The purpose of this study was to examine the effect of various community-based interventions in support of HPV vaccination implemented by cities and towns within Tochigi prefecture, Japan with a view to identifying useful indicators which might guide future interventions to improve HPV vaccination coverage in the prefecture. A postal questionnaire survey of all 27 local governments in Tochigi Prefecture was conducted in December 2010. All 27 responded, and 22 provided the exact numbers of the targeted and vaccinated populations of 13- to 15-year-old girls from April to December 2010. The local governments also answered questions on the type of interventions implemented including public subsidies, school-based programs, direct mail, free tickets and recalls. Local governments that conducted a school-based vaccination program reported 96.8% coverage for the 1st dose, 96.2% for the 2nd dose, and 91.2% for the 3rd dose. Those that provided subsidies without school-based programs reported a wide range of vaccination rates: 45.7%–95.0% for the 1st dose, 41.1%–93.7% for the 2nd dose and 3.1%–90.1% for the 3rd dose. Among this group, the combination of a free ticket, direct mail and recall was most effective, with 95.0% coverage for the 1st dose, 93.7% for the 2nd dose, and 90.1% for the 3rd dose. The governments that did not offer a subsidy had the lowest vaccination coverage, with 0.8%–1.4% for the 1st dose, 0.0%–0.8% for the 2nd dose, and 0.1%–0.1% for the 3rd dose. The results of this survey indicate that school-based vaccinations and public subsidies are the most effective method to improve HPV vaccination coverage; however, the combination of a free ticket, direct mail, and recalls with public subsidies are also important measures in increasing the vaccination rate. These data may afford important indicators for the successful implementation of future HPV vaccination programs.
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