Table 2.
Descriptive analysis HPV-vaccination uptake and predictor variables on individual, postal code and municipality level (n = 299,883)
| 2012 | 2014 | 2017 | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Variable | N | HPV-uptake % (a) |
Multi- level univariate COR |
p-value | N | HPV-uptake % (a) |
Multi- level univariate COR |
p-value | N | HPV-uptake % (a) |
Multi- level univariate COR |
p-value |
| Total | 102,456 | 60.0% | 100,988 | 62.8% | 96,439 | 46.6% | ||||||
| Individual level | ||||||||||||
| MMR-vaccination status | 2012 | < 0.001 | 2014 | < 0.001 | 2017 | < 0.001 | ||||||
| Zero vaccinations | 5355 | 3.7% | reference | ref. | 3190 | 6.6% | ref. | ref. | 2548 | 6.0% | ref. | ref. |
| One vaccination | 3079 | 28.4% | 9.72 | < 0.001 | 3304 | 26.2% | 4.68 | < 0.001 | 3162 | 13.3% | 2.24 | < 0.001 |
| Two Vaccinations | 94,022 | 64.3% | 44.05 | < 0.001 | 94,494 | 66.0% | 25.34 | < 0.001 | 90,729 | 48.9% | 13.95 | < 0.001 |
| DT (aP)-IPV-vaccination status | 2012 | < 0.001 | 2014 | < 0.001 | 2017 | < 0.001 | ||||||
| Zero vaccinations | 5549 | 6.1% | ref. | ref. | 3258 | 10.3% | ref. | ref. | 2656 | 8.2% | ref. | ref. |
| Primary series | 2851 | 28.2% | 5.67 | < 0.001 | 3088 | 25.9% | 2.81 | < 0.001 | 3539 | 20.0% | 2.63 | < 0.001 |
| Completed series | 94,056 | 64.2% | 25.84 | < 0.001 | 94,642 | 65.8% | 15.50 | < 0.001 | 90,244 | 48.7% | 9.94 | < 0.001 |
| Ethnicity | 2012 | < 0.001 | 2014 | < 0.001 | 2017 | < 0.001 | ||||||
| NLD - NLD | 17,319 | 63.6% | ref. | ref. | 17,761 | 65.2% | ref. | ref. | 70,614 | 49.4% | ref. | ref. |
| NLD - Turkey | 352 | 32.4% | 0.30 | < 0.001 | 405 | 34.6% | 0.30 | < 0.001 | 1023 | 26.0% | 0.34 | < 0.001 |
| Turkey - Turkey | 1306 | 27.9% | 0.26 | < 0.001 | 1133 | 30.3% | 0.25 | < 0.001 | 1802 | 20.5% | 0.24 | < 0.001 |
| NLD - Morocco | 199 | 36.2% | 0.36 | < 0.001 | 224 | 35.7% | 0.34 | < 0.001 | 762 | 18.8% | 0.22 | < 0.001 |
| Morocco - Morocco | 1272 | 18.2% | 0.16 | < 0.001 | 1249 | 23.9% | 0.20 | < 0.001 | 2920 | 16.5% | 0.18 | < 0.001 |
| NLD - Surinam | 369 | 52.8% | 0.73 | 0.003 | 414 | 54.8% | 0.70 | 0.001 | 927 | 41.3% | 0.71 | < 0.001 |
| Surinam - Surinam | 544 | 48.5% | 0.68 | < 0.001 | 463 | 57.9% | 0.86 | 0.108 | 708 | 45.6% | 0.86 | 0.048 |
| NLD - Ned Antilles/Aruba | 186 | 51.6% | 0.65 | 0.004 | 161 | 57.8% | 0.74 | 0.058 | 475 | 35.6% | 0.55 | < 0.001 |
| Ned Antilles/Aruba –Ned Antilles/Aruba | 214 | 23.8% | 0.20 | < 0.001 | 150 | 44.7% | 0.45 | < 0.001 | 183 | 35.5% | 0.57 | < 0.001 |
| NLD - other WC | 748 | 58.6% | 0.84 | 0.020 | 858 | 64.1% | 0.95 | 0.493 | 2331 | 51.0% | 1.03 | 0.573 |
| other WC - other WC | 430 | 43.5% | 0.44 | < 0.001 | 468 | 53.2% | 0.62 | < 0.001 | 704 | 46.9% | 0.84 | 0.025 |
| NLD - other NWC | 490 | 58.0% | 0.84 | 0.071 | 581 | 59.9% | 0.82 | 0.027 | 1673 | 50.0% | 0.99 | 0.778 |
| other NWC - other NWC | 1184 | 47.6% | 0.57 | < 0.001 | 1192 | 59.3% | 0.83 | 0.004 | 2190 | 51.1% | 1.05 | 0.252 |
| other WC - other NWC | 92 | 43.5% | 0.50 | 0.001 | 104 | 44.2% | 0.45 | < 0.001 | 196 | 35.7% | 0.53 | < 0.001 |
