Journal of Community Health

, Volume 37, Issue 6, pp 1151–1156 | Cite as

HPV Infection Awareness and Self-Reported HPV Vaccination Coverage in Female Adolescent Students in Two German Cities

  • F. Samkange-Zeeb
  • L. Spallek
  • S. J. Klug
  • H. Zeeb
Original Paper


Low levels of human papillomavirus (HPV) awareness and knowledge have been observed in the few studies conducted among school-going adolescents. Such data are lacking in Germany. To assess awareness of HPV and of vaccination status among girls attending grades 8–13 in Bremen and Bremerhaven, two German cities. Participants completed a questionnaire in school including questions on demographic characteristics, about HPV awareness and on vaccination status. We analysed the relationship between awareness of HPV, of vaccination status and vaccine uptake and several variables including age and migrant background using univariate and multivariate logistic regression. Six hundred and thirty-two girls aged 12–20 years completed the questionnaire. 50 % had no awareness of HPV, 12 % reported being vaccinated against HPV and 57 % did not know whether or not they were vaccinated against HPV. In multivariate analyses, ever had sex was associated with awareness of HPV, and ever been to a gynaecologist with awareness of vaccination status. Our results may be an indication that female adolescents in Germany are not adequately informed and counselled about HPV and associated issues.


HPV awareness Vaccination status Adolescents 



We would like to thank Beate Schütte, Svea Eichholz, Sinja Ernst, Stefanie Helmer, Kathi Liegmann, Natalya Makarova, Anna Muschalek, Julia Nürnberg, Saskia Pöttgen and Sandra Wegeng for their support during the conduction of the survey in the schools. We especially thank the 8 schools in which we conducted the survey for their co-operation.


