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Aldhouse NVJ, Chan EKH, Al-Zubeidi T, McKee S, Oriol Mathieu V, El Khoury AC, Kitchen H. Perceptions and Acceptance of a Prophylactic Vaccine for Human Immunodeficiency Virus (HIV): A Qualitative Study. THE PATIENT 2024; 17:457-469. [PMID: 38581599 PMCID: PMC11189960 DOI: 10.1007/s40271-024-00686-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Despite advances in human immunodeficiency virus (HIV) prevention methods, such as the advent of pre-exposure prophylaxis (PrEP), the number of people with newly acquired HIV remains high, particularly in at-risk groups. A prophylactic HIV vaccine could contribute to reduced disease prevalence and future transmission and address limitations of existing options, such as suboptimal long-term adherence to PrEPs. METHODS This qualitative study aimed to capture perceptions towards and acceptance of prophylactic HIV vaccination in three adult populations in the United States: the general population, 'at-risk' individuals (e.g. men who have sex with men, transgender individuals, gender-nonconforming individuals, and individuals in a sexual relationship with a person living with HIV), and parents/caregivers of children aged 9-17 years. Interviews were conducted with 55 participants to explore key drivers and barriers to HIV vaccine uptake, and a conceptual model was developed. RESULTS The sample was diverse; participants were 51% female, aged 20-57 years (mean 37 years), 33% with high school diploma as highest education level, and identified as White (42%), Black or African American (35%), of Hispanic, Latino, or Spanish origin (22%), or other races/ethnicities (8%) [groupings are not mutually exclusive]. Perceptions were influenced by individual, interpersonal, community, institutional, and structural factors. Overall, 98% of participants thought vaccination would be beneficial in preventing HIV. Key considerations/barriers included perceived susceptibility, i.e. whether participants felt there was a risk of contracting HIV (discussed by 90%); the clinical profile of the vaccine (e.g. the adverse effect profile [98%], and vaccine efficacy [85%], cost [73%] and administration schedule [88%]); and concerns around potential vaccine-induced seropositivity (VISP; 62%). Stigma was not found to be an important barrier, with a general view that vaccination status was personal. Participants in the 'at-risk' group were the most likely to accept an HIV vaccine (70%). Unique concerns in the subgroups included how a potential vaccine's clinical profile compared with PrEP, voiced by those receiving/considering PrEP, and considerations of children's views on the topic, voiced by parents/caregivers. CONCLUSIONS Understanding these factors could help develop HIV vaccine research strategies and contribute toward public health messaging to support future HIV vaccination programs.
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Pergialiotis V, Papageorgiou D, Douligeris A, Mortaki A, Vlachos DE, Thomakos N, Rodolakis A, Haidopoulos D. Awareness, knowledge and attitudes of human papillomavirus infection, screening and vaccination: a survey study in Greece. Arch Gynecol Obstet 2024; 309:2031-2040. [PMID: 38459177 PMCID: PMC11018653 DOI: 10.1007/s00404-024-07398-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/25/2024] [Indexed: 03/10/2024]
Abstract
PURPOSE To evaluate the awareness and existing knowledge of a portion of the Greek population about prevention, screening, and HPV vaccination. METHODS A questionnaire designed in Google forms has been distributed through social media between June 2021 and December 2021 in men and women aged > 16 years old. Statistical analysis was performed using the SPSS 20.0 program. Inferential analysis was performed to evaluate differences in responses among men and women. RESULTS We enrolled 2685 participants. Of those, 2285 were women, 386 were men, while 14 respondents chose not to respond to this question. Various age groups were detected with those aged between 26 and 30 years old being the predominant one. Participants with a higher education constituted 36.5% of the population. Most respondents were married (59.8%). In socioeconomic terms 75.5% of participants were employed whereas, monthly income ranged between 1000 and 1500 euros in the predominant group (36.8%). Only 40% of females and 3.9% of males were vaccinated against HPV. Adolescent immunization, acceptability rates reached 92.7% among female and 82.1% among male responders. Although, only a small proportion of the participants were not aware of the existence of HPV, 24.1% of males and 23.4% of females had the impression that condom use may provide absolute immunity to HPV and only 51.6% of males and 60.4% of females were aware about the high prevalence of HPV in the general population. Logistic regression analysis indicated that male participants as well as those aged > 50 years and those choosing to reject vaccination had decreased knowledge of the basic pathophysiology of HPV infection, as well as knowledge related to the existence and use of HPV DNA as a screening tool and the existence and efficacy of HPV vaccination. CONCLUSION Our results indicate that although awareness of the existence of HPV infection is high in Greek general population, the actual perception of the pathophysiology of transmission and importance of HPV testing and vaccination is low. Targeting specific population groups is essential to help increase HPV coverage and screening.
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Affiliation(s)
- Vasilios Pergialiotis
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Avenue 80, Athens, Greece
| | - Dimitrios Papageorgiou
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Avenue 80, Athens, Greece
| | - Athanasios Douligeris
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Avenue 80, Athens, Greece.
| | - Anastasia Mortaki
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Avenue 80, Athens, Greece
| | - Dimitrios Efthymios Vlachos
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Avenue 80, Athens, Greece
| | - Nikolaos Thomakos
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Avenue 80, Athens, Greece
| | - Alexandros Rodolakis
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Avenue 80, Athens, Greece
| | - Dimitrios Haidopoulos
- 1st Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Alexandra Hospital, National and Kapodistrian University of Athens, Vasilissis Sofias Avenue 80, Athens, Greece
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Jun J, Wickersham K, Zain A, Ford R, Zhang N, Ciccarelli C, Kim SH, Liang C. Cancer and COVID-19 Vaccines on Twitter:The Voice and Vaccine Attitude of Cancer Community. JOURNAL OF HEALTH COMMUNICATION 2023; 28:1-14. [PMID: 36755484 DOI: 10.1080/10810730.2023.2168800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
We investigate social media discourses on the relationship between cancer and COVID-19 vaccines focusing on the key textual topics, themes reflecting the voice of cancer community, authors who contribute to the discourse, and valence toward vaccines. We analyzed 6,427 tweets about cancer and COVID-19 vaccines, posted from when vaccines were approved in the U.S. (December 2020) to the February 2022. We mixed quantitative text mining, manual coding and statistical analysis, and inductive qualitative thematic analysis. Nearly 16% of the tweets posted by a cancer community member mentioned about refusal or delay of their vaccination at the state/local level during the initial rollout despite the CDC's recommendation to prioritize adults with high-risk medical conditions. Most tweets posted by cancer patients (pro = 82.4% vs. anti = 5.1%) and caregivers (pro = 89.2% vs. anti = 4.2%) showed positive valence toward vaccines and advocated for vaccine uptake increase among cancer patients and the general population. Vaccine hesitancy, self-reported adverse events, and COVID-19 disruption of cancer treatment also appeared as key themes. The cancer community called for actions to improve vaccination procedures to become safe and accessible especially for elderly cancer patients, develop COVID-19 vaccines suitable for varying type, stage, and treatment of cancer, and advance cancer vaccines. Future research should continue surveilling conversations around continuous impacts of COVID-19 interference with the cancer control continuum, beyond vaccination, focusing on the voice and concern of cancer community.
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Affiliation(s)
- Jungmi Jun
- School of Journalism and Mass Communication, University of South Carolina, Columbia, SC, USA
| | - Karen Wickersham
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Ali Zain
- School of Journalism and Mass Communication, University of South Carolina, Columbia, SC, USA
| | - Rachel Ford
- School of Journalism and Mass Communication, University of South Carolina, Columbia, SC, USA
| | - Nanlan Zhang
- School of Journalism and Mass Communication, Chongqing University, Chongqing, China
| | - Carl Ciccarelli
- School of Journalism and Mass Communication, University of South Carolina, Columbia, SC, USA
| | - Sei-Hill Kim
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Chen Liang
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Influence of LINE-Assisted Provision of Information about Human Papillomavirus and Cervical Cancer Prevention on HPV Vaccine Intention: A Randomized Controlled Trial. Vaccines (Basel) 2022; 10:vaccines10122005. [PMID: 36560414 PMCID: PMC9787927 DOI: 10.3390/vaccines10122005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
We conducted a prospective, randomized two-arm, parallel group, and open label trial to investigate whether the use of LINE would increase HPV vaccine intention among not completely vaccinated university students. In June 2020, we recruited students aged between 18 and 35 years from four universities in Japan. Among the 357 enrollees (female, 53%), 178 and 179 participants were randomized into the LINE and Mail groups, respectively. At baseline, within three years, vaccine intention was observed in 40% vs. 42% of participants, respectively. At the first intervention, which provided similar PDF leaflets about HPV vaccine and cervical cancer prevention, there was no significant difference in vaccine intention between the two groups. However, at the second intervention of LINE-assisted knowledge intervention for 5 days per week for 7 weeks, the LINE group had a higher proportion of vaccine intention than the no intervention group (66% vs. 44%, OR: 2.62, 95% confidence interval (CI): 1.59-4.35) in per-protocol analysis. The significance remained in the intention-to-treat analysis of multiply imputed datasets. Although LINE did not directly increase HPV vaccine intention compared to conventional posts, the LINE-assisted provision of information was effective in improving HPV vaccine intention among Japanese university and college students.
