Vaccination coverage for the adult 10-year booster against diphtheria, tetanus, and polio (DTP) and for the human papillomavirus (HPV) vaccine for adolescent girls is insufficient in France. The French Institute for Public Health Surveillance (InVS) analyzed data from the Health and Social Protection Survey (ESPS) conducted in 2012 by the Institute for Research and Documentation in Health Economics (Irdes) to explore the socioeconomic determinants of these vaccinations, as well as those of cervical cancer screening via Pap smears (Pap smear). The survey covered a representative random sample of health insurance beneficiaries. Information was collected through interviews and self-administered questionnaires, and the data were adjusted. Questions regarding screening (over 3 and 5 years) and vaccinations were asked only of individuals aged 15 or older. The data were analyzed using Stata 12® according to a survey design that included weighting and the primary sampling unit. Poisson regressions with robust variance were used to analyze the association between explanatory variables and vaccination/screening, and the results were expressed as prevalence ratios (PR). DTP booster vaccination coverage (VC) was insufficient (50%) and heterogeneous, decreasing notably with age, socioeconomic status, and in certain regions such as the North and the Mediterranean, with results comparable to those obtained by the 2002 ESPS survey. Coverage of FCU screening was 72% over 3 years and 81% over 5 years, confirming the available data. Low household income, lack of private supplemental health insurance, low educational attainment, and severe obesity were all associated with lower screening rates. HPV vaccination coverage was generally very low (31% for 3 doses). Factors associated with lower vaccination rates were the lack of private supplemental health insurance (OR close to 0.5), living in a low-income family (OR close to 0.3), and the absence of FCU screening for the household’s primary female (the mother in 88% of cases) in the past 3 (OR close to 0.6) or 5 (OR close to 0.5) years. This survey showed that young girls not vaccinated against HPV tend to belong to the lowest socioeconomic categories and are more likely to have mothers who have not undergone screening. These young girls are at risk of not benefiting from either of the two cervical cancer prevention measures, suggesting a limited impact of the prevention program. The current implementation of the HPV vaccination program thus risks widening social health inequalities regarding cervical cancer.

• Guthmann JP, Pelat C, Célant N, Parent du Chatelet I, Duport N, Rochereau T, Lévy-Bruhl D. Socioeconomic determinants of vaccination and cervical cancer screening via Pap smear (FCU). Factors associated with the adult diphtheria-tetanus-polio (DTP) booster and HPV vaccination in adolescent girls - Health and Social Protection Survey (ESPS), 2012.