Changing to a single-dose HPV vaccine schedule: impact on vaccine uptake and inequities in Ireland
Abstract
Cervical cancer disproportionately affects socioeconomically disadvantaged populations in Ireland. HPV vaccination is central to Ireland’s cervical cancer elimination strategy. In the 2022/2023 academic year, the school-based immunisation programme introduced a single-dose HPV schedule to simplify delivery and improve uptake. The impact of this change, particularly in disadvantaged schools where attendance rates are poorer, has not been examined. This was a retrospective register-based cohort study using national aggregate school-level data. Vaccine uptake among first-year secondary school students in Ireland was examined across four academic years, spanning the transition from a two-dose to a single-dose schedule. Delivering Equality of Opportunity in Schools (DEIS) status was used as a proxy for socioeconomic status. Median uptake percentages were compared using non-parametric tests. Associations between school characteristics and uptake were examined using multivariable linear regression, while logistic regression assessed factors linked to achieving the ≥90% uptake target. A total of 2,918 school records were analysed, with about one-third classified as DEIS. Median HPV uptake increased after the single-dose introduction (80.1%) compared to the previous year (73.6%) but declined to 76.4% by 2024/2025. Uptake was consistently lower in DEIS schools. Few schools achieved the ≥90% target (14.6% in 2022/2023), with DEIS schools significantly less likely to do so. DEIS status was independently associated with lower uptake, while fee-paying and all-girls schools showed higher uptake. Following the introduction of the single-dose HPV vaccine schedule, there was a short-term increase in uptake, but this was not sustained. DEIS schools consistently demonstrated 13–15% lower uptake. These findings suggest that while a single-dose schedule may reduce logistical barriers, other factors continue to influence HPV uptake.
Key messages: • Single-dose HPV vaccination led to a short-term rise in uptake, but gains were not sustained over time.
• Disadvantaged schools have consistently lower uptake and are less likely to reach the ≥90% target, highlighting persistent socioeconomic inequalities.
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BibTeX
@article{sharkey2026changing,
title = {{Changing to a single-dose HPV vaccine schedule: impact on vaccine uptake and inequities in Ireland}},
author = {CM Sharkey and C White and L Marron},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1895},
url = {https://doi.org/10.1093/eurpub/ckag169.1895},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Changing to a single-dose HPV vaccine schedule: impact on vaccine uptake and inequities in Ireland
AU - CM Sharkey
AU - C White
AU - L Marron
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1895
UR - https://doi.org/10.1093/eurpub/ckag169.1895
AB - Cervical cancer disproportionately affects socioeconomically disadvantaged populations in Ireland. HPV vaccination is central to Ireland’s cervical cancer elimination strategy. In the 2022/2023 academic year, the school-based immunisation programme introduced a single-dose HPV schedule to simplify delivery and improve uptake. The impact of this change, particularly in disadvantaged schools where attendance rates are poorer, has not been examined. This was a retrospective register-based cohort study using national aggregate school-level data. Vaccine uptake among first-year secondary school students in Ireland was examined across four academic years, spanning the transition from a two-dose to a single-dose schedule. Delivering Equality of Opportunity in Schools (DEIS) status was used as a proxy for socioeconomic status. Median uptake percentages were compared using non-parametric tests. Associations between school characteristics and uptake were examined using multivariable linear regression, while logistic regression assessed factors linked to achieving the ≥90% uptake target. A total of 2,918 school records were analysed, with about one-third classified as DEIS. Median HPV uptake increased after the single-dose introduction (80.1%) compared to the previous year (73.6%) but declined to 76.4% by 2024/2025. Uptake was consistently lower in DEIS schools. Few schools achieved the ≥90% target (14.6% in 2022/2023), with DEIS schools significantly less likely to do so. DEIS status was independently associated with lower uptake, while fee-paying and all-girls schools showed higher uptake. Following the introduction of the single-dose HPV vaccine schedule, there was a short-term increase in uptake, but this was not sustained. DEIS schools consistently demonstrated 13–15% lower uptake. These findings suggest that while a single-dose schedule may reduce logistical barriers, other factors continue to influence HPV uptake. Key messages: • Single-dose HPV vaccination led to a short-term rise in uptake, but gains were not sustained over time. • Disadvantaged schools have consistently lower uptake and are less likely to reach the ≥90% target, highlighting persistent socioeconomic inequalities.
SN - 1101-1262
SN - 1464-360X
ER -