dept Gynecol Oncol, Wolfsburg, Germany - Author
‎ PATH, Seattle, WA USA - Author
‎ Queen Mary Univ London, Ctr Canc Prevent, Wolfson Inst Prevent Med, London, England - Author
‎ Sciensano, Belgian Canc Ctr, Unit Canc Epidemiol, Brussels, Belgium - Author
‎ SFR CAP SANTE, UMR S 1250, Reims, France - Author
‎ Univ Copenhagen, Rigshosp, Dept Gynecol, Copenhagen, Denmark - Author
‎ Univ Ljubljana, Fac Med, Inst Microbiol & Immunol, Ljubljana, Slovenia - Author
‎ Univ Oberta Catalunya UOC, Fac Hlth Sci, Barcelona, Spain - Author
‎ Univ Reims, INSERM P3Ce11, Ctr Hosp Univ CHU Reims, Reims, France - Author
‎ Univ Tampere, Dept Hlth Sci, Tampere, Finland - Author
‎ Univ Tampere, Dept Obstet & Gynecol, Tampere, Finland - Author
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Abstract

Human papillomavirus-vaccinated cohorts, irrespective of age, will likely reduce their subsequent screening requirements, thus opening opportunities for global cost reduction and program sustainability. The determinants of uptake and completion of a 3-dose human papillomavirus vaccination program by adult women in a European context were estimated.This was an intervention study.Study participants were women aged 25-45 years, attending opportunistic or population-based cervical cancer screening in Belgium, Denmark, Finland, France, Germany, Slovenia, Spain, Sweden, and the United Kingdom between April 2016 and May 2018.Study participants completed a questionnaire on awareness and attitudes on adult female human papillomavirus vaccination and were invited to receive free human papillomavirus vaccination.Main outcome measures were acceptance, uptake, and completion of vaccination schedule. Determinants of vaccine uptake were explored using multilevel logistic models in 2019.Among 3,646 participants, 2,748 (range by country=50%-96%) accepted vaccination, and 2,151 (range=30%-93%) received the full vaccination course. The factors associated with higher vaccine acceptance were previous awareness of adult female (OR=1.22, 95% CI=1.00, 1.48) and male (OR=1.59, 95% CI=1.28, 1.97) vaccination. Women in stable relationships (OR=0.56, 95% CI=0.45, 0.69) or with higher educational level (OR=0.76, 95% CI=0.63, 0.93) were more likely to refuse vaccination. Recruitment by postal invitation versus personal invitation from a healthcare professional resulted in lower vaccine acceptance (OR=0.13, 95% CI=0.02, 0.76). Vaccination coverage of >70% of adolescent girls in national public programs was of borderline significance in predicting human papillomavirus vaccine uptake (OR=3.23, 95% CI=0.95, 10.97). The main reasons for vaccine refusal were vaccine safety concerns (range=30%-59%) and the need for more information on human papillomavirus vaccines (range=1%-72%). No safety issues were experienced by vaccinated women.Acceptance and schedule completion were largely dependent on recruitment method, achieved coverage of national vaccination programs, and personal relationship status. Knowledge of benefits and safety reassurance may be critical to expanding vaccination target ages. Study results suggest that there are no major opinion barriers in adult women to human papillomavirus vaccination, especially when vaccination is offered face to face in healthcare settings.EudraCT Number 2014-003177-42.Copyright © 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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Keywords

AdolescentAdultArticleAttitude to healthAwarenessBelgiumCancer immunizationCancer screeningControlled studyDenmarkDrug safetyDrug uptakeEarly cancer diagnosisEarly detection of cancerEuropeEuropeanFemaleFinlandFranceGermanyHealth care personnelHealth care systemHealth knowledge, attitudes, practiceHumanHumansIntervention studyMaleMultivariate logistic regression analysisNonhumanOutcome assessmentPapillomavirus infectionPapillomavirus infectionsPapillomavirus vaccinesPatient acceptance of health carePatient attitudePopulation researchPredictionRisk benefit analysisSloveniaSocial acceptanceSpainSwedenUnited kingdomUterine cervical neoplasmsUterine cervix cancerUterine cervix tumorVaccinationVaccination coverageVaccination refusalWart virusWart virus vaccine

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal AMERICAN JOURNAL OF PREVENTIVE MEDICINE due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2021, it was in position 33/210, thus managing to position itself as a Q1 (Primer Cuartil), in the category Public, Environmental & Occupational Health.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations from Scopus Elsevier, it yields a value for the Field-Weighted Citation Impact from the Scopus agency: 1.04, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 13, 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2026-04-02, the following number of citations:

  • WoS: 15
  • Scopus: 15
  • Europe PMC: 8
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-02:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 148.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 148 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 2.
  • The number of mentions on the social network X (formerly Twitter): 3 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Belgium; Denmark; Finland; France; Germany; Slovenia; Sweden; United Kingdom; United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (ROBLES HELLIN, CLAUDIA) and Last Author (Bosch Jose, FcoJavier).

the author responsible for correspondence tasks has been ROBLES HELLIN, CLAUDIA.

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Awards linked to the item

This research was funded by the European Commission FP7 Framework Health 2013 Innovation 1 (Grant 603019; Comparing Health Services Interventions for the Prevention of HPVRelated Cancer project). This work was also partially supported in Spain by the Instituto de Salud Carlos III (Spanish Government), cofunded by FEDER funds/European Regional Development Fund-a way to build Europe (Redes tematicas de investigacion cooperativa en salud RD12/0036/0056 [FXB, LB], Juan de la Cierva de Incorporacion IJCI-2016-29502 [CR], Centro de Investigacion Biomedica en Red: Epidemiologia y Salud Publica CB06/02/0073 [SDS], Centro de Investigacion Biomedica en Red: Oncologia CB16/12/00401 [LB, FXB]), and the Agencia de Gestio d'Ajuts Universitaris i de Recerca (Catalan Government 2014SGR756 [SDS, CR], 2014SGR1077 [FXB, LB], 2017SGR793 [AA] and 2017SGR1718 [FXB, LB], and 2017SGR1085 [SDS]). The authors thank CERCA Programme/Generalitat de Catalunya for institutional support at the Catalan Institute of Oncology.
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