  1. 1.
    Agius, P. A., Pitts, M. K., Smith, A. M., & Mitchell, A. (2010). Human papillomavirus and cervical cancer: Gardasil vaccination status and knowledge amongst a nationally representative sample of Australian secondary school students. Vaccine, 28, 4416–4422.PubMedCrossRefGoogle Scholar
  2. 2.
    Blödt, S., Holmberg, C., Müller-Nordhorn, J., Rieckmann, N. (2011). Human papillomavirus awareness, knowledge and vaccine acceptance: A survey among 18–25 year old male and female vocational school students in Berlin, Germany. The European Journal of Public Health, 23 Dec. [Epub ahead of print].Google Scholar
  3. 3.
    Blumenthal, J., Frey, M. K., Worley, M. J. Jr., Tchabo, N. E., Soren, K., Slomovitz, B. M. (2012). Adolescent understanding and acceptance of the HPV vaccination in an underserved population in New York city. Journal of Oncology, 904034. Epub 2011, 11 Dec.Google Scholar
  4. 4.
    Das, A., Madhwapathi, V., Davies, P., et al. (2010). Knowledge and acceptability of the HPV vaccine by school children and their parents in Birmingham. Vaccine, 28(6), 1440–1446.PubMedCrossRefGoogle Scholar
  5. 5.
    Gelman, A., Nikolajski, C., Schwarz, E. B., & Borrero, S. (2011). Racial disparities in awareness of the human papillomavirus. Journal of Women’s Health, 20(8), 1165–1173. doi: 10.1089/jwh.2010.2617.PubMedCrossRefGoogle Scholar
  6. 6.
    Gottvall, M., Larsson, M., Högkund, A. T., & Tydén, T. (2009). High HPV vaccine acceptance despite low awareness among Swedish upper secondary school students. The European Journal of Contraception and Reproductive Health Care, 14, 399–405.CrossRefGoogle Scholar
  7. 7.
    Höglund, A. T., Tydén, T., Hannerfors, A. K., & Larsson, M. (2009). Knowledge of human papillomavirus and attitudes to vaccination among Swedish high school students. International Journal of STD and AIDS, 20, 102–107.PubMedCrossRefGoogle Scholar
  8. 8.
    Klug, S. J., Hetzer, M., & Blettner, M. (2005). Screening for breast and cervical cancer in a large German city: Participation, motivation and knowledge of risk factors. European Journal of Public Health, 15, 70–77.PubMedCrossRefGoogle Scholar
  9. 9.
    Lenselink, C. H., Schmeink, C. E., Melchers, W. J. G., et al. (2008). Young adults and acceptance of the human papillomavirus vaccine. Public Health, 122, 1295–1301.PubMedCrossRefGoogle Scholar
  10. 10.
    Limia, A. (2011). Coverage of human papillomavirus vaccination during the first year of its introduction in Spain. Euro surveillance, 16(21),pii = 19873. Accessed 24 Jan 2012.
  11. 11.
    Marek, E., Dergez, T., Rebek-Nagy, G., et al. (2011). Adolescents ‘awareness of HPV infections and attitudes towards HPV vaccination 3 years following the introduction of the HPV vaccine in Hungary. Vaccine, 29, 8591–8598.PubMedCrossRefGoogle Scholar
  12. 12.
    Marlow, L. A. V., Waller, J., & Wardle, J. (2007). Public awareness that HPV is a risk factor for cervical cancer. British Journal of Cancer, 97, 691–694.PubMedCrossRefGoogle Scholar
  13. 13.
    Marlow, L. A. V., Wardle, J., Forster, A. S., & Waller, J. (2009). Ethnic difference in human papillomavirus awareness and vaccine acceptability. Journal of Epidemiology and Community Health, 63, 1010–1015. doi: 10.1136/jech.2008.085886.PubMedCrossRefGoogle Scholar
  14. 14.
    Ogilvie, G. S., Remple, V. P., Marra, F., et al. (2007). Parental intention to have daughters receive the human papillomavirus vaccine. Canadian Medical Association Journal, 177, 506–521.Google Scholar
  15. 15.
    Pelucchi, C., Esposito, S., Galeone, C., et al. (2010). Knowledge of human papillomavirus infection and its prevention among adolescents and parents in the greater Milan area Northern Italy. BioMed Central Public Health, 10, 378.PubMedGoogle Scholar
  16. 16.
    Sheridan, A., White, J. L., Barlow, T., Soldan, K. (2010). Annual HPV vaccine uptake in England: 2008/09. London: Health Protection Agency, Department of Health. Accessed 24 Jan 2012.
  17. 17.
    Simoens, C., Sabbe, M., Van Damme, P., Beutels, P., Arbyn, M. (2009). Introduction of human papillomavirus (HPV) vaccination in Belgium, 2007–2008. Euro surveillance, 14(46), pii = 19407. Accessed 24 Jan 2012.
  18. 18.
    Ständige Impfkommission (STIKO) am Robert Koch Institut. (2007). Impfung gegen humane Papillomaviren (HPV) für Mädchen von 12 bis 17 Jahren—Empfehlung und Begründung. Epidemiologisches Bulletin, 12, 97–103.Google Scholar
  19. 19.
    Stupiansky, N. W., Zimet, G. D., Cummings, T., Fortenberry, J. D., & Shew, M. (2012). Accuracy of self-reported human papillomavirus vaccine receipt among adolescent girls and their mothers. Journal of Adolescent Health, 50(1), 103–105.PubMedCrossRefGoogle Scholar
  20. 20.
    UNESCO. International Standard Classification of Education. (2010).
  21. 21.
    Walboomers, J. M., Jacobs, M. V., Manos, M. M., et al. (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. Journal of Pathology, 189(1), 12–19.PubMedCrossRefGoogle Scholar
  22. 22.
    Walsh, C. D., Gera, A., Shah, M., Sharma, A., Powell, J. E., & Wilson, S. (2008). Public knowledge and attitudes towards Human Papilloma Virus (HPV) vaccination. BioMed Center of Public Health, 8, 368.Google Scholar
  23. 23.
    Woodhall, S. C., Lehtinen, M., Verho, T., Huhtala, H., Hokkanen, M., & Kosunen, E. (2007). Anticipated acceptance of HPV vaccination at the baseline of implementation: A survey of parental and adolescent knowledge and attitudes in Finland. Journal of Adolescent Health, 40, 466–469.PubMedCrossRefGoogle Scholar
  24. 24.
    Zylka-Menhorn, V., Meyer, R. (2009). Humane Papillomaviren: In Deutschland wird spät geimpft. Dtsch Arztebl., 106(36), A-1713/B-1474/C-1442.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • F. Samkange-Zeeb
    • 1
  • L. Spallek
    • 1
  • S. J. Klug
    • 2
  • H. Zeeb
    • 1
  1. 1.BIPS–Institute for Epidemiology and Prevention ResearchBremenGermany
  2. 2.Cancer Epidemiology, University Cancer CenterDresden University of TechnologyDresdenGermany

Personalised recommendations