Parental attitudes and information needs in an adolescent HPV vaccination programme

Abstract

We sent a questionnaire to 38% (1084) of 2817 parents whose daughters had been offered human papillomavirus vaccination and who had agreed to participate. Of these, 60% (651) returned a questionnaire. Responses suggested that fact sheets and parent information evenings confirmed, rather than changed, consent decisions. The views of active refusers on safety and efficacy may be difficult to change, lowering vaccine coverage. British Journal of Cancer (2008Cancer ( ) 99, 1908Cancer ( -1911 In the United Kingdom, routine human papillomavirus (HPV) vaccination for 12 -13-year-old girls to prevent cervical cancer has begun. The highest possible vaccine uptake is required to achieve maximum impact on future cancer incidence and to ensure cost effectiveness (Goldhaber-Fiebert et al, 2008). Two parental acceptability studies in the UK anticipated an uptake of about 80% (Brabin et al, 2006;Marlow et al, 2007a), which would be similar to the coverage achieved by the cervical screening programme. As those girls who are not vaccinated may include some who would not take advantage of future cervical screening, reducing non-acceptance is important (Jit et al, 2008).A school-based programme increases the possibility of high coverage, but the acceptability of vaccinating adolescents against a sexually transmitted infection remains uncertain, and the general public is relatively uninformed, or even misinformed, about cervical cancer and its prevention (Friedman and Shepheard, 2007;Marlow et al, 2007b). We assessed vaccine acceptability in a feasibility study ahead of the national vaccine programme. Two primary care trusts (PCTs) in Greater Manchester that offered Cervarix (GlaxoSmithKline, Rixensart, Belgium) to girls attending 36 secondary schools achieved a 71% uptake of the first HPV vaccine dose . Here we present the results of a parental questionnaire survey shortly after the second dose, which focussed on factors that had influenced the parents' vaccine decision and included a small group of respondents who had declined vaccination. MATERIALS AND METHODSThe North Manchester NHS Research Ethics Committee approved the study. Cervarix was offered at 0, 1 and 6 months to 2817 girls aged 12 -13 years between October 2007 and July 2008 . In the covering letter, parents were informed that the funding source was GlaxoSmithKline and that Cervarix was one of two licensed vaccines; it explained that the vaccine for the future national immunisation programme and the policy for vaccinating older girls had not yet been determined. Parents received information about cervical cancer and the vaccine, a flier summarising the content of an educational film for girls (Vallely et al, 2008), details of parent evenings and a separate consent form for the follow-up research questionnaire. Information evenings provided an overview of HPV vaccines and the study aims; the educational film was shown, followed by a question and answer session facilitated either by school nurses or by a consultant in communicable diseases.Primary care trusts forwarded...

Human papillomavirus vaccine and behavioural disinhibition

“…The proportion of parents we found who held this belief is consistent with previous studies where estimates ranged from 6–12% before HPV vaccine licensure and as high as about 30% in more recent studies 2 19 20 25 27. Taken together, these estimates suggest some variability in sexual disinhibition beliefs and that they may be changing over time.…”

“…Belief that regular Pap smears are unnecessary after HPV vaccination was infrequent. This is consistent with past research showing that most adult women and parents recognised the need for Pap smear screening after HPV vaccination 25 26. However, belief that Pap smears may safely be stopped was somewhat more common among male parents and those from minority racial and ethnic groups.…”

Parental Decision Making about the HPV Vaccine

“…This finding corroborates a number of studies conducted before vaccine marketing that suggested that parental concerns about behaviors such as earlier age at sexual debut or less attention to safe sex were associated with lower rates of vaccine intentions (22,23). The proportion of parents reporting concerns about sexual disinhibition varies considerably across studies, with low levels of concerns in some (19,24) and high levels (25-30%) in others (25,26). In this population-based sample, 22% agreed or strongly agreed that "vaccinating my daughter would send a message that it is okay to have sex.…”

Factors Influencing Mothers' Acceptance of Human Papillomavirus Vaccination to Prevent Cervical Cancer in their Daughters

“…외국의 선행연구결과 HPV 백신접종에 대한 어머니들의 수 용도는 전반적으로 긍정적이었는데 (Khan et al, 2008;Marlow, Waller, & Wardle, 2008;Olshen, Woods, Austin, Luskin, & Bauchner, 2005;Stretch et al, 2008;Walsh et al, 2008) (Peres, 2010), 이와 같은 경제적 부 담으로 인하여 외국에서도 대상자의 70.5%가 무료 백신접 종을 원하였고 (Walsh et al, 2008), 84%의 어머니들이 무료 백신이라면 자녀에게 접종할 것이라고 보고하였다 (Fazekas et al, 2008). 국내에서도 HPV 백신은 기관마다 차이는 있 지만 4가 백신의 경우 50~60만원 수준으로 국내 시판되는 백신중에서 가장 비싸기 때문에, 백신접종 권장에 대한 경 제성 논란도 제기되고 있는 실정이다 (Yoo, 2010) Yoo, 2010 (Lee & Park, 2011;Reiter, Brewer, Gottlieb, McRee, & Smith, 2009;Stretch et al, 2008;Tissot et al, 2007), 백신 이 성적 활동을 일찍 촉진할 수 있다는 걱정 (Bartolini et al, 2010)과 HPV에 대한 정보와 백신의 필요성 (Fazekas et al, 2008)이 제시되었다. 그 외로 어머니의 과거 생식기 사마귀 또는 HPV 감염력 (Dempsey et al, 2006), Pap 검사결과 (Mays, Strum, & Zimet, 2004), 어머니의 HPV 백신접종 (Brewer & Fazekas, 2007) (Table 1).…”