Cross-sectional study about primary health care professionals views on the inclusion of the vaccine against human papillomavirus in the vaccine schedules

Factors influencing healthcare professionals' confidence in vaccination in Europe: a literature review

Health-care professionals (HCPs) have a fundamental role in vaccination, their own beliefs and attitudes affecting both their uptake and recommendation of vaccines. This literature review (n = 89) summarises evidence on HCPs’ perceptions of the risks and benefits of vaccination, trust, and perceptions of mandatory vaccination in Europe. HCPs across studies believed that vaccination is important to protect themselves and their patients. However, beliefs that some diseases such as influenza are less risky were reported by some HCPs as a reason for not getting vaccinated. Concerns about both short- and long-term side effects were identified among HCPs in most studies, such as those affecting the immune or neurological system. Mistrust toward health authorities and pharmaceutical industry was reported in some studies. The question of mandatory vaccination revealed mixed opinions, with some favoring self-determination and others viewing vaccination as a duty. This review highlights key factors influencing HCPs’ confidence in vaccination in Europe.

Continuing education programme on vaccines for primary healthcare professionals: mixed-method protocol

INTRODUCTION

Vaccination is a fundamental intervention in disease prevention; therefore, the advice and recommendations of health professionals have a major influence on the population's decision to be vaccinated or not. Professionals must have sufficient competencies to carry out their work and recommend vaccination with evidence-based knowledge. The aim is to design and validate a strategy to improve professional competencies in vaccination to positively influence adherence and increase vaccination rates in the population.

METHODS AND ANALYSIS

Training will be designed based on evidence and previous studies and piloted with healthcare providers. To test changes in knowledge, a pretest and post-test will be conducted. To test feasibility, a think-aloud method will be used with participants and triangulated with focus groups using SWOT (strengths, weaknesses, opportunities and threats) analysis. Transfer will be measured using the questionnaire 'factors for the indirect evaluation of transfer' and an efficacy questionnaire 1½ months later; for satisfaction, an ad hoc questionnaire will be used. A summative approach will be used for the analysis of the focus groups and descriptive and bivariate statistics for the questionnaires.

ETHICS AND DISSEMINATION

This study was approved by the Andalusian Research Ethics Committee, Spain (approval number: 0524-N-20). The results will be made available to the public at journal publications and scientific conferences.

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

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.

Perceptions of nurses on human papillomavirus vaccinations in the Republic of Korea

BACKGROUND

In June 2016, the Republic of Korea included free human papillomavirus (HPV) vaccinations for all 12-year-old girls in its national immunization program.

PURPOSE

This study investigated perceptions of nurses on HPV vaccination and their intent to vaccinate preteens at the best ages.

METHODS

Recruited for the survey were 514 health teachers (181, 35.2%), public health nurses (168, 32.7%), and clinical nurses (165, 32.1%). Factor-analysis was conducted to validate the Vaccine-Hesitancy Scale for Korean nurses. Related variables associated with vaccine-acceptance were examined using the Kruskal-Wallis test and Spearman's rho coefficients, due to lack of normalization.

RESULTS

Factor-analysis results showed that two factors of positive acceptance (7 items) and negative acceptance (3 items) accounted for 67.46% of the total variance, and explained 47.4% and 20.1%, respectively. Nurses who positively accepted HPV vaccine differed significantly in agreement to vaccinate girls or boys. For the proper vaccination age, a significant difference emerged between answers for girls and vaccine-acceptance scores, whereas no difference emerged between answers for boys and the scores. The vaccinated status of respondents significantly related to higher HPV vaccine acceptance, although age, religion, marital status, education, and working duration did not.

CONCLUSIONS

This study showed that vaccine-acceptance levels reflect nurses' attitudes and opinions about HPV vaccination for girls and boys.

Adequacy of information provided by healthcare professionals on vaccines: Results of a population survey in Spain

OBJECTIVE

To describe the population who self-reported perceiving information on vaccines provided by health professionals as inadequate, and to analyze factors associated.