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Media attention and Vaccine Hesitancy: Examining the mediating effects of Fear of COVID-19 and the moderating role of Trust in leadership. PLoS One 2022; 17:e0263610. [PMID: 35180249 PMCID: PMC8856543 DOI: 10.1371/journal.pone.0263610] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 01/21/2022] [Indexed: 02/07/2023] Open
Abstract
Vaccination has emerged as the most cost-effective public health strategy for maintaining population health, with various social and economic benefits. These vaccines, however, cannot be effective without widespread acceptance. The present study examines the effect of media attention on COVID-19 vaccine hesitancy by incorporating fear of COVID-19 as a mediator, whereas trust in leadership served as a moderator. An analytical cross-sectional study is performed among rural folks in the Wassa Amenfi Central of Ghana. Using a questionnaire survey, we were able to collect 3079 valid responses. The Smart PLS was used to estimate the relationship among the variables. The results revealed that media attention had a significant influence on vaccine hesitancy. Furthermore, the results showed that fear of COVID-19 played a significant mediating role in the relationship between media and vaccine hesitancy. However, trust in leadership had an insignificant moderating relationship on the fear of COVID-19 and vaccine hesitancy. The study suggests that the health management team can reduce vaccine hesitancy if they focus on lessening the negative impact of media and other antecedents like fear on trust in leadership.
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Trevors G, Bohn-Gettler C, Kendeou P. The effects of experimentally induced emotions on revising common vaccine misconceptions. Q J Exp Psychol (Hove) 2021; 74:1966-1980. [PMID: 33926324 DOI: 10.1177/17470218211017840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Knowledge revision is the process of updating incorrect prior knowledge in light of new, correct information. Although theoretical and empirical knowledge has advanced regarding the cognitive processes involved in revision, less is known about the role of emotions, which have shown inconsistent relations with key revision processes. This study examined the effects of experimentally induced emotions on online and offline knowledge revision of vaccination misconceptions. Before reading refutation and non-refutation texts, 96 individuals received a positive, negative, or no emotion induction. Findings showed that negative emotions, more than positive emotions, resulted in enhanced knowledge revision as indicated by greater ease of integrating correct information during reading and higher comprehension test scores after reading. Findings are discussed with respect to contemporary frameworks of knowledge revision and emotion in reading comprehension and implications for educational practice.
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Yoda T, Katsuyama H. Willingness to Receive COVID-19 Vaccination in Japan. Vaccines (Basel) 2021; 9:vaccines9010048. [PMID: 33466675 PMCID: PMC7828811 DOI: 10.3390/vaccines9010048] [Citation(s) in RCA: 176] [Impact Index Per Article: 58.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 11/29/2022] Open
Abstract
In the wake of the COVID-19 pandemic, vaccines are being developed by many countries for the safety of their population. However, people of various nations have revealed hesitancy towards being vaccinated, citing reasons such as side effects, safety, a lack of trust in vaccine effectiveness, etc. This study aimed to explore the willingness of people in Japan to be vaccinated or not be vaccinated and the reasons for either decision. A sample of 1100 respondents was drawn from an internet research panel, and a questionnaire survey was administered to evaluate their willingness to be vaccinated by gender, age group, place of living, and underlying illness history. After using descriptive statistics and the chi-squared test to evaluate categorical variables, 65.7% of the participants indicated a willingness to be vaccinated; among them were older age groups, those in rural areas, and those with underlying medical conditions. In addition, males showed less hesitancy towards being vaccinated. Although selectivity bias exists, this study is the first to examine the willingness of Japanese people to be vaccinated. Since vaccine hesitancy and refusal ratio were found to be higher in Japan than in other countries, policy efforts are needed to make the country’s vaccination program viable.
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Affiliation(s)
- Takeshi Yoda
- Department of Public Health, Kawasaki Medical School, Kurashiki 701-0192, Japan;
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki 701-0193, Japan
- Correspondence: ; Tel.: +81-(0)86-462-1111
| | - Hironobu Katsuyama
- Department of Public Health, Kawasaki Medical School, Kurashiki 701-0192, Japan;
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Eisenhauer L, Hansen BR, Pandian V. Strategies to improve human papillomavirus vaccination rates among adolescents in family practice settings in the United States: A systematic review. J Clin Nurs 2020; 30:341-356. [PMID: 33270305 DOI: 10.1111/jocn.15579] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/04/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore the interventions aimed at increasing human papillomavirus (HPV) vaccination rates among adolescents in family practice settings. BACKGROUND HPV is the most common sexually transmitted disease in the United States, and the cause of thousands of anogenital and oropharyngeal cancers annually. Although HPV infection can be prevented with recommended vaccination during adolescence, national HPV vaccine rates remain low. DESIGN Systematic review. METHODS Four databases (MEDLINE, CINAHL, EMBASE and the Cochrane Library) were searched. The search was guided by PRISMA and by the question, 'What are targeted interventions that improve HPV vaccination rates among adolescents in family practice settings?' Articles were reviewed for study characteristics and appraised for quality using the revised Cochrane risk of bias tools. RESULTS Eleven studies met inclusion and exclusion criteria. Individual study size samples ranged from 749-147,294, with a combined total from all included studies of 276,205; the largest sample reviewed to date from family practice settings. Interventions used to increase HPV vaccination rates included reminder systems; provider and staff education; sensory incentives such as hitting a gong or petting a puppy; and iPad tailored messaging programmes. Studies that employed interventions pre-, during and postvisit were most effective in increasing HPV vaccination rates. CONCLUSIONS This review provides the largest data supporting multimodal strategies to increase HPV vaccination rates among adolescent populations. It provides strong evidence to suggest that vaccination rates can be improved using measures at varying times of the patient visit. RELEVANCE TO CLINICAL PRACTICE Adolescents seek health care in various settings. Many studies have examined interventions to increase HPV vaccination in paediatric settings, but few have examined interventions in family practice settings. This review suggests that family practices should implement multimodal measures before, during and after visits to increase HPV vaccination among adolescent patients.
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Okuhara T, Ishikawa H, Ueno H, Okada H, Kiuchi T. Examining Long-Term Effects of Human Papillomavirus Vaccine Recommendation Messages: A 4-Month Follow-Up Survey of a Randomized Controlled Study in Japan. Healthcare (Basel) 2020; 8:E549. [PMID: 33321946 PMCID: PMC7763459 DOI: 10.3390/healthcare8040549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 11/16/2022] Open
Abstract
We previously conducted a randomized controlled study to examine persuasive messages recommending HPV vaccination to mothers with daughters in Japan. That study showed that the three types of intervention message used (statistical information only, a patient's narrative in addition to statistical information, and a mother's narrative in addition to statistical information) all significantly improved mothers' intention to have their daughter(s) receive the HPV vaccine, in comparison with mothers who received no messaging. The present study is a follow-up survey to assess the long-term effect of the intervention. Four months after the initial study, in January 2018, participants in the previous study were contacted and queried about their current intention to have their daughter(s) receive the HPV vaccine. Statistical analysis was conducted using the paired t-test and analysis of variance. A total of 978 mothers participated in the current survey. Vaccination intention 4 months after intervention had decreased to a level that did not differ significantly from the level prior to intervention in all three intervention conditions. The amount of change in vaccination intention 4 months after intervention did not differ significantly among the three intervention groups (p = 0.871). A single exposure to messaging was insufficient to produce a persistent intervention effect.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
| | - Hirono Ishikawa
- School of Public Health, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan;
| | - Haruka Ueno
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
| | - Hiroko Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo 113-8655, Japan; (H.U.); (H.O.); (T.K.)
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Sato R, Fintan B. Fear, knowledge, and vaccination behaviors among women in Northern Nigeria. Hum Vaccin Immunother 2020; 16:2438-2448. [PMID: 32083514 DOI: 10.1080/21645515.2020.1723365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: Although vaccine hesitancy is a global concern, the evaluation on how fear of vaccination affects vaccination-related knowledge, behaviors, and perceptions is extremely scarce in developing countries. This study contributes to the literature by filling the knowledge gap on the fear of vaccination by focusing on Nigerian caregivers. Methods: The study evaluates the correlation between fear of vaccination and knowledge, actual behaviors, and perception among caregivers in 11 settlements in the Jada local government area of Adamawa State, northeastern Nigeria. The data were collected in September 2019. We use logistic regression analysis to evaluate the correlation. Results and Discussions: About 15% of caregivers have some form of fear regarding vaccination. However, such fear is not correlated with most of the socio-demographic characteristics among caregivers. Fear is significantly correlated with the lack of accurate vaccination knowledge, with a lower likelihood of vaccination uptake for their children, and with the lack of perceptions of vaccination importance and intention to vaccinate their children. Results from our study are consistent with findings from existing studies conducted in developed countries.
