Human papillomavirus vaccination: expected impacts and unresolved issues

The relationship of knowledge, health value and health self-efficacy with men's intentions to receive the human papillomavirus (HPV) vaccine

The aim of the present study was to determine whether it was possible to predict Human Papillomavirus (HPV) vaccination intentions an Australian male sample. One hundred and twenty one males aged 18 to 26 (M = 22.3, SD = 2.06), completed an online survey assessing HPV-related knowledge, health beliefs and health self-efficacy. HPV knowledge and health self-efficacy were significant independent predictors of vaccine acceptance. A moderating effect was found between HPV knowledge and health self-efficacy. It was concluded that the results of previous research into the predictors of HPV vaccination intentions can largely be applied to an Australian male population.

Perceived need of a parental decision aid for the HPV vaccine: content and format preferences

The human papillomavirus (HPV) is a precursor of cervical cancer. In 2006, the Federal Drug Administration licensed a vaccine to protect against four types of HPV. Three years postlicensure of the vaccine, HPV vaccination is still fraught with controversy. To date, research suggests that contrary to popular notions, parents are less concerned with controversies on moral issues and more with uncertainty regarding because long-term safety of a drug is resolved after licensure. This study was designed to understand whether mothers from diverse ethnicities perceive a need for a decision support tool. Results suggest that the design of a culturally tailored decision support tool may help guide parents through the decision-making process.

How can we communicate about vaccines with adolescents and their parents?

OBJECTIVE

To describe parents' and adolescents' perceptions about vaccination.

METHODS

Qualitative interviews of 22 mothers/grandmothers and 25 10- to 14-year-olds.

RESULTS

Themes emerged in 3 focus areas. (a) Understanding: Both adults and adolescents had difficulty understanding concepts of risks, benefits, prevention, and vaccination. (b) Decision making: Adults saw vaccination as an opportunity to help their adolescent develop skills for transition to adulthood. Adolescents worried about being lied to (reinforced by being told "it won't hurt"), physical pain, and cleanliness. ( c) Preventing sexually transmitted infections: Adults were divided between those who felt their child would not need such a vaccine and those who wanted to "be safe" to protect their child in the future.

CONCLUSIONS

At the same time that even basic concepts about vaccination should be explained to both adults and adolescents, adolescence represents a time for learning about responsible decision making. Discussion regarding the risks and benefits of vaccines can be part of transitioning to adult decision making.

Defining a strategy to evaluate cervical cancer prevention and early detection in the era of HPV vaccination

OBJECTIVE

The purpose of this paper is to outline the short-, medium- and long-term requirements of a strategy to evaluate the impact of HPV immunization and to define a framework to facilitate planning and evaluation.

METHOD

This strategy was developed in Ontario from January to August 2008. Literature review was completed to assess existing material relevant to vaccine evaluation, and HPV vaccine specifically. Scientists and epidemiologists within our organization attended meetings to brainstorm and identify key requirements for vaccine evaluation. Other selected internal and external experts were consulted to review preliminary lists of potential indicators and questions for inclusion in an evaluation strategy.

RESULTS

Results are reported in three sections--literature review, proposed evaluation framework and data requirements.

CONCLUSION

The first vaccine evaluation strategy that integrates primary and secondary prevention of cervical cancer is presented. Among women who are neither screened nor immunized, customized interventions will be required to ensure that they are aware of potential risks and benefits. This evaluation strategy may serve as a useful outline for jurisdictions in Canada and elsewhere. This new paradigm of combined primary and secondary intervention will encourage cooperation for effective evaluation of an integrated approach for control of cervical cancer and other HPV-related disease.