Chapter 24: Psychosocial aspects of vaccine acceptability
Introduction
In this chapter we will address critical issues associated with possible acceptance or rejection of HPV vaccination. We will discuss some of the potential barriers to HPV immunization that have been mentioned in the literature and examine the extent to which existing empirical research supports, refutes, and/or adds to these hypothesized barriers. In addition, the issue of unintended consequences of HPV vaccination will be covered, specifically with reference to concerns about post-immunization sexual behavior change and decreased rates of Pap testing. Future research needs will be identified throughout, with particular attention paid to the need for more research outside of the US and Western Europe.
Section snippets
Potential obstacles to vaccination
Several reviews and commentaries have addressed potential problems that may interfere with widespread acceptance of STI/HPV vaccines [1], [2], [3]. Issues identified include structural, pragmatic, and attitudinal factors and address problems related to implementation of any new vaccine, especially one for a targeted age-cohort like adolescents, as well as possible unique issues associated with a vaccine designed to prevent a sexually transmitted infection (STI). Some of the structural/pragmatic
Knowledge about HPV
Innumerable research studies, primarily undertaken in the US, Canada, and the UK, confirm poor levels of knowledge about HPV, Pap testing, and cervical cancer in women [8], [9], [10], [11], and the few recent studies on men, including research on college students and gay/bisexual men, indicate that HPV knowledge among young men is even lower [12], [13], [14]. The articles referenced here represent a small fraction of the total number of published HPV knowledge studies, all of which are largely
Conclusions
Current research on psychosocial issues and HPV vaccination indicates that many women and healthcare providers have relatively low levels of knowledge about HPV and could benefit from educational interventions. Part of this education ought to focus on the importance of targeting vaccination, particularly to pre- and early-adolescents, in order to ensure that immunity is conferred before the most vulnerable youth engage in sexual intercourse. Research studies also indicate that healthcare
Disclosed potential conflicts of interest
GDZ: Consultant (GlaxoSmithKline, Merck and Co., Inc.)
SLR: Speakers Bureau (Merck and Co.); Advisory Board (GlaxoSmithKline, Merck and Co., Inc.); Research Grants (GlaxoSmithKline)
EL: Consultant (Merck and Co., Inc.).
References (47)
- et al.
‘The cold hard facts’ immunisation and vaccine preventable diseases in Australia's newsprint media 1993–1998
Soc Sci Med
(2002) Anti-vaccination movements and their interpretations
Soc Sci Med
(2006)- et al.
Knowledge about human papillomavirus among adolescents
Obstet Gynecol
(2000) - et al.
Beliefs about the risk factors for cervical cancer in a British population sample
Prev Med
(2004) - et al.
Acceptability of a human papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico
Arch Med Res
(2001) - et al.
Pediatricians’ intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes
J Adolesc Health
(2005) - et al.
Attitudes about human papillomavirus vaccine among family physicians
J Pediatr Adolesc Gynecol
(2005) - et al.
Delivery of STD/HIV preventive services to adolescents by primary care physicians
J Adolesc Health
(1996) - et al.
Parental perspectives on vaccinating children against sexually transmitted infections
Soc Sci Med
(2004) - et al.
Predictors of STI vaccine acceptability among parents and their adolescent children
J Adolesc Health
(2005)