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Affiliation(s)
- Ryoko Sato
- Global Health and Population, Harvard T.H Chan School of Public Health , Boston, MA, USA
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Karafillakis E, Simas C, Jarrett C, Verger P, Peretti-Watel P, Dib F, De Angelis S, Takacs J, Ali KA, Pastore Celentano L, Larson H. HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe. Hum Vaccin Immunother 2019; 15:1615-1627. [PMID: 30633623 PMCID: PMC6783136 DOI: 10.1080/21645515.2018.1564436] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/03/2018] [Accepted: 12/18/2018] [Indexed: 11/15/2022] Open
Abstract
Europe is increasingly described as the region in the world with the least confidence in vaccination, and particularly in the safety of vaccines. The aim of this systematic literature review was to gather and summarise all peer-reviewed and grey literature published about determinants of Human Papillomavirus (HPV) vaccine hesitancy in Europe. Ten thematic categories were identified across the 103 articles which were included in the review. Participants from European studies most commonly reported issues with the quantity and quality of information available about HPV vaccination; followed by concerns about potential side effects of the vaccine; and mistrust of health authorities, healthcare workers, and new vaccines. Comparative analyses indicated that confidence determinants differed by country and population groups. This evidence supports the need to develop context-specific interventions to improve confidence in HPV vaccination and design community engagement strategies aiming to build public trust.
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Affiliation(s)
- Emilie Karafillakis
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Clarissa Simas
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
| | - Caitlin Jarrett
- Swiss Centre for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Universität Basel, Basel, Switzerland
| | - Pierre Verger
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Aix Marseille Université, UMR_S 912, IRD, Marseille, France
- INSERM, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), GH Cochin Broca Hôtel Dieu, Paris, France
| | - Patrick Peretti-Watel
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France
- ORS PACA, Southeastern Health Regional Observatory, Marseille, France
- Aix Marseille Université, UMR_S 912, IRD, Marseille, France
- INSERM, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), GH Cochin Broca Hôtel Dieu, Paris, France
| | - Fadia Dib
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology, Paris, France
- INSERM CIC 1417, F-CRIN, I-REIVAC, Paris, France
- Assistance Publique Hopitaux de Paris (AP-HP), Hôpital Cochin, CIC Cochin, Pasteur, Paris, France
| | - Stefania De Angelis
- Vaccine Preventable Disease Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Judit Takacs
- Centre for Social Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Karam Adel Ali
- Vaccine Preventable Disease Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Lucia Pastore Celentano
- Vaccine Preventable Disease Programme, European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Heidi Larson
- Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
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Karamanidou C, Dimopoulos Κ. Knowledge, beliefs and communication preferences with regards to the HPV vaccine; the perspective of unvaccinated Greek adolescent girls, young women, and mothers of vaccine-eligible girls. Health Psychol Behav Med 2018; 6:180-202. [PMID: 34040827 PMCID: PMC8114387 DOI: 10.1080/21642850.2018.1505518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background: Every year in Europe 60,000 women develop cervical cancer and 30,000 die from the disease. HPV vaccines are currently believed to constitute an important element of cervical cancer control strategy. The introduction of the HPV vaccine constitutes a shift in health policy and health promotion practice. The aim of this study was to investigate knowledge, beliefs and communication preferences of the Greek public with regards to the HPV vaccine. Methods: Six focus groups (5–8 participants) were conducted with unvaccinated teenage girls, young women and mothers of vaccine-eligible girls, recruited via schools and universities. Pre-focus group questionnaires consisted of: socio-demographic details and a knowledge questionnaire. The discussion guide was based on issues raised by relevant studies such as disease severity and personal risk perception, perceived benefits and barriers to vaccination, etc. Participants were also shown three types of stimuli namely, a leaflet, an expert interview and a documentary containing equivalent information on HPV and the HPV vaccine. Thematic analysis was used for analysis of the qualitative data. Findings: Findings revealed that participants had low to moderate knowledge levels on HPV and cervical cancer. Beliefs specific to the HPV vaccine as well as general beliefs about medicines and their use in everyday life were prevalent. The vaccination dilemma was exacerbated by the conflicting advice received by health professionals coupled with the difficulties participants experienced in evaluating relevant health information. Participants judged all stimuli according to content and format but the documentary was their preferred health information communication option. Conclusions: Findings could contribute to the understanding of health decision making with regards to preventive vaccination and help formulate recommendations for health policy adjustments.
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Affiliation(s)
- Christina Karamanidou
- Department of Social and Educational Policy, Faculty of Social Sciences, University of Peloponnese, Damaskinou and Kolokotroni str, Korinthos, Greece.,Department of Education, University of Nicosia, Nicosia, Cyprus
| | - Κostas Dimopoulos
- Department of Social and Educational Policy, Faculty of Social Sciences, University of Peloponnese, Damaskinou and Kolokotroni str, Korinthos, Greece
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Okuhara T, Ishikawa H, Okada M, Kato M, Kiuchi T. Persuasiveness of Statistics and Patients' and Mothers' Narratives in Human Papillomavirus Vaccine Recommendation Messages: A Randomized Controlled Study in Japan. Front Public Health 2018; 6:105. [PMID: 29707533 PMCID: PMC5906532 DOI: 10.3389/fpubh.2018.00105] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/27/2018] [Indexed: 12/02/2022] Open
Abstract
Background The human papillomavirus (HPV) vaccination percentage among age-eligible girls in Japan is only in the single digits. This signals the need for effective vaccine communication tactics. This study aimed to examine the influence of statistical data and narrative HPV vaccination recommendation massages on recipients’ vaccination intentions. Methods This randomized controlled study covered 1,432 mothers who had daughters aged 12–16 years. It compared message persuasiveness among four conditions: statistical messages only; narrative messages of a patient who experienced cervical cancer, in addition to statistical messages; narrative messages of a mother whose daughter experienced cervical cancer, in addition to statistical messages; and a control. Vaccination intentions to have one’s daughter(s) receive the HPV vaccine before and after reading intervention materials were assessed. Statistical analysis was conducted using analysis of variance with Tukey’s test or Games–Howell post hoc test, and analysis of covariance with Bonferroni correction. Results Vaccination intentions after intervention in the three intervention conditions were higher than the control condition (p < 0.001). A mother’s narrative messages in addition to statistical messages increased HPV vaccination intention the most of all tested intervention conditions. A significant difference in the estimated means of intention with the covariate adjustment for baseline value (i.e., intention before intervention) was found between a mother’s narrative messages in addition to statistical messages and statistical messages only (p = 0.040). Discussion Mothers’ narrative messages may be persuasive when targeting mothers for promoting HPV vaccination. This may be because mothers can easily relate to and identify with communications from other mothers. However, for effective HPV vaccine communication, further studies are needed to understand more about persuasive differences in terms of statistics, narratives, and narrators. Directions for future research are also suggested.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hirono Ishikawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Masafumi Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Mio Kato
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan
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Okuhara T, Ishikawa H, Okada M, Kato M, Kiuchi T. Contents of Japanese pro- and anti-HPV vaccination websites: A text mining analysis. PATIENT EDUCATION AND COUNSELING 2018; 101:406-413. [PMID: 29031425 DOI: 10.1016/j.pec.2017.09.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 09/22/2017] [Accepted: 09/23/2017] [Indexed: 05/13/2023]
Abstract
OBJECTIVE In Japan, the human papillomavirus (HPV) vaccination rate has sharply fallen to nearly 0% due to sensational media reports of adverse events. Online anti-HPV-vaccination activists often warn readers of the vaccine's dangers. Here, we aimed to examine frequently appearing contents on pro- and anti-HPV vaccination websites. METHODS We conducted online searches via two major search engines (Google Japan and Yahoo! Japan). Targeted websites were classified as "pro," "anti," or "neutral" according to their claims, with the author(s) classified as "health professionals," "mass media," or "laypersons." We then conducted a text mining analysis. RESULTS Of the 270 sites analyzed, 16 contents were identified. The most frequently appearing contents on pro websites were vaccine side effects, preventable effect of vaccination, and cause of cervical cancer. The most frequently appearing contents on anti websites were vaccine side effects, vaccine toxicity, and girls who suffer from vaccine side effects. Main disseminators of each content according to the author's expertise were also revealed. CONCLUSION Pro-HPV vaccination websites should supplement deficient contents and respond to frequent contents on anti-HPV websites. PRACTICE IMPLICATIONS Effective tactics are needed to better communicate susceptibility to cervical cancer, frequency of side effects, and responses to vaccine toxicity and conspiracy theories.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Hirono Ishikawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Masahumi Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Mio Kato
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
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15
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Hoefer L, Tsikis S, Bethimoutis G, Nicolaidou E, Paparizos V, Antoniou C, Kanelleas A, Chardalias L, Stavropoulos GE, Schneider J, Charnot-Katsikas A. HPV vaccine acceptability in high-risk Greek men. Hum Vaccin Immunother 2017; 14:134-139. [PMID: 28937851 DOI: 10.1080/21645515.2017.1379640] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
HPV is associated with malignancy in men, yet there is a lack of data on HPV knowledge, vaccine acceptability, and factors affecting vaccine acceptability in Greek men. This study aims to identify determinants of knowledge and willingness to vaccinate against HPV among high-risk Greek men. Men (n = 298) between the ages of 18 and 55 were enrolled from the STI and HIV clinics at "Andreas Syggros" Hospital in Athens, Greece from July-October 2015. Participants completed a survey on demographics, economic factors, sexual history, HPV knowledge, and vaccine acceptability. The majority of participants were younger than 40 (76.6%) and unmarried (84.6%). Our sample was 31.2% MSM (men who have sex with men), and 20.1% were HIV-positive. Most participants (>90%) were aware that HPV is highly prevalent in both men and women; however, fewer identified that HPV causes cancers in both sexes (68%) and that vaccination protects men and women (67%). Amongst participants, 76.7% were willing to vaccinate themselves against HPV, 71.4% an adolescent son, and 69.3% an adolescent daughter. HIV-positive men were more likely to be willing to vaccinate themselves (OR 2.83, p = .015), a son (OR 3.3, p = .015) or a daughter (3.01, p = .020). Higher income levels were associated with increased willingness to vaccinate oneself (OR 1.32, p = .027), a son (1.33, p = .032) or daughter (1.34, p = .027). Although there is a HPV knowledge gap, HPV vaccine acceptability is high despite lack of vaccine promotion to Greek men. Future studies should include lower-risk men to adequately inform public health efforts.
