Parental Refusal of the Human Papillomavirus Vaccine

A community-based, interdisciplinary approach to improving HPV vaccine uptake at a large urban public university

The purpose of this project was to pilot and determine the outcomes of a multi-faceted, interdisciplinary human papillomavirus awareness and vaccination campaign within a university community.

Students, faculty, and staff of a large urban Midwest-based public university.

METHODS

This consisted of five key interventions: promotion and outreach, volunteer training, patient education, access, and documentation. Perceived knowledge and attitudes toward HPV and the HPV vaccine, and HPV vaccine uptake were measured as outcome variables.

The project resulted in statistically significant increases in perceived knowledge regarding HPV and the HPV vaccine, willingness to receive HPV vaccination, and likeliness to recommend HPV vaccination (p < 0.001). The project also resulted in a 76.6% increase in the number of HPV vaccines administered at the university's Campus Health Center.

A novel HPV awareness and vaccination campaign led to increases in knowledge regarding HPV and HPV vaccines, and substantially increased HPV vaccinations administered at a large, urban public university.

HPV vaccine narratives on Twitter during the COVID-19 pandemic: a social network, thematic, and sentiment analysis

INTRODUCTION

The COVID-19 pandemic has increased online interactions and the spread of misinformation. Some researchers anticipate benefits stemming from improved public awareness of the value of vaccines while others worry concerns around vaccine development and public health mandates may have damaged public trust. There is a need to understand whether the COVID-19 pandemic, vaccine development, and vaccine mandates have influenced HPV vaccine attitudes and sentiments to inform health communication strategies.

METHODS

We collected 596,987 global English-language tweets from January 2019-May 2021 using Twitter's Academic Research Product track. We determined vaccine confident and hesitant networks discussing HPV immunization using social network analysis. Then, we used a neural network approach to natural language processing to measure narratives and sentiment pertaining to HPV immunization.

RESULTS

Most of the tweets in the vaccine hesitant network were negative in tone (54.9%) and focused on safety concerns surrounding the HPV vaccine while most of the tweets in the vaccine confident network were neutral (51.6%) and emphasized the health benefits of vaccination. Growth in negative sentiment among the vaccine hesitant network corresponded with legislative efforts in the State of New York to mandate HPV vaccination for public school students in 2019 and the WHO declaration of COVID-19 as a Global Health Emergency in 2020. In the vaccine confident network, the number of tweets concerning the HPV vaccine decreased during the COVID-19 pandemic but in both vaccine hesitant and confident networks, the sentiments, and themes of tweets about HPV vaccine were unchanged.

CONCLUSIONS

Although we did not observe a difference in narratives or sentiments surrounding the HPV vaccine during the COVID-19 pandemic, we observed a decreased focus on the HPV vaccine among vaccine confident groups. As routine vaccine catch-up programs restart, there is a need to invest in health communication online to raise awareness about the benefits and safety of the HPV vaccine.

Parents attitudes toward the human papilloma virus (HPV) vaccine: A new concept in the State of Qatar

Background

Human papillomavirus (HPV) is one of the leading causes of cervical and genital cancer in both genders.

Purpose

To delineate parental attitude regarding HPV in Qatar.

Methods

A cross-sectional study using a questionnaire was conducted at Sidra Medicine, Qatar.

Results

A total of 334 questioners were completed. More than 60% of the parents were not aware that HPV can cause cervical and genital cancer. When asked about the level of comfort in giving their children a vaccine that would prevent them from getting genital cancer, 77% of the participants answered "very comfortable." Interestingly, less than 4% of the parents stated that their children's primary care physicians ever mentioned that such a vaccine exists. When asked about the most preferable mode of receiving information regarding the HPV vaccine, 54% preferred the clinician's office, followed by 34% of whom preferred social media. In terms of the preferred age to receive the vaccine, 45% of the participants preferred to administer the vaccine to their children before they were mature enough to understand sexual relations, while 22% recommended vaccination right before marriage and 15% preferred to wait till they were grown up and decide for themselves. Furthermore, only 42% of the caregivers agreed that it is important to explain to their children that the vaccine can protect against some of the sexually transmitted infections. Finally, approximately 20% of the participants were not convinced about the HPV vaccine.

Conclusion

A large proportion of parents residing in Qatar have a positive perception regarding the HPV vaccine. TheParents' attitudes and perceptions are considered indispensable targets for community health intervention. We will share the result of our study with the ministry of public health in Qatar with a goal to incorporate the HPV vaccine in the National Immunization Schedule.

Psychological Variables Associated with HPV Vaccination Intent in Romanian Academic Settings

The aim of this study was to evaluate (1) the female medical students’ knowledge about HPV infection; (2) the associations between the HPV vaccination intent and coping strategies, health locus of control (HLOC), and sense of coherence; and (3) the specific differences between preclinical and clinical students in terms of the vaccination intent. Participants included 1243 female medicine students (mean age = 21.526, SD = 2.007), who completed The Multidimensional Health Locus of Control (MHLC)—Form A, the Brief COPE Scale, the Sense of Coherence Scale (SOC-13), and two questionnaires measuring the knowledge about the HPV infection and the HPV vaccination intent. Results show a good knowledge about HPV, which progressively increased during the study cycles. Still, the main contributors to vaccination intent are represented by coping strategies and health locus of control. Refusal of vaccination is associated to behavioral disengagement and the use of religion, precontemplation and contemplation to denial, and preparation to planning, positive reframing, and the powerful others component of HLOC. Sense of coherence did not predict vaccination intent. In clinical years, active coping outweighs HLOC in making the decision to get vaccinated. These results could be helpful in designing personalized strategies for addressing vaccine hesitancy in academic communities.

