In 2023, as a response to low vaccination coverage against human papillomavirus (HPV), a nationwide free HPV vaccination campaign was implemented in French schools, targeting students aged 12–13 years. An evaluation of this campaign was carried out in the Nouvelle-Aquitaine region to identify the factors associated with refusal of school-based vaccination, (barriers as well as levers to adherence), and to estimate its overall impact on vaccination coverage.

Vaccination of students with parental consent was organized in all volunteering public and private middle schools by vaccination centers in Nouvelle-Aquitaine between September 2023 and June 2024. The study was based on data collected on parental decision forms and by vaccination centers, after anonymization. Parents completed two online surveys, one during the collection of parental decision forms and the other after vaccination. Vaccination coverage gains were estimated from HPV vaccines administered in schools and in general practices during the campaign.

Despite the low participation of private schools, the vaccination campaign was well- accepted, as 25 % of students were vaccinated. While the campaign also encouraged vaccination of students by general practitioners (GPs), it did not reduce inequalities in vaccination coverage. The evaluation process highlighted the key role of GPs in decision-making and attained a substantial increase in HPV vaccination coverage among the target population (+28 to + 29 points), partially due to the anticipation of vaccination.

Based on these promising results, school-based vaccination campaigns could substantially contribute to the prevention of HPV-related cancers. This would not only pave the way for other prevention campaigns, but also improvs vaccine access for populations with limited access to healthcare.