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Affiliation(s)
- Lea Hoefer
- a Biological Sciences Division , University of Chicago Pritzker School of Medicine , Chicago , USA
| | - Savas Tsikis
- a Biological Sciences Division , University of Chicago Pritzker School of Medicine , Chicago , USA
| | - George Bethimoutis
- b 1st Department of Dermatology and Venereology , National and Kapodistrian University of Athens School of Medicine, "Andreas Syggros" Hospital , Athens , Greece
| | - Electra Nicolaidou
- b 1st Department of Dermatology and Venereology , National and Kapodistrian University of Athens School of Medicine, "Andreas Syggros" Hospital , Athens , Greece
| | - Vassilios Paparizos
- b 1st Department of Dermatology and Venereology , National and Kapodistrian University of Athens School of Medicine, "Andreas Syggros" Hospital , Athens , Greece
| | - Christina Antoniou
- b 1st Department of Dermatology and Venereology , National and Kapodistrian University of Athens School of Medicine, "Andreas Syggros" Hospital , Athens , Greece
| | - Antonios Kanelleas
- b 1st Department of Dermatology and Venereology , National and Kapodistrian University of Athens School of Medicine, "Andreas Syggros" Hospital , Athens , Greece
| | - Leonidas Chardalias
- c National and Kapodistrian University of Athens School of Medicine , Athens , Greece
| | | | - John Schneider
- d University of Chicago Medicine , Department of Medicine , Chicago , USA.,e University of Chicago, Medicine , Department of Public Health Sciences , Chicago , USA
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16
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Okuhara T, Ishikawa H, Okada M, Kato M, Kiuchi T. Readability comparison of pro- and anti-HPV-vaccination online messages in Japan. PATIENT EDUCATION AND COUNSELING 2017; 100:1859-1866. [PMID: 28532860 DOI: 10.1016/j.pec.2017.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/14/2017] [Accepted: 04/21/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE In Japan, the HPV vaccination rate has sharply fallen to nearly 0% due to a series of sensational media reports of adverse events. Online anti-HPV-vaccination activists often warn readers of the vaccine's dangers. We aimed to examine distribution and readability of pro-and anti-vaccination online messages with relation to these authors' professional expertise. METHODS We conducted online searches via two major search engines. Identified sites were classified as "anti," "pro," or "neutral" depending on their claims, and "health professional" or "non-health professional" depending on their authors' expertise. Readability was determined using a validated measure of Japanese readability. Statistical analysis was conducted using two-way analysis of variance and Tukey's test. RESULTS Of the total 270 sites analyzed, up to 137 (50.7%) were deemed anti- and 101 (37.4%) pro-HPV-vaccination. Of the pro-vaccination sites 71% were written by health professionals. Anti-vaccination messages were found to be considerably easier to read than pro-vaccination ones; both among those by health professionals and non-health professionals. CONCLUSION Our findings substantiate concern that the anti messages may serve to prolong the HPV vaccination crisis. PRACTICE IMPLICATIONS We recommend that health professionals use readability assessment tools and improve the text for easier reading if necessary.
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Affiliation(s)
- Tsuyoshi Okuhara
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Hirono Ishikawa
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Masahumi Okada
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Mio Kato
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
| | - Takahiro Kiuchi
- Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
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17
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Karafillakis E, Larson HJ. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine 2017; 35:4840-4850. [PMID: 28760616 DOI: 10.1016/j.vaccine.2017.07.061] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The success of vaccination strategies depends in part on population perceptions of benefits and risks of vaccines and related confidence in vaccination. Better knowledge of public concerns about vaccines and what is driving them is needed to inform vaccination strategies and communications. This literature reviewer examined studies on vaccine and vaccination risk perceptions and concerns across European populations. METHODS A systematic literature review was conducted to identify studies published between 2004 and 2014 in Europe. A descriptive analysis was performed. FINDINGS A total of 145 articles were selected, most of which were conducted in the UK, the Netherlands and France and studied seasonal influenza, HPV and pandemic influenza vaccination. Across all countries and vaccines, the primary area of concern was vaccine safety, followed by perceptions of low likelihood of contracting vaccine-preventable diseases (VPDs), perceived low severity of VPDs, beliefs that vaccines do not work, and overall lack of information. Concerns were found to be vaccine-, country- and population-specific. CONCLUSION In addition to identifying concerns about vaccination in Europe, this study confirmed the notion that individuals have many safety concerns about vaccination and often believe that the risks of vaccination outweigh their benefits. More research needs to be conducted to explore the impact of different types of communication strategies, which would frame the benefits of vaccination as well as risks of not vaccinating. Strategies to better inform public perceptions of vaccines should include the provision of unbiased, comprehensive information tailored to population information needs, and delivered using multiple and new communication technologies such as social media.
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Affiliation(s)
- Emilie Karafillakis
- Vaccine Confidence Project, London School of Hygiene & Tropical medicine, London, United Kingdom
| | - Heidi J Larson
- Vaccine Confidence Project, London School of Hygiene & Tropical medicine, London, United Kingdom; Department of Global Health, University of Washington, Seattle, USA.
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18
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Forster AS, McBride KA, Davies C, Stoney T, Marshall H, McGeechan K, Cooper SC, Skinner SR. Development and validation of measures to evaluate adolescents' knowledge about human papillomavirus (HPV), involvement in HPV vaccine decision-making, self-efficacy to receive the vaccine and fear and anxiety. Public Health 2017; 147:77-83. [PMID: 28404501 PMCID: PMC5476903 DOI: 10.1016/j.puhe.2017.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 02/03/2017] [Accepted: 02/06/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We describe the development and validation of measures of human papillomavirus (HPV)/HPV vaccination knowledge, fear/anxiety about vaccination, involvement in HPV vaccine decision-making, and self-efficacy with regard to getting the vaccine, designed to evaluate the efficacy of an intervention to affect these domains (collectively termed the HAVIQ: HPV Adolescent Vaccine Intervention Questionnaire). STUDY DESIGN Literature search, cognitive interviews and cross-sectional survey. METHODS A literature search identified existing items that were modified for the present measures. Experts reviewed draft measures for face and content validity. Cognitive interviews with adolescents were also used to assess content validity. Adolescents completed the measures and an internal reliability analysis of each measure was performed. RESULTS The four experts concurred that the measures had face validity. Cognitive interviews identified items requiring refinement. Content validity was examined with ten experts and was deemed acceptable. There were 1800 adolescents who completed the measures; Cronbach's alpha was >0.6 for three of the four measures. The four final measures are brief, comprising 25 items in total. CONCLUSIONS The measures are robustly developed and validity-tested. The HAVIQ may be used in research settings to evaluate adolescents' knowledge and experiences of the process of HPV vaccination in a school-based vaccination programme.
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Affiliation(s)
- A S Forster
- Department of Behavioural Science and Health, UCL, London, WC1E 6BT, UK
| | - K A McBride
- Centre for Health Research, Western Sydney University, NSW, Australia
| | - C Davies
- Discipline of Child and Adolescent Health, Children's Hospital Westmead, University of Sydney, NSW, Australia
| | - T Stoney
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - H Marshall
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network and Robinson Research Institute and School of Medicine, University of Adelaide, Adelaide, Australia
| | - K McGeechan
- School of Public Health, University of Sydney, Sydney, Australia
| | - S C Cooper
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Policy, New York, USA
| | - S R Skinner
- Discipline of Child and Adolescent Health, Children's Hospital Westmead, University of Sydney, NSW, Australia.