Factors associated with HPV vaccination initiation among United States college students

Human papillomavirus (HPV) remains the most common sexually transmitted infection (STI) in the U.S. despite widespread availability of a safe, effective vaccine. Although young adults are at greatest risk of HPV infection, extensive vaccine promotion and intervention efforts has been directed toward 11-12-year-olds. College students represent an ideal audience for HPV vaccine "catch-up;" however, research indicates inconsistent HPV vaccination rates within this demographic. An online survey assessing HPV and HPV vaccine knowledge and behaviors was distributed to all undergraduate college students at a large, public university in the Deep South region of the U.S. The primary outcome was receipt of HPV vaccination (binary response options of Yes/No). Logistic regression analyses were performed to determine predictors of HPV vaccination. Of the 1,725 who completed the survey, 47.0% reported having received at least one dose of HPV vaccine; overall series completion (series = 3 doses for this population) was 17.4%. The primary outcome was HPV initiation among college students, defined as having received at least one dose of the HPV vaccine. Results indicated substantial gaps in participants' knowledge of their vaccination status. Provider and parental recommendations as well as social influences were shown to significantly impact student vaccination status, emphasizing the importance of incorporating these elements in future interventions, potentially as multi-level strategies. Future college interventions should address HPV and vaccination knowledge and the importance of provider and parental recommendations.

Resources for assessing parents' vaccine hesitancy: a systematic review of the literature

The concept of Vaccine Hesitancy has begun to appear in the scientific landscape, referring to the reluctance of a growing proportion of people to accept the vaccination offer. A variety of factors were identified as being associated with vaccine hesitancy but there was no universal algorithm and currently there aren’t any established metrics to assess either the presence or impact of vaccine hesitancy. The aim of this study was to systematically review the published questionnaires evaluating parental vaccine hesitancy, to highlight the differences among these surveys and offer a general overview on this matter. This study offers a deeper perspective on the available questionnaires, helping future researches to identify the most suitable one according to their own aim and study setting.

An Integrative Review of the Influences on Decision-Making of Young People About Human Papillomavirus Vaccine

The human papillomavirus (HPV) vaccine is a key intervention in the prevention of HPV infection and associated cancers. This review emphasizes the importance of understanding what influences decision-making about this vaccine. Guided by the work of Whittemore and Knafl, and Pluye and Hong, we identified 25 studies, from which four prominent themes emerged: fear and risk, pain, parental involvement, and involvement of others. Fear of cervical cancer was a strong motivation to receive the vaccine, and the extent of parental involvement also had an impact on decision-making. Recommendations to receive the vaccine by health-care providers were also an important influence. School nurses are fundamental to the promotion and delivery of the HPV vaccine and should stress the significant role that it plays in the prevention of cancer. Additionally, school nurses should ensure that discussions about HPV infection and vaccine include parents where appropriate and should distinctly recommend vaccination to those eligible.

Parental Refusal of Human Papillomavirus Vaccine: Multisite Study

INTRODUCTION

The purpose of this study was to explore reasons why parents may refuse administration of the human papillomavirus vaccine to their children. The data from this multisite study will contribute to our understanding of why parents may refuse administration of the vaccine.

METHODS

This mixed-methods study took place in several pediatric settings after a pilot study was completed. After a health visit in which the vaccine was refused, a survey was provided to the parent in a private room. The survey was kept confidential and anonymous.

RESULTS

There were 72 surveys completed. Demographic data were reported. Data were analyzed for descriptive statistics, and themes were extracted. Overall, 58% of parents refused the vaccine because it was too new, and 50% believed the vaccine required more research.

DISCUSSION

The data from this study correlated with the pilot study regarding parental perceptions of the vaccine; however, it appears that with new public campaigns and education, parents' perceptions are improving. Nurse practitioners are in an excellent position to clarify information about human papillomavirus vaccination.

Adolescent human papillomavirus vaccination in the United States: Opportunities for integrating pharmacies into the immunization neighborhood

Human Papillomavirus (HPV) vaccination faces several barriers, including a social stigma which carries religious and philosophical implications among parents of adolescents as well as young adults. Hundreds of immunization interventions and programs have been developed to address these factors and boost HPV vaccination rates in the United States. We sought to review the existing literature highlighting barriers to HPV immunization, as well as programs targeting increased HPV vaccine uptake in effort to develop novel vaccination initiatives. The most impactful barriers identified were parental stigma and low quality of provider recommendations for the vaccine. Despite the implementation of many HPV initiatives, outcomes of these programs are largely limited to modest improvements in vaccine uptake in small, homogeneous populations. We describe pharmacies as distinctly advantageous but underutilized resources within the immunization neighborhood and propose a novel concept to improve vaccination rates as well as reduce HPV-related disease burden in all demographics.