Effect of ethnic group should be clarified

One of the most striking findings in the study of Brabin et al on the uptake of human papillomavirus (HPV) vaccine by schoolgirls was the apparent effect of ethnic group on compliance with vaccination.¹ The accompanying editorial also highlighted the possible effect of religion on uptake, two schools having declined to participate in the study on religious grounds.² It would have been interesting to know their religious affiliation.

The apparent effect of ethnic group on vaccine uptake is not clear cut. One can only infer from the article that schoolgirls from “ethnic minority groups” have a lower vaccine uptake.

The effects of ethnic group and possibly religion on vaccine uptake are potentially important findings. They suggest that the successful implementation of the national HPV vaccine programme may vary across the United Kingdom according to local variation in demography. That the authors did not provide a more detailed exposition of their findings was therefore disappointing. The collective term “ethnic minority” lacks precision. The latest UK population census contained no less than 16 ethnic groupings.³

Whether the research questionnaire gathered data on ethnicity on an individual basis is also not clear. These data would be helpful to the authorities that are to introduce the vaccine, especially in cities such as London, where in 2003 about 40% of the population was not classified as “white British.”⁴