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19
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Mapping information exposure on social media to explain differences in HPV vaccine coverage in the United States. Vaccine 2017; 35:3033-3040. [PMID: 28461067 DOI: 10.1016/j.vaccine.2017.04.060] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Together with access, acceptance of vaccines affects human papillomavirus (HPV) vaccine coverage, yet little is known about media's role. Our aim was to determine whether measures of information exposure derived from Twitter could be used to explain differences in coverage in the United States. METHODS We conducted an analysis of exposure to information about HPV vaccines on Twitter, derived from 273.8 million exposures to 258,418 tweets posted between 1 October 2013 and 30 October 2015. Tweets were classified by topic using machine learning methods. Proportional exposure to each topic was used to construct multivariable models for predicting state-level HPV vaccine coverage, and compared to multivariable models constructed using socioeconomic factors: poverty, education, and insurance. Outcome measures included correlations between coverage and the individual topics and socioeconomic factors; and differences in the predictive performance of the multivariable models. RESULTS Topics corresponding to media controversies were most closely correlated with coverage (both positively and negatively); education and insurance were highest among socioeconomic indicators. Measures of information exposure explained 68% of the variance in one dose 2015 HPV vaccine coverage in females (males: 63%). In comparison, models based on socioeconomic factors explained 42% of the variance in females (males: 40%). CONCLUSIONS Measures of information exposure derived from Twitter explained differences in coverage that were not explained by socioeconomic factors. Vaccine coverage was lower in states where safety concerns, misinformation, and conspiracies made up higher proportions of exposures, suggesting that negative representations of vaccines in the media may reflect or influence vaccine acceptance.
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20
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Yagi A, Ueda Y, Egawa-Takata T, Tanaka Y, Morimoto A, Terai Y, Ohmichi M, Ichimura T, Sumi T, Murata H, Okada H, Nakai H, Mandai M, Yoshino K, Kimura T, Saito J, Kudoh R, Sekine M, Enomoto T, Hirai K, Horikoshi Y, Takagi T, Shimura K. Development of an efficient strategy to improve HPV immunization coverage in Japan. BMC Public Health 2016; 16:1013. [PMID: 27663658 PMCID: PMC5035494 DOI: 10.1186/s12889-016-3676-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 09/16/2016] [Indexed: 11/21/2022] Open
Abstract
Background In Japan, new HPV immunizations have dropped dramatically after repeated adverse media reports and a June 2013 temporary suspension of the government’s recommendation for the vaccine. The aim of the present study was to develop an efficient strategy to improve HPV immunization coverage across Japan. Methods We conducted an internet survey in Japan of mothers of 12–16 year-old girls who were unvaccinated as of May, 2015. The goal was to gather behavioral information from the mothers to develop a strategy for improving Japanese HPV immunization coverage. Results Valid survey answers were obtained from 2060 mothers. The survey found that a hypothetical restart of a governmental recommendation for the vaccine would induce 4.1 % of all the mothers surveyed to be more likely to encourage vaccination of their daughters, without any other preconditions. This initial result would be followed by a moderate spread of vaccinations to these daughters’ close friends and acquaintances, hypothetically resulting in a total vaccination rate of 21.0 % of the targeted age-eligible girls. As a second critical step for improving vaccinations, an educational information sheet integrating the concepts of behavioral economics for changing behaviors was found to be significantly effective for persuading mothers with poorer decision-making facilities, who would otherwise prefer to wait to first see the vaccination of other girls of the same age as their daughter. Conclusions Following what we foresee as the inevitable restart of the Japanese government’s recommendation for receiving the HPV vaccine, we expect to first see vaccinations occurring in a very small group of girls, the daughters of the most willing mothers, which will be roughly 4 % of those eligible for government paid vaccinations. This will be followed by the spread of vaccinations outward through these girls’ circle of friends and acquaintances, and, finally, to the daughters of the most skeptical mothers, those who would await the return of new vaccine safety results from a large group of similarly-aged girls. As a critical step in improving HPV vaccine coverage in Japan, an educational information sheet that integrates the concepts of behavioral economics for changing behaviors can be employed to persuade mothers with poor decision-making facilities.
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Affiliation(s)
- Asami Yagi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. .,The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.
| | - Tomomi Egawa-Takata
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.,The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan
| | - Yusuke Tanaka
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.,The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan
| | - Akiko Morimoto
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.,The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan
| | - Yoshito Terai
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Department of Obstetrics and Gynecology, Osaka Medical College Graduate School of Medical Sciences, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | - Masahide Ohmichi
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Department of Obstetrics and Gynecology, Osaka Medical College Graduate School of Medical Sciences, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan
| | - Tomoyuki Ichimura
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Department of Obstetrics and Gynecology, Osaka City University Graduate School and Faculty of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Toshiyuki Sumi
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Department of Obstetrics and Gynecology, Osaka City University Graduate School and Faculty of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan
| | - Hiromi Murata
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Department of Obstetrics and Gynecology, Kansai Medical University Graduate School of Medicine, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Hidetaka Okada
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Department of Obstetrics and Gynecology, Kansai Medical University Graduate School of Medicine, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Hidekatsu Nakai
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Department of Obstetrics and Gynecology, Kinki University Graduate School of Medical Sciences, 377-2 Ono-Higashi, Sayama, Osaka, 589-8511, Japan
| | - Masaki Mandai
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Department of Obstetrics and Gynecology, Kinki University Graduate School of Medical Sciences, 377-2 Ono-Higashi, Sayama, Osaka, 589-8511, Japan
| | - Kiyoshi Yoshino
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.,The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.,The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan
| | - Junko Saito
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Saito Women's Clinic, 1-6-1 Miyahara, Yodogawa-ku, Osaka, 532-0003, Japan
| | - Risa Kudoh
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Takayuki Enomoto
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan.,Department of Obstetrics and Gynecology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan
| | - Kei Hirai
- Institute for Academic Initiatives, Osaka University, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Yorihiko Horikoshi
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan
| | - Tetsu Takagi
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan
| | - Kentaro Shimura
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan
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Karamanidou C, Dimopoulos K. Greek health professionals' perceptions of the HPV vaccine, state policy recommendations and their own role with regards to communication of relevant health information. BMC Public Health 2016; 16:467. [PMID: 27260348 PMCID: PMC4891886 DOI: 10.1186/s12889-016-2831-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 02/04/2016] [Indexed: 11/21/2022] Open
Abstract
Background Every year in Europe 60,000 women develop cervical cancer and 30,000 die from the disease. HPV vaccines are currently believed to constitute an important element of cervical cancer control strategy. Currently in Greece, the HPV vaccine is given on demand after prescription by a healthcare professional. Health care professionals’ role is key as they are in a position to discuss HPV vaccination with parents, adolescents and young women. This study is aiming to explore health care professionals’ perceptions of the HPV vaccine, state policy recommendations and their own role with regards to communication of relevant health information. Methods This was an in-depth, qualitative study, employing a stratified, purposeful sampling. Fifteen face-to-face, semi-structured interviews were conducted with health care professionals from a variety of disciplines: pediatrics, obstetrics and gynecology, infectious diseases, pharmacy, dermatology, general practice. Thematic qualitative analysis was used to analyze participants’ accounts. Results Five major themes were identified: health care professionals’ perceptions towards the HPV vaccine (recognition of importance, concerns about safety, effectiveness and impact of long-term use), animosity between medical specialties (territorial disputes among professional bodies, role advocacy, role limitations), health care professionals’ perceptions of the public’s attitudes (effects of cultural beliefs, health professionals’ attitudes, media and family), the role of the state (health policy issues, lack of guidance, unmet expectations) and their own role (provision of health information, sex education). Conclusions Health professionals’ concerns, lack of role definition and uniform information provision have led to territorial disputes among professional bodies and distrust among different medical specialties. Positive and negative judgements deriving from a multitude of sources have resulted in the confusion of the general public, as manifested by low vaccination rates. Due to the lack of clear regulation of vaccination prescription, administration and mode of delivery, factors such as lack of knowledge, cultural beliefs and personal attitudes have shaped the vaccination landscape. These factors have neither been explored nor addressed prior to the initiation of this public health effort and as such there is an evident less than efficient use of resources.
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Affiliation(s)
- Christina Karamanidou
- Department of Social and Educational Policy, University of Peloponnese, Damaskinou & Kolokotroni Str, 20100, Corinth, Greece.
| | - Kostas Dimopoulos
- Department of Social and Educational Policy, University of Peloponnese, Damaskinou & Kolokotroni Str, 20100, Corinth, Greece
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Gee J, Weinbaum C, Sukumaran L, Markowitz LE. Quadrivalent HPV vaccine safety review and safety monitoring plans for nine-valent HPV vaccine in the United States. Hum Vaccin Immunother 2016; 12:1406-17. [PMID: 27029786 PMCID: PMC4964727 DOI: 10.1080/21645515.2016.1168952] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Quadrivalent human papillomavirus (4vHPV) vaccine was licensed for use in the United States in 2006 and through 2015 was the predominate HPV vaccine used. With the exception of syncope, a known preventable adverse event after any injected vaccination, both pre-licensure and post-licensure 4vHPV safety data have been reassuring with no confirmed safety signals identified. Nine-valent HPV vaccine (9vHPV) was licensed in 2014. This review includes post-licensure 4vHPV safety findings published to date that have informed the US vaccination program; these data will inform US safety monitoring and evaluation for 9vHPV.
