Vaccination against Human Papillomavirus in relation to Financial Crisis: The “Evaluation and Education of Greek Female Adolescents on Human Papillomaviruses’ Prevention Strategies” ELEFTHERIA Study

HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe

“…Insufficient knowledge or information, and beliefs that the information available is unclear, biased and/or inadequate were identified in almost all articles reviewed. An average of 44% of hesitant participants from quantitative studies reported that there was insufficient information available about HPV vaccination, and/or that their own knowledge was insufficient, [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] particularly in studies in Romania (2015, 81%), 30 the Netherlands (2009-2011, 67%), 26,28 and Denmark (2010, 70%). 35 This was also reported by 53% of general study participants [42][43][44][45][46][47][48][49][50][51] and 11% of favourable study participants.…”

“…Concerns about the safety of HPV vaccination and potential long-or short-term side effects were reported by an average of 43% of hesitant study participants. [23][24][25][26][27][28][29]31,32,[34][35][36][37][38]40,42,46,49,[70][71][72][73][74][75][76][77][78][79][80][81] Fear of side effects was reported by an average of 52% of general study participants 51,[82][83][84][85][86][87][88][89][90][91][92][93][94][95][96][97] and 17% of favourable study participants. 25,37,71 Concerns about si...…”

“…25,37,71 Concerns about side effects were particularly prevalent among hesitant participants from studies in the Netherlands (2009-2011, 69%), 26,28 Romania (2010, 60%), 79 and Greece (2005-2014, 54%). 31,34,40,42,78 Qualitative results Almost all qualitative articles described concerns about potential side effects of HPV vaccination, [52][53][54][55][56][57]59,60,62,64,66,69,[98][99][100][101][102][103][104][105][106][107] often described as fears of long-term side effects not yet identified through trials. 54,55,59,60,62,64,66,69,81,[98][99][100][101][102][103]…”

“…These are discussed in more detail in the following subsections. The themes most frequently identified in qualitative studies ( Figure 2) were: concerns about potential side effects of HPV vaccination (37 studies with qualitative data), beliefs that information about the vaccine is insufficient and inadequate (31), and issues related to the sexual health aspects of the vaccine (22). The categories of concerns raised by the highest average proportions of hesitant participants across all quantitative studies in the review ( Figure 2) were: perceived insufficient and/or inadequate information and knowledge about the vaccine (average of 44.2% of participants across all studies), fear of perceived side effects (43.3%), mistrust of health authorities, any type of doctor and new vaccines (39.7%), and doubts about the effectiveness of the vaccine (33.7%).…”

Economic stress and child health—the Greece experience

“…On the other hand, a Greek study of 632 females aged 11‐16 years showed that vaccination for human papilloma virus (HPV) dropped considerably during the crisis years, despite designation of HPV vaccine in the NIP as ‘necessary’. Authors claim financial issues, as visits to the paediatricians, and stress the need to maintain health insurance coverage to children in a country suffering recession …”