Elsevier

Vaccine

Volume 24, Supplement 3, 21 August 2006, Pages S201-S209
Vaccine

Chapter 24: Psychosocial aspects of vaccine acceptability

https://doi.org/10.1016/j.vaccine.2006.06.017Get rights and content

Abstract

In this chapter we identify psychosocial issues that have been raised with respect to human papillomavirus (HPV) vaccination and review the research literature on HPV vaccine acceptability. Many women and physicians have relatively poor knowledge about HPV, but despite this, most healthcare providers are willing to recommend HPV vaccination and parents are interested in having their children vaccinated. Concerns about post-vaccination sexual behavior change do not appear to be justified, but can certainly be addressed through anticipatory guidance. Most research studies have come out of the United States and other English-speaking industrialized countries. More psychosocial research regarding HPV vaccination is therefore needed from developing countries.

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.).

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