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Affiliation(s)
- Julianne Gee
- a Division of Healthcare and Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Cindy Weinbaum
- a Division of Healthcare and Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Lakshmi Sukumaran
- a Division of Healthcare and Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
| | - Lauri E Markowitz
- b Division of Viral Diseases, National Center Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA
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Navarro-Illana P, Caballero P, Tuells J, Puig-Barberá J, Diez-Domingo J. Acceptability of human papillomavirus vaccine in mothers from Valencia (Spain). An Pediatr (Barc) 2015. [DOI: 10.1016/j.anpede.2015.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Egawa-Takata T, Ueda Y, Morimoto A, Yoshino K, Kimura T, Nishikawa N, Sekine M, Horikoshi Y, Takagi T, Enomoto T. Survey of Japanese mothers of daughters eligible for human papillomavirus vaccination on attitudes about media reports of adverse events and the suspension of governmental recommendation for vaccination. J Obstet Gynaecol Res 2015; 41:1965-71. [DOI: 10.1111/jog.12822] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/28/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Tomomi Egawa-Takata
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Yutaka Ueda
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Akiko Morimoto
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Kiyoshi Yoshino
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Tadashi Kimura
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Osaka University Graduate School of Medicine; Osaka Japan
| | - Nobumichi Nishikawa
- Department of Obstetrics and Gynecology; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - Masayuki Sekine
- Department of Obstetrics and Gynecology; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | | | - Tetsu Takagi
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
| | - Takayuki Enomoto
- The Obstetrical Gynecological Society of Osaka; Osaka Japan
- Department of Obstetrics and Gynecology; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
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Dunn AG, Leask J, Zhou X, Mandl KD, Coiera E. Associations Between Exposure to and Expression of Negative Opinions About Human Papillomavirus Vaccines on Social Media: An Observational Study. J Med Internet Res 2015; 17:e144. [PMID: 26063290 PMCID: PMC4526932 DOI: 10.2196/jmir.4343] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/22/2015] [Indexed: 11/22/2022] Open
Abstract
Background Groups and individuals that seek to negatively influence public opinion about the safety and value of vaccination are active in online and social media and may influence decision making within some communities. Objective We sought to measure whether exposure to negative opinions about human papillomavirus (HPV) vaccines in Twitter communities is associated with the subsequent expression of negative opinions by explicitly measuring potential information exposure over the social structure of Twitter communities. Methods We hypothesized that prior exposure to opinions rejecting the safety or value of HPV vaccines would be associated with an increased risk of posting similar opinions and tested this hypothesis by analyzing temporal sequences of messages posted on Twitter (tweets). The study design was a retrospective analysis of tweets related to HPV vaccines and the social connections between users. Between October 2013 and April 2014, we collected 83,551 English-language tweets that included terms related to HPV vaccines and the 957,865 social connections among 30,621 users posting or reposting the tweets. Tweets were classified as expressing negative or neutral/positive opinions using a machine learning classifier previously trained on a manually labeled sample. Results During the 6-month period, 25.13% (20,994/83,551) of tweets were classified as negative; among the 30,621 users that tweeted about HPV vaccines, 9046 (29.54%) were exposed to a majority of negative tweets. The likelihood of a user posting a negative tweet after exposure to a majority of negative opinions was 37.78% (2780/7361) compared to 10.92% (1234/11,296) for users who were exposed to a majority of positive and neutral tweets corresponding to a relative risk of 3.46 (95% CI 3.25-3.67, P<.001). Conclusions The heterogeneous community structure on Twitter appears to skew the information to which users are exposed in relation to HPV vaccines. We found that among users that tweeted about HPV vaccines, those who were more often exposed to negative opinions were more likely to subsequently post negative opinions. Although this research may be useful for identifying individuals and groups currently at risk of disproportionate exposure to misinformation about HPV vaccines, there is a clear need for studies capable of determining the factors that affect the formation and adoption of beliefs about public health interventions.
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Affiliation(s)
- Adam G Dunn
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
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Abstract
INTRODUCTION Between 2006 and 2009, two different human papillomavirus virus (HPV) vaccines were licensed for use: a quadrivalent (qHPVv) and a bivalent (bHPVv) vaccine. Since 2008, HPV vaccination programmes have been implemented in the majority of the industrialized countries. Since 2013, HPV vaccination has been part of the national programs of 66 countries including almost all countries in North America and Western Europe. Despite all the efforts made by individual countries, coverage rates are lower than expected. Vaccine safety represents one of the main concerns associated with the lack of acceptance of HPV vaccination both in the European Union/European Economic Area and elsewhere. AREAS COVERED Safety data published on bivalent and quadrivalent HPV vaccines, both in pre-licensure and post-licensure phase, are reviewed. EXPERT OPINION Based on the latest scientific evidence, both HPV vaccines seem to be safe. Nevertheless, public concern and rumors about adverse events (AE) represent an important barrier to overcome in order to increase vaccine coverage. Passive surveillance of AEs is an important tool for detecting safety signals, but it should be complemented by activities aimed at assessing the real cause of all suspect AEs. Improved vaccine safety surveillance is the first step for effective communication based on scientific evidence.
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Affiliation(s)
- Michela Stillo
- Department of Public Health and Paediatric sciences, University of Turin
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Navarro-Illana P, Caballero P, Tuells J, Puig-Barberá J, Diez-Domingo J. [Acceptability of human papillomavirus vaccine in mothers from Valencia (Spain)]. An Pediatr (Barc) 2015; 83:318-27. [PMID: 25619797 DOI: 10.1016/j.anpedi.2014.11.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 11/02/2014] [Accepted: 11/28/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION In October 2008, Valencian Community started its human papillomavirus (HPV) vaccination schedules for 14 year-old girls. The aim of this study is to assess knowledge about HPV infection and its vaccine among the mothers of these girls, and to identify factors associated with the willingness to vaccinate their daughters. MATERIAL AND METHODS Cross-sectional study by means of a questionnaire to mothers of girls born in 1995, and attending secondary schools in the province of Valencia during 2010-2011. Cluster stratified random sample (n=1279). STATISTICAL ANALYSIS percentages, confidence intervals, OR, Chi-squared and multivariate logistic regression contrasts. RESULTS A total of 833 (65.1%) questionnaires were completed. The results obtained showed that, 76.6% of mothers had vaccinated their daughters against HPV; 93.8% knew about the vaccine, particularly through television (71.5%); and 78.5% received positive advice from a health professional which increased the vaccination of their daughters (OR: 2.4). There was low overall knowledge about HPV infection and vaccination. Confidence of the mothers in vaccines as a preventative method increases the HPV vaccination (OR: 3.8). The first reason for refusal was the fear of adverse events (45.6%). CONCLUSIONS Apparently, the media does not influence the willingness to vaccinate. It would be desirable to minimize the perception of risk of the vaccine. Positive health advice from a health professional can have a positive effect on vaccination. There is a gap between the level of knowledge and decision-making to vaccinate.
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Affiliation(s)
- P Navarro-Illana
- Facultad de Enfermería, Universidad Católica de Valencia «San Vicente Mártir», Valencia, España
| | - P Caballero
- Cátedra de Vacunología Balmis UA-FISABIO, Universidad de Alicante, Alicante, España
| | - J Tuells
- Cátedra de Vacunología Balmis UA-FISABIO, Universidad de Alicante, Alicante, España.
| | - J Puig-Barberá
- Área de Investigación en Vacunas, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)-Salud Pública, Valencia, España
| | - J Diez-Domingo
- Área de Investigación en Vacunas, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)-Salud Pública, Valencia, España
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Agorastos T, Chatzistamatiou Κ, Zafrakas Μ, Siamanta V, Katsamagkas T, Constantinidis T, Lampropoulos Α. Distinct demographic factors influence the acceptance of vaccination against HPV. Arch Gynecol Obstet 2015; 292:197-205. [DOI: 10.1007/s00404-015-3614-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 01/05/2015] [Indexed: 11/25/2022]
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Female students receiving post-secondary education in Greece: the results of a collaborative human papillomavirus knowledge survey. Public Health 2014; 128:1099-105. [PMID: 25443133 DOI: 10.1016/j.puhe.2014.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 08/25/2014] [Accepted: 09/08/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Contrary to the optimistic forecasts, existing until 2008 and despite the incorporation of the vaccine into the Greek National Immunization Program, six years later, the percentage of HPV vaccination coverage in Greece remains disappointingly low. The aim of this extended study was to investigate the knowledge, behaviour and attitude of a representative sample of the initial target group; young female students of Greek higher education institutions to Pap cervical screening, biology of HPV infection and principles of HPV vaccination. STUDY DESIGN Cross-sectional study. METHODS One thousand two hundred ten (1210) questionnaires were completed by young female students aged 17-24 years. The survey questionnaire sought data relating to sociodemographic characteristics, health behaviour and knowledge about HPV, as well as vaccination status. RESULTS 79.6% of the sample reported at least one annual gynaecologic examination and 92.6% were familiar with the rationale of cervical screening; however only 52.9% had undergone a Pap smear. 69.7% reported adequate knowledge about HPV and 89.3% were aware of the possible course of HPV infection. Despite most (95.9%) were aware of vaccine availability, vaccinated students represented only 33.1%. According to the multivariate analysis, vaccination status was associated with university studies (OR 1.96; 95% CI: 1.19-3.20), parental area of expertise (OR 2.77; 95% CI: 1.18-6.53, OR 2.03; 95% CI: 1.05-3.94), and adequate knowledge of the reasons for which women should undergo regular cervical screening (OR 4.23; 85% CI: 1.55-11.55). Fear of side-effects and equivocal information were the main reasons of non-vaccination (52.2% and 33.1% respectively). Finally, the majority of unvaccinated individuals showed a positive attitude towards prospective HPV vaccination, providing they received well-documented advising. CONCLUSIONS Young women attending Greek higher education exhibit a good level of knowledge about HPV and its correlation with cervical cancer. These data highlight the need for further sensitization of the general population.
