Girls with mental illness or neurodevelopmental disorders are less likely than their peers to be vaccinated with the HPV vaccine that protects against future cervical cancer, according to a new registry study by the Karolinska Institutet in Sweden, which was The Lancet – Public Health.

The study involved more than 115,000 girls who participated in the Swedish school vaccination program against human papillomavirus (HPV). The vaccine, which prevents cervical cancer, among other things, is offered to all children in Sweden and administered by the school health service.

Key differences

The researchers found clear differences when they examined the relationship between vaccination coverage and psychiatric diagnoses or the use of psychotropic medications.

In girls with psychiatric diagnoses, the vaccination rate for the first dose of the HPV vaccine was 11 percent lower than in girls of the same age without such diagnoses. The difference was particularly pronounced in girls with autism or intellectual disability, where the vaccination rate was over 20 percent lower.

Among girls receiving medication for mental illness, vaccination rates were 7 percent lower, although figures varied considerably depending on the type of medication prescribed. Among girls receiving antipsychotic medication, vaccination rates were up to 32 percent lower than among girls of the same age who did not receive such medication.

Ensuring health equity

Our study highlights the need for targeted interventions to ensure equitable health care for all children. All girls should have equal access to life-saving vaccines, regardless of their mental health status.”

Kejia Hu, Postdoctoral Fellow, Department of Environmental Medicine, Karolinska Institutet

In contrast, girls with psychiatric diagnoses or mental illness who received the first dose of vaccine were just as likely as their peers to also receive the second dose of vaccine, which is given within one year of the first dose. In addition, parents’ mental health did not significantly influence their daughters’ vaccination rates.

Find the underlying causes

“To address this challenge, further research is needed to find out the underlying reasons why fewer girls with mental illness or neuropsychiatric conditions are vaccinated against HPV,” says Karin Sundström, senior researcher at the Center for Cervical Cancer Elimination in the Department of Clinical Science, Intervention and Technology at Karolinska Institutet.