METHODS

A Spanish nationwide representative health survey conducted in individuals ≥18 in 2015 (N = 7 800) was used. Respondents were classified according to the question: 'Do you think that health professionals inform adequately to patients about the advantages and risks of vaccines prior to their administration? (yes/no/non-responders). The association with socio-demographic and health-related characteristics and with opinions/attitudes regarding vaccines were analyzed.

RESULTS

33.7% of respondents felt not adequately informed. These individuals had lower influenza vaccination coverage (16.0% vs. 24.1%), and were more distrustful of vaccines in general (8.4% vs. 3.3%) as well as regarding on the influenza vaccine (11.9% vs. 7.6%). Inadequate information was associated with female gender (aOR:1.21,95%CI:1.08-1.35), autochthonous origin (aOR:1.54,95%CI:1.27--1.87), household income ≤600€/month (aOR:1.45,95%CI:1.10-1.91), poor self-perceived health (aOR:3.17,95%CI:1.36-7.39), and a lower satisfaction with the National Health Service and nurses (aOR:0.92,95%CI:0.89-0.95 and aOR:0.85,95%CI:0.82-0.88).

CONCLUSION

A large proportion of the population considers that the information provided regarding vaccines is inadequate. This perception is associated with negative attitudes towards vaccination.

PRACTICE IMPLICATIONS

Further studies are required to deepen our understanding of the problem and to enhance communication provided by healthcare professionals.

Primary care pediatricians' attitudes and practice towards HPV vaccination: A nationwide survey in Italy

This national online cross-sectional survey in Italy assessed primary care pediatricians’ (PCPs) attitudes and practices regarding Human papillomavirus (HPV) vaccination and the contribution of several characteristics. The questionnaire was distributed from September 2016 to June 2017 to a random sample of 640 PCPs by email via an internet-link leading to a web-based survey platform (Lime Survey). Only 18.4% of PCPs always recommend the HPV vaccine to 11–12 year old boys. PCPs with longer practice activity, working in solo practice, always recommended the HPV vaccine to 11–12 year old girls, and believed that the vaccine was effective for boys were more likely to always recommend the HPV vaccine. PCPs working in a Region where the vaccination was actively recommended and provided free of charge to 11–12 year old boys had higher odds of recommending vaccination. More than two thirds of PCPs (77.4%) always recommend the HPV vaccine to 11–12 year old girls. PCPs who believed that the vaccine was effective for girls and safe in both boys and girls, who always talk with patients of 11–18 years or their parents about HPV infection and vaccination, and who obtain vaccine information from scientific journals were more likely to always recommend the vaccine. PCPs should employ evidence-based educational strategies in order to achieve a better coverage and to reduce the morbidities and mortality of diseases associated with HPV.

A Survey of Wisconsin Pediatricians’ Knowledge and Practices Regarding the Human Papillomavirus Vaccine

Objective

The human papillomavirus (HPV) is common and carries a significant burden of disease. This is increasingly apparent in males with the rising incidence of HPV-related oropharyngeal cancer. Unfortunately, vaccination rates remain poor and are lowest in males. It is unclear if pediatricians are aware of the alarming rise of HPV-mediated head and neck cancers and the disproportionate effect on males.

Study Design

This investigation used a cross-sectional descriptive survey research design.

Setting

The survey was developed by investigators in the University of Wisconsin Division of Otolaryngology.

Subjects and Methods

The survey was distributed to 831 members of the Wisconsin Chapter of the American Academy of Pediatrics.

Results

A total response rate of 49.6% was achieved. Most supported routine vaccination in both sexes. Females are regarded as being at higher risk of an HPV-related cancer and are more often recommended vaccination. Most providers are unaware of the magnitude of HPV-related oropharyngeal cancer and the greater affliction in males.

Conclusions

Male vaccination is overwhelmingly supported by Wisconsin pediatricians, yet there is a preponderance toward vaccinating females, who are perceived as having greater risk for HPV-associated disease. This is likely because providers are unaware of the magnitude of HPV-driven oropharyngeal cancer and its predilection for males. A lack of provider awareness, in combination with out-of-date education material for parents, likely contributes to poor vaccination rates in males.