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Morimoto A, Ueda Y, Egawa-Takata T, Yagi A, Terai Y, Ohmichi M, Ichimura T, Sumi T, Murata H, Kanzaki H, Nakai H, Mandai M, Yoshino K, Fujita M, Kimura T, Saito J, Sobue T, Nishikawa N, Sekine M, Enomoto T, Horikoshi Y, Takagi T. Effect on HPV vaccination in Japan resulting from news report of adverse events and suspension of governmental recommendation for HPV vaccination. Int J Clin Oncol 2014; 20:549-55. [PMID: 25001869 DOI: 10.1007/s10147-014-0723-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/12/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Administration of the human papillomavirus (HPV) vaccine decreased dramatically in Japan after extensive news of adverse vaccine events and suspension of the governmental recommendation for the vaccine. In this study, we investigated the knowledge and acceptance of vaccinated adolescents concerning cervical cancer, cancer screening and the HPV vaccine. Furthermore, we analyzed whether and by how much the news affected acceptance of the vaccination. METHODS This study was conducted as a part of Osaka Clinical resEArch of HPV vacciNe (OCEAN) study. A questionnaire was distributed to 2,777 study registrants. RESULTS The response rate was 38%. The recognition rate of the news of the vaccine's adverse events was 80%; it was 68% for awareness of the government's announcement of the suspension of its recommendation for the vaccine. Among those who had a chance to hear or see the negative news during their vaccination period, 46 (60%) continued vaccination while knowing of the news, 22 (29%) discontinued vaccination, and 9 (11%) continued vaccination without an awareness of the news. Reports of the vaccine's adverse events were the main reason for not continuing the vaccination series. Those who consulted doctors after hearing the adverse news were significantly more likely to continue their vaccinations than those who did not. CONCLUSIONS Our results should help in understanding the need for a strong promotion of vaccine usage and cancer screening after future retraction of the recommendation suspension. This may apply to other countries with an unsatisfactory rate of HPV vaccination due to fears of adverse vaccine events.
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Affiliation(s)
- Akiko Morimoto
- The Obstetrical Gynecological Society of Osaka, 4-4-3 Kawaramachi, Chuo-ku, Osaka, 541-0048, Japan
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Wakimizu R, Nishigaki K, Fujioka H, Maehara K, Kuroki H, Saito T, Uduki K. How adolescent Japanese girls arrive at human papilloma virus vaccination: A semistructured interview study. Nurs Health Sci 2014; 17:15-25. [DOI: 10.1111/nhs.12123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 11/28/2013] [Accepted: 11/29/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Rie Wakimizu
- Faculty of Medicine; University of Tsukuba; Tsukuba Japan
- Faculty of Health Sciences; Tokyo Healthcare University; Tsukuba Japan
| | - Kaori Nishigaki
- Faculty of Health Sciences; Tokyo Healthcare University; Tsukuba Japan
- Faculty of Health Sciences; Tsukuba International University; Tsukuba Japan
| | - Hiroshi Fujioka
- Faculty of Health Sciences; Tokyo Healthcare University; Tsukuba Japan
- MAEHARA Pediatric Clinic; Tokyo Japan
| | - Koji Maehara
- Faculty of Health Sciences; Tokyo Healthcare University; Tsukuba Japan
- SOTOBO Children's Clinic; Chiba Japan
| | - Haruo Kuroki
- Faculty of Health Sciences; Tokyo Healthcare University; Tsukuba Japan
- Department of Pediatrics; TAKO Central Hospital; Chiba Japan
| | - Tadashi Saito
- Faculty of Health Sciences; Tokyo Healthcare University; Tsukuba Japan
- SHIROAMU Pediatric Clinic; Kushiro Japan
| | - Katsuya Uduki
- Faculty of Health Sciences; Tokyo Healthcare University; Tsukuba Japan
- Investigative Commission of Qualitative Study; Society of Ambulatory and General Pediatrics of Japan; Tokyo Japan
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Chatzistamatiou K, Sotiriadis A, Agorastos T. Letter to the editor referring to the manuscript entitled: “Increasing fear of adverse effects drops intention to vaccinate after the introduction of prophylactic HPV vaccine” reported by Sotiriadis et al. (Arch Gynecol Obstet. 2012 Jun;285(6):1719–24). Arch Gynecol Obstet 2014; 289:471-2. [DOI: 10.1007/s00404-013-3010-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 08/08/2013] [Indexed: 11/29/2022]
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Donadiki EM, Jiménez-García R, Hernández-Barrera V, Sourtzi P, Carrasco-Garrido P, López de Andrés A, Jimenez-Trujillo I, Velonakis EG. Health Belief Model applied to non-compliance with HPV vaccine among female university students. Public Health 2014; 128:268-73. [PMID: 24529635 DOI: 10.1016/j.puhe.2013.12.004] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 10/14/2013] [Accepted: 12/06/2013] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To investigate the reasons for refusal of human papillomavirus (HPV) vaccination, and to explore participants' perceptions and attitudes about Health Belief Model (HBM) constructs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy) among a sample of female university students. STUDY DESIGN Cross-sectional. A self-administered questionnaire based on the HBM was used. METHODS Confirmatory factor analysis was applied to the data to examine the construct validity of the six factor models extracted from the HBM. The predictors of non-HPV vaccination were determined by logistic regression models, using non-HPV vaccination as the dependent variable. RESULTS The sample included 2007 students. The participation rate was 88.9% and the percentage of non-vaccination was 71.65%. Participants who had high scores for 'general perceived barriers', 'perceived barriers to vaccination', 'no perceived general benefits', 'no perceived specific benefits' and 'no general benefits' were more likely to report being unvaccinated. CONCLUSIONS The findings demonstrated the utility of HBM constructs in understanding vaccination intention and uptake. There is an urgent need to improve health promotion and information campaigns to enhance the benefits and reduce the barriers to HPV vaccination.
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Affiliation(s)
- E M Donadiki
- Department of Public Health, Faculty of Nursing, University of Athens, Athens, Greece.
| | - R Jiménez-García
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - V Hernández-Barrera
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - P Sourtzi
- Department of Public Health, Faculty of Nursing, University of Athens, Athens, Greece
| | - P Carrasco-Garrido
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - A López de Andrés
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - I Jimenez-Trujillo
- Department of Preventive Medicine and Public Health and Medical Immunology and Microbiology, Av. of Athens, Alcorcón, Madrid, Spain
| | - E G Velonakis
- Department of Public Health, Faculty of Nursing, University of Athens, Athens, Greece
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Wakimizu R, Nishigaki K, Fujioka H, Maehara K, Kuroki H, Saito T, Uduki K. Factors Affecting Japanese HPV-Vaccination: Findings from the Semi-Structured Interviews with Adolescent Girls and Caregivers. Health (London) 2014. [DOI: 10.4236/health.2014.613193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kim TH, Lee HH. Media effect--Letter to the editor about the manuscript titled: increasing fear of adverse effects drops intention to vaccinate after the introduction of prophylactic HPV vaccine. Arch Gynecol Obstet 2013; 289:473-4. [PMID: 24318275 DOI: 10.1007/s00404-013-3115-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 11/25/2013] [Indexed: 11/24/2022]
Affiliation(s)
- Tae-Hee Kim
- Department of Obstetrics and Gynecology, Soonchunhyang University College of Medicine Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, Gyunggi-do, 420-767, Republic of Korea
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Sotiriadis A, Dagklis T, Siamanta V, Chatzigeorgiou K, Agorastos T. Response to: Media effect-letter to the editor about the manuscript titled Increasing fear of adverse effects drops intention to vaccinate after the introduction of prophylactic HPV vaccine. Arch Gynecol Obstet 2013; 289:475-6. [PMID: 24310411 DOI: 10.1007/s00404-013-3119-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alexandros Sotiriadis
- Fourth Department of Obstetrics and Gynecology, Ippokration General Hospital, 49 Constantinoupoleos Street, 546 42, Thessaloniki, Greece,
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Papagiannis D, Rachiotis G, Symvoulakis EK, Daponte A, Grivea IN, Syrogiannopoulos GA, Hadjichristodoulou C. Vaccination against human papillomavirus among 865 female students from the health professions in central Greece: a questionnaire-based cross-sectional study. J Multidiscip Healthc 2013; 6:435-9. [PMID: 24324338 PMCID: PMC3855014 DOI: 10.2147/jmdh.s49558] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There are still sparse data on vaccination coverage against human papillomavirus (HPV) among students in the health professions. The aim of this study was to investigate HPV vaccination coverage in female students from the health professions in Greece. METHODS A self-administered, anonymous questionnaire was distributed to second-year and third-year female students pursuing degrees in medicine, nursing, and paramedical health disciplines in central Greece. RESULTS Overall vaccination coverage was 44.3%. The major reason for lack of vaccination was fear about safety of the vaccine. Participants who had received information about safety of the vaccine from the mass media and paramedical students had lower vaccination coverage in comparison with students who had received information about vaccine safety from alternative sources. CONCLUSION Further quantitative and qualitative research is needed to design educational activities targeting female students in the health professions in order to create a positive domino effect and improve HPV vaccination coverage levels in Greece.
