The introduction of policies for human papillomavirus vaccination in Europe

Acceptability and uptake of female adolescent HPV vaccination in Hong Kong: a survey of mothers and adolescents

BACKGROUND

Organized population-based HPV vaccination programs can be effective in reducing the burden of cervical cancer, especially in the absence of a comprehensive cervical screening program (e.g. Hong Kong). Assessment of vaccine acceptability is important when evaluating the feasibility and cost-effectiveness of such vaccination programs.

METHODS

To provide a more representative and updated assessment on the acceptability of female adolescent HPV vaccination in Hong Kong, we conducted surveys in 2008 among 1022 mothers with daughters aged ≤ 18 years through random digit-dialing telephone interviewing and 2167 schoolgirls aged 11-18 years using two-stage stratified cluster sampling. We conducted the maternal survey again in 2012 with an independent group of 1005 mothers.

RESULTS

In 2008, 2.4% (95% confidence interval [CI]=1.8-3.2%) of the recruited schoolgirls reported having received HPV vaccination. In 2012, the mothers reported that 9.1% (7.0-11.6%) of their daughters who were in the same age range (11-18 years) as the schoolgirls had been vaccinated (p<0.01). Regarding acceptability, 27.5% (24.8-30.4%) and 37.6% (34.5-40.8%) of the mothers were willing to have their daughters vaccinated at market price in 2008 and 2012 (p<0.01), respectively. 27.1% (25.2-29.1%) of the schoolgirls were willing to receive HPV vaccination at market price in 2008. The willingness to pay for full-course vaccination among mothers had a median of US$128/HK$1000 (50% central range=US$64-192/HK$500-1500), i.e. substantially lower than the current market price.

CONCLUSIONS

The gap between acceptability and actual uptake of HPV vaccination among adolescent girls suggested that coverage is likely to be low without an organized HPV vaccination program, although the difference might be partially attributed to the possibility that at the time of the interview female adolescents who were willing to be vaccinated had not yet taken action. Policymakers should devise tailored, targeted and efficient vaccination strategies to achieve universal coverage for an effectively organized HPV vaccination program.

Human papillomavirus vaccine introduction in Vietnam: formative research findings

BACKGROUND

Formative research is a useful tool for designing new health interventions. This paper presents key findings from formative research conducted in Vietnam to guide human papillomavirus (HPV) vaccine introduction.

METHODS

We explored the sociocultural environment, health system capacity and the policy-making process using a combined quantitative and qualitative methodology. Data collection was done through literature review, in-depth interviews, focus group discussions, observation checklists and a structured questionnaire on knowledge, attitudes and practices. Populations of interest included 11- to 14-year-old girls, their parents, community leaders, teachers, health workers, health and education officials, and policy-makers at all levels.

RESULTS

Although HPV vaccines are new, we found high potential acceptance among parents and girls. HPV vaccine introduction was also favourably supported by health professionals if assurances for system preparedness, e.g. cold chain and human resources, were made. There were no significant barriers from the policy perspective that would prevent the introduction of a new vaccine. However, several concerns related to this new vaccine would need to be adequately addressed before implementation.

CONCLUSION

Our findings provide options for potential vaccine delivery strategies, appropriate communication strategies and targeted advocacy strategies to introduce HPV vaccines in the Vietnamese context.