20 Dec Understanding HPV Attitudes: Current Research Insights
Research suggests that addressing misinformation, including reiterating scientific evidence, may help restore confidence in the vaccine. Community-based outreach to seed conversations with a trusted provider also may be an opportunity.
Adolescents and caregivers reacted positively to an educational approach that seeds a conversation about HPV vaccination with their trusted providers. They also agreed that it is important to acknowledge their concerns about vaccine side effects, such as pain at the injection site.
Knowledge
The vaccine acceptance rate for HPV is highly variable across different regions of the world due to attitudes toward HPV. It is essential to understand why the vaccine has varying uptake rates amongst different groups of individuals, as this may inform strategies for successful vaccination programs in a given region. The present study aimed to examine the level of knowledge and attitudes of University students towards the HPV virus, cervical cancer, and HPV vaccine. Participants were surveyed online and asked to complete a questionnaire that included questions about their current knowledge, beliefs and attitudes towards the vaccine. The results of the questionnaire were analysed using statistical methods.
Overall, the majority of participants had positive attitudes and high levels of knowledge on HPV, cervical cancer, and the HPV vaccine. In addition, the participants reported that they would be willing to receive the vaccine if it was introduced into the national immunization program. However, the vaccine acceptance rate for HPV is relatively low compared to other childhood vaccinations such as polio and measles. This is likely due to a number of factors, including cultural and economic barriers.
Previous studies have shown that a lack of information is a major barrier to the HPV vaccine uptake in general populations. This is true even for a population with good healthcare access, as a recent survey of British women found that only 2.5% of respondents knew that HPV was the cause of cervical cancer. The study also showed that the perception of a link between HPV and unsafe sexual behaviour was a significant factor in the decision to avoid the vaccine.
A new VCU-led study has found that evidence-based messaging is effective in improving parental understanding and promoting the use of HPV vaccines. Messages focused on four key themes improved parents’ perceptions of the vaccine and increased their willingness to get their children vaccinated. The findings are a step toward developing interventions that can be tailored to specific populations and settings to help increase uptake of the vaccine.
Attitude
A majority of respondents in one study had a positive attitude towards HPV vaccines with over 70% agreeing that the vaccination is safe and effective. In contrast, over a third of participants disagreed that the vaccine should be provided as part of the national immunization program (NIP).
The majority of respondents in another survey indicated that they would advise their children to get the HPV vaccine. However, the number of people who actually did get the vaccine was significantly lower than this, with only 44% of respondents stating that they had either received or were planning to receive the vaccine for themselves or their children.
Many factors are associated with HPV vaccine attitudes and practices. For example, urban residence, higher education levels, and positive attitudes correlated with favorable outcomes, while marital status, frequency of sexual activity, and use of condoms correlated with less favorable behaviors. The results of this study suggest that more family-specific (versus disease-prevention) messaging and recommendations may be needed to improve HPV vaccine uptake.
In addition, researchers have conducted focus groups with adolescents to better understand the specific social and environmental antecedents of attitudinal formation, shifts, and decision-making about HPV vaccine uptake. Findings from these qualitative studies show that adolescent perceptions of the relationship between cervical cancer, HPV infection, and the HPV vaccine are important predictors of vaccine uptake.
Furthermore, the findings from a recent qualitative study of mothers and daughters indicate that some parents are reluctant to discuss the HPV vaccine with their children because of concerns about the safety and efficacy of the vaccine. In particular, some parents are concerned that the vaccine will lead to sexual disinhibition and that their daughter is too young for the vaccine.
Similarly, other studies have shown that community-based delivery of information about the HPV vaccine is important in order to promote its uptake among women and adolescents. In one study, adolescents and caregivers reported that they were willing to accept HPV vaccine information in community settings that could seed a conversation with their trusted main healthcare provider. The findings from these studies suggest that there is a need for additional research to explore the role of health professionals in providing patients with accurate and comprehensive information about HPV vaccines.
Practice
In a study of adolescent girls in Italy, only 23% of the participants had ever heard of HPV infection and cervical cancer. Most of the vaccinated girls were aware that HPV vaccine can prevent them from getting the disease, but the majority of unvaccinated women believed that they could get the disease because the vaccine only protects against a limited number of HPV types. This misperception was mainly caused by the lack of guidance and vaccine recommendations provided to teenagers by healthcare providers (26).
In another study, female gender and employment in the health sector were significant correlates of having heard about HPV infection and vaccination. Similarly, urban residency, higher education levels, and positive attitudes correlated with favorable outcomes. However, these factors were inversely related to the likelihood of practicing self-sampling for HPV testing. This suggests that individuals who are at higher self-perceived risk of HPV infection may be more willing to practice self-sampling for HPV screening.
A large proportion of surveyed individuals indicated that they would be willing to receive the HPV vaccine if recommended. These results indicate that if physicians are able to dispel the myths about the vaccine and convince their patients that it is safe, they will have better patient uptake rates.
Despite the positive attitude and high willingness to accept the vaccine, many respondents were concerned about the side effects of the vaccine. The main reason for these concerns was that they feared that the vaccine would make them feel sick. Other concerns were that the vaccine was not proven to be effective and that it was difficult to obtain.
A VCU-led study found that different science-based messaging around four key themes was successful in improving parents’ perceptions of the vaccine and increasing their likelihood of vaccinating their children against HPV (27). This research can help guide medical professionals when communicating with their patients regarding the HPV vaccine. The findings can also help identify potential barriers to vaccine uptake among specific groups. For example, the studies can be used to develop educational programs and counseling to increase knowledge about HPV, cervical cancer, and the HPV vaccine among Arabic immigrants to the Western world.
Recommendation
Vaccination uptake is highly influenced by the attitudes of individuals and the context in which they live. For instance, misinformation and lack of support can erode public confidence in vaccines. Additionally, community-level factors such as accessibility can influence uptake. Understanding the barriers and drivers of vaccination will help individuals determine if the HPV vaccine is right for them. The findings from this study can also inform health communication and outreach efforts.
In addition to identifying key factors that influence vaccine uptake, this research also explored how adolescents and caregivers would react to a scenario in which the first shot in the HPV vaccination series was offered in a community setting. Findings indicated that adolescent and caregiver reactions were positive towards this proposed alternative delivery strategy. This reflects the importance of building trust and fostering a sense of community among individuals who are likely to be the primary vaccine providers in these settings.
Our focus group discussions revealed that adolescent and caregiver beliefs were shaped by a variety of personal and contextual factors, including religion, education, family status, marriage, sexual behavior, and knowledge about HPV and HPV vaccination. The most important factor influencing adolescent willingness to be vaccinated was their relationship with their doctor or healthcare provider. Those who felt their doctor was supportive of the vaccine were more willing to receive it.
Additionally, those who had received a previous dose of the vaccine were more willing to receive the next one. However, those who had not received a prior dose were less interested in receiving the vaccine even though they believed it was beneficial for their health.
Those who were not vaccinated were most concerned about the pain and discomfort associated with the vaccine, as well as the possibility of side effects such as menstrual symptoms or sexual dysfunction. They also feared that the vaccine was not effective or safe for their age group. However, these concerns can be addressed by educating adolescents and caregivers about the benefits of the HPV vaccine and by addressing specific misconceptions that may be affecting their decision.