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Affiliation(s)
- Dimitrios Papagiannis
- Department of Hygiene and Epidemiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Thessalia, Greece
| | - George Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Thessalia, Greece
| | | | - Alexandros Daponte
- Department of Obstetrics and Gynaecology, University of Thessalia Medical School, Thessalia, Greece
| | - Ioanna N Grivea
- Department of Paediatrics, University of Thessaly, School of Medicine, General University Hospital of Larissa, Thessalia, Greece
| | - George A Syrogiannopoulos
- Department of Paediatrics, University of Thessaly, School of Medicine, General University Hospital of Larissa, Thessalia, Greece
| | - Christos Hadjichristodoulou
- Department of Hygiene and Epidemiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Thessalia, Greece
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Markowitz LE, Tsu V, Deeks SL, Cubie H, Wang SA, Vicari AS, Brotherton JML. Human papillomavirus vaccine introduction--the first five years. Vaccine 2013. [PMID: 23199957 DOI: 10.1016/j.vaccine.2012.05.039] [Citation(s) in RCA: 226] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The availability of prophylactic human papillomavirus (HPV) vaccines has provided powerful tools for primary prevention of cervical cancer and other HPV-associated diseases. Since 2006, the quadrivalent and bivalent vaccines have each been licensed in over 100 countries. By the beginning of 2012, HPV vaccine had been introduced into national immunization programs in at least 40 countries. Australia, the United Kingdom, the United States, and Canada were among the first countries to introduce HPV vaccination. In Europe, the number of countries having introduced vaccine increased from 3 in 2007 to 22 at the beginning of 2012. While all country programs target young adolescent girls, specific target age groups vary as do catch-up recommendations. Different health care systems and infrastructure have resulted in varied implementation strategies, with some countries delivering vaccine in schools and others through health centers or primary care providers. Within the first 5 years after vaccines became available, few low- or middle-income countries had introduced HPV vaccine. The main reason was budgetary constraints due to the high vaccine cost. Bhutan and Rwanda implemented national immunization after receiving vaccine through donation programs in 2010 and 2011, respectively. The GAVI Alliance decision in 2011 to support HPV vaccination should increase implementation in low-income countries. Evaluation of vaccination programs includes monitoring of coverage, safety, and impact. Vaccine safety monitoring is part of routine activities in many countries. Safety evaluations are important and communication about vaccine safety is critical, as events temporally associated with vaccination can be falsely attributed to vaccination. Anti-vaccination efforts, in part related to concerns about safety, have been mounted in several countries. In the 5 years since HPV vaccines were licensed, there have been successes as well as challenges with vaccine introduction and implementation. Further progress is anticipated in the coming years, especially in low- and middle-income countries where the need for vaccine is greatest. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.
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Affiliation(s)
- Lauri E Markowitz
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, Georgia, 30333, US.
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Tuells J, Duro Torrijos JL, Chilet Rosell E, Pastor Villalba E, Portero Alonso A, Navarro Ortiz C, Galiana de la Villa EM. [News items on human papillomavirus and its vaccine in the Valencian press (2006-2011)]. GACETA SANITARIA 2013; 27:374-7. [PMID: 23416026 DOI: 10.1016/j.gaceta.2012.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 12/20/2012] [Accepted: 12/23/2012] [Indexed: 11/19/2022]
Abstract
The process of introducing the human papillomavirus (HPV) vaccine aimed at teenage girls has not been entirely without controversy in Spain. This vaccine was originally hyped as a preventive measure in the fight against cervical cancer but the resulting euphoria was tempered by a message calling for evidence. During administration of the second dose of the vaccine in February 2009, an unexpected turn of events attracted vast media coverage when two teenagers experienced adverse effects after immunization in Valencia (Spain). This study analyzes the scope and content of news items on HPV, immunization and cervical cancer published between 2006 and 2011 in two widely disseminated regional newspapers in Valencia. We also discuss the extent to which the messages transmitted may have influenced acceptability of the vaccine.
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Affiliation(s)
- José Tuells
- Cátedra de Vacunología Balmis, Facultad de Ciencias de la Salud, Universidad de Alicante, Centro Superior de Investigación en Salud Pública, Valencia, España.
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Betsch C, Schmid P. [Does fear affect the willingness to be vaccinated? The influence of cognitive and affective aspects of risk perception during outbreaks]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:124-30. [PMID: 23275965 PMCID: PMC7080000 DOI: 10.1007/s00103-012-1595-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
During the influenza pandemic in 2009 individuals had the choice of either receiving a vaccination or running the risk of becoming infected with the pandemic influenza virus A (H1N1). For many individuals knowledge of a likely infection and possibly serious health consequences stood in contrast to a vague fear of the vaccination itself. What has a stronger influence on the decision to be vaccinated: the cognitive estimation of risk or the feeling of risk? Based on data collected during the 2009 influenza A (H1N1) pandemic we tested the relative influence of the cognitive and affective aspects of risk on estimation of the individual willingness to be vaccinated. In doing so we also focused on fear. The results indicate that the feeling of risk had a significant effect on the willingness to be vaccinated. In contrast, the classic, cognitive estimation of a risk was no longer a significant predictor when the feeling of risk was also used to predict the willingness to be vaccinated. A highly felt risk to become infected with influenza A (H1N1) substantially increased the willingness to be vaccinated. A highly felt risk regarding the vaccination, on the other hand, decreased the willingness to be vaccinated. Fear of the vaccination significantly decreased the willingness to be vaccinated even when fear of the spreading disease was also very high. The implications of the results for crisis communications will also be discussed.
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Affiliation(s)
- C Betsch
- Center for Empirical Research in Economics and Behavioral Sciences, Universität Erfurt, Nordhäuser Str. 63, 99089, Erfurt, Deutschland.
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Watson-Jones D, Tomlin K, Remes P, Baisley K, Ponsiano R, Soteli S, de Sanjosé S, Changalucha J, Kapiga S, Hayes RJ. Reasons for receiving or not receiving HPV vaccination in primary schoolgirls in Tanzania: a case control study. PLoS One 2012; 7:e45231. [PMID: 23115621 PMCID: PMC3480345 DOI: 10.1371/journal.pone.0045231] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 08/20/2012] [Indexed: 11/19/2022] Open
Abstract
Background There are few data on factors influencing human papillomavirus (HPV) vaccination uptake in sub-Saharan Africa. We examined the characteristics of receivers and non-receivers of HPV vaccination in Tanzania and identified reasons for not receiving the vaccine. Methods We conducted a case control study of HPV vaccine receivers and non-receivers within a phase IV cluster-randomised trial of HPV vaccination in 134 primary schools in Tanzania. Girls who failed to receive vaccine (pupil cases) and their parents/guardians (adult cases) and girls who received dose 1 (pupil controls) of the quadrivalent vaccine (Gardasil™) and their parents/guardians (adult controls) were enrolled from 39 schools in a 1∶1 ratio and interviewed about cervical cancer, HPV vaccine knowledge and reasons why they might have received or not received the vaccine. Conditional logistic regression was used to determine factors independently associated with not receiving HPV vaccine. Results We interviewed 159 pupil/adult cases and 245 pupil/adult controls. Adult-factors independently associated with a daughter being a case were older age, owning fewer household items, not attending a school meeting about HPV vaccine, and not knowing anyone with cancer. Pupil-factors for being a case included having a non-positive opinion about the school de-worming programme, poor knowledge about the location of the cervix, and not knowing that a vaccine could prevent cervical cancer. Reasons for actively refusing vaccination included concerns about side effects and infertility. Most adult and pupil cases reported that they would accept the HPV vaccine if it were offered again (97% and 93% respectively). Conclusions Sensitisation messages, especially targeted at older and poorer parents, knowledge retention and parent meetings are critical for vaccine acceptance in Tanzania. Vaccine side effects and fertility concerns should be addressed prior to a national vaccination program. Parents and pupils who initially decline vaccination should be given an opportunity to reconsider their decision.
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