| Unknown | 77,751 | 61.2% | 0.85 | < 0.001 | 75,825 | 63.9% | 0.94 | 0.003 | 9931 | 42.9% | 0.74 | < 0.001 |
| Postal code level | ||||||||||||
| Socioeconomic status (b) | 2012 | < 0.001 | 2014 | < 0.001 | 2017* | < 0.001 | ||||||
| Low | 17,723 | 51.4% | ref. | ref. | 19,395 | 54.9% | ref. | ref. | 18,149 | 36.9% | ref. | ref. |
| Low-intermediate | 29,714 | 58.8% | 1.27 | < 0.001 | 26,556 | 62.9% | 1.34 | < 0.001 | 25,467 | 44.6% | 1.36 | < 0.001 |
| High-intermediate | 38,297 | 62.7% | 1.50 | < 0.001 | 37,747 | 64.4% | 1.57 | < 0.001 | 34,292 | 48.8% | 1.64 | < 0.001 |
| High | 15,981 | 65.3% | 1.84 | < 0.001 | 16,732 | 68.4% | 1.93 | < 0.001 | 18,099 | 54.8% | 2.09 | < 0.001 |
| Road distance | 2012* | 0.129 | 2014 | 0.031 | 2017 | 0.340 | ||||||
| 0 km | 12,694 | 60.3% | ref. | ref. | 13,661 | 62.3% | ref. | ref. | 13,104 | 45.8% | ref. | ref. |
| 0–5 km | 44,246 | 59.3% | 1.03 | 0.279 | 41,395 | 62.0% | 1.04 | 0.105 | 38,045 | 46.9% | 1.02 | 0.547 |
| 5–10 km | 28,986 | 60.6% | 1.06 | 0.026 | 28,560 | 63.9% | 1.07 | 0.003 | 29,079 | 46.7% | 1.04 | 0.081 |
| > 10 km | 16,495 | 60.8% | 1.05 | 0.115 | 17,343 | 63.3% | 1.05 | 0.072 | 16,185 | 46.2% | 1.02 | 0.333 |
| Municipality level | ||||||||||||
| Urbanization level (c) | 2012* | 0.020 | 2014* | 0.134 | 2017 | 0.058 | ||||||
| Very high | 23,398 | 53.3% | ref. | ref. | 19,446 | 57.9% | ref. | ref. | 19,280 | 45.3% | ref. | ref. |
| High | 31,870 | 60.3% | 1.14 | 0.272 | 30,512 | 62.9% | 1.03 | 0.793 | 29,502 | 46.1% | 0.95 | 0.642 |
| Moderately high | 17,260 | 62.7% | 1.28 | 0.038 | 18,314 | 64.0% | 1.16 | 0.232 | 17,512 | 47.9% | 1.03 | 0.819 |
| Low | 21,315 | 63.8% | 1.36 | 0.007 | 23,200 | 65.5% | 1.22 | 0.099 | 21,526 | 48.3% | 1.07 | 0.572 |
| Very low | 8604 | 63.1% | 1.25 | 0.062 | 9513 | 64.1% | 1.11 | 0.390 | 8618 | 44.3% | 0.87 | 0.266 |
| Voting % political parties (d) | 2012 | 2014* | 2017 | |||||||||
| Lower or higher than national mean | ||||||||||||
| People’s Party for Freedom and Democracy (VVD) | ||||||||||||
| Lower | 64,595 | 57.3% | ref. | ref. | 60,833 | 60.5% | ref. | ref. | 58,855 | 43.6% | ref. | ref. |
| Higher | 37,852 | 64.8% | 1.30 | < 0.001 | 40,152 | 66.3% | 1.27 | < 0.001 | 37,583 | 51.3% | 1.47 | < 0.001 |
| Labor Party (PvdA), Denk (DENK) | ||||||||||||
| Lower | 36,543 | 60.9% | reference | ref. | 39,038 | 62.7% | ref. | ref. | 34,880 | 46.7% | ref. | ref. |
| Higher | 65,904 | 59.6% | 1.09 | 0.096 | 61,947 | 62.9% | 1.10 | 0.076 | 61,558 | 46.5% | 1.00 | 0.931 |
| Party for Freedom (PPV), Forum for Democracy (FvD) | ||||||||||||
| Lower | 57,814 | 59.7% | reference | ref. | 56,784 | 62.3% | ref. | ref. | 52,307 | 48.1% | ref. | ref. |
| Higher | 44,633 | 60.5% | 1.14 | 0.007 | 44,201 | 63.5% | 1.10 | 0.077 | 44,131 | 44.8% | 0.88 | 0.006 |
| Socialist Party (SP) | ||||||||||||
| Lower | 52,335 | 57.6% | reference | ref. | 53,199 | 59.8% | ref. | ref. | 4665 | 44.3% | ref. | ref. |
| Higher | 50,112 | 62.6% | 1.40 | < 0.001 | 47,786 | 66.2% | 1.45 | < 0.001 | 41,773 | 49.5% | 1.29 | < 0.001 |
| Christian Democratic Appeal (CDA) | ||||||||||||
| Lower | 77,344 | 59.9% | ref. | ref. | 73,747 | 63.0% | ref. | ref. | 71,075 | 46.8% | ref. | ref. |
| Higher | 25,103 | 60.6% | 0.94 | 0.201 | 27,238 | 62.4% | 0.97 | 0.487 | 25,363 | 45.9% | 0.94 | 0.221 |
| Democrats 66 (D66) | ||||||||||||
| Lower | 43,514 | 59.9% | ref. | ref. | 45,849 | 61.2% | ref. | ref. | 38,093 | 42.7% | ref. | ref. |
| Higher | 58,933 | 60.1% | 1.25 | < 0.001 | 55,136 | 64.2% | 1.30 | < 0.001 | 58,345 | 49.1% | 1.46 | < 0.001 |
| Christian Union (CU), Reformed Political Party (SGP) | ||||||||||||
| Lower | 78,482 | 61.8% | ref. | ref. | 75,461 | 64.9% | ref. | ref. | 71,521 | 48.5% | ref. | ref. |
| Higher | 23,965 | 54.3% | 0.59 | < 0.001 | 25,524 | 56.7% | 0.60 | < 0.001 | 24,917 | 41.1% | 0.62 | < 0.001 |
| Green Left (GL) | ||||||||||||
| Lower | 44,692 | 62.0% | ref. | ref. | 47,846 | 63.2% | ref. | ref. | 38,670 | 45.0% | ref. | ref. |
| Higher | 57,755 | 58.6% | 1.07 | 0.196 | 53,139 | 62.5% | 1.11 | 0.046 | 57,768 | 47.6% | 1.21 | < 0.001 |
| Party for the Animals (PvdD) | ||||||||||||
| Lower | 37,964 | 61.9% | ref. | ref. | 40,832 | 63.7% | ref. | ref. | 38,633 | 46.7% | ref. | ref. |
| Higher | 64,483 | 59.0% | 1.03 | 0.561 | 60,153 | 62.2% | 1.02 | 0.737 | 57,805 | 46.5% | 1.03 | 0.588 |
| 50PLUS (50+) | ||||||||||||
| Lower | 57,554 | 58.1% | reference | ref. | 55,729 | 61.0% | ref. | ref. | 55,484 | 46.5% | ref. | ref. |
| Higher | 44,893 | 62.6% | 1.31 | < 0.001 | 45,256 | 65.0% | 1.25 | < 0.001 | 40,954 | 46.7% | 1.10 | 0.052 |
Abbreviations: COR crude odds ratio, MMR mumps-measles-rubella, DT (aP)-IPV diphtheria-tetanus-pertussis-polio, NL the Netherlands, Ned Antilles/Aruba the Netherlands Antilles and Aruba, WC western countries, NWC non-western countries. km kilometer, VVD People’s Party for Freedom and Democracy, PvdA Labor Party, PVV Party for Freedom, FvD Forum for Democracy, SP Socialist Party, CDA Christian Democratic Appeal, D66 Democrats 66, CU Christian Union, SGP Reformed Political Party, GL Green Left, PvdD The Party for the Animals, 50 + =50PLUS. For explanatory notes on the political parties we refer to Supplementary material 1
(a) HPV-uptake % = % of total of girls (N) with a completed HPV-vaccination series. Girls invited in 2012 were offered a three-dose series, girls invited in 2014 and 2017 a 2-dose series.
(b) Socioeconomic status classification; low (≤ − 1.0000), low-intermediate (− 0.9999 to 0.0000), high-intermediate (0.0001–0.9999), high (≥1.0000).
(c) Urbanization classification; Very high: > 2500 addresses per km2, high: 1500–2500 addresses per km2, moderately high: 1000–1500 addresses per km2, low: 500–1000 addresses per km2, very low < 500 addresses per km2.
(d) Voting % classification: higher or lower compared to the national mean.
* For this variable/ invitation year, data from the most recent year available was used (See Table 1 for variable details)