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Not the right time: why parents refuse to let their daughters have the human papillomavirus vaccination
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Sexual and Reproductive Health)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Linnéuniversitetet. (Sexual and Reproductive Health)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. (Sexual and Reproductive Health)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Pediatrisk inflammationsforskning/Nevéus)
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2014 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 4, 436-441 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To explore why parents refused to allow their 10- to 12-year-old daughters to receive the human papillomavirus (HPV) vaccination from the Swedish school-based vaccination programme.

Methods: Individual interviews with 25 parents who had been offered, but not consented to, their daughters receiving the HPV vaccination.

Results: Five themes emerged through the interviews: 1) she is just a little girl, 2) inadequate information, 3) not compatible with our way of life, 4) scepticism about the vaccination and 5) who can you trust? The parents made their decisions with their child’s best interests in mind. This was not considered the right time, and the vaccine as perceived as unnecessary and different from other vaccines. Mistrust in Government recommendations and a lack of evidence or information were other reasons to decline.

Conclusion: The decision-making process was complex. These parents preferred to wait until their daughter was older and believed the information they received from the school health system was insufficient. The results indicate that a more flexible HPV vaccination schedule may improve vaccine uptake. This includes more transparent information about the virus and the vaccine and information about who to contact to get the daughter vaccinated at a later date.

Place, publisher, year, edition, pages
2014. Vol. 103, no 4, 436-441 p.
Keyword [en]
Decision-making, Human papillomavirus, Parents, School, Vaccination programmes
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Caring Sciences
URN: urn:nbn:se:uu:diva-214970DOI: 10.1111/apa.12545ISI: 000332694700025OAI: oai:DiVA.org:uu-214970DiVA: diva2:685821
Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2016-04-21Bibliographically approved
In thesis
1. Prevention of Human Papillomavirus in a school-based setting
Open this publication in new window or tab >>Prevention of Human Papillomavirus in a school-based setting
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to examine beliefs about human papillomavirus (HPV) prevention, especially vaccination, among parents, immigrant women, adolescents and school nurses, and to promote primary prevention among adolescents.

The methods used in the thesis were focus group interviews, individual interviews, a web-based questionnaire, and finally, a randomised controlled intervention study.

The immigrant women were largely in favour of HPV prevention, although barriers, such as logistic difficulties, and cultural or gender norms were found. Parents’ decision concerning vaccination of their daughters depended on several factors. Regardless of their final choice, they made the decision they believed was in the best interest of their daughter. The benefits outweighed the risks for parents choosing to vaccinate while parents declining made the opposite judgement. The majority of the school nurses reported that the governmental financial support given because of the vaccination programme had not been used for the intended purpose. Three out of four nurses had been contacted by parents who raised questions regarding the vaccine; most were related to side effects. The educational intervention had favourable effects on the adolescents’ beliefs regarding HPV prevention, especially among those with an immigrant background. Furthermore, the intention to use condom as well as actual vaccination rates among girls was slightly increased by the intervention.

Trust in the governmental recommendations and the amounts of information given are important factors in the complex decision about HPV vaccination. Attention given to specific needs and cultural norms, as well as the possibility to discuss HPV vaccination with the school nurse and provision of extra vaccination opportunities at a later time are all strategies that might facilitate participation in the school-based HPV vaccination programme. School nurses need sufficient resources, knowledge and time to meet parents’ questions and concerns. The vaccinations are time-consuming and the governmental financial support needs to be used as intended, for managing the vaccination programme. A school-based intervention can have favourable effects on the beliefs and actual actions of young people and may possibly thus, in the long term, decrease the risk for HPV-related cancer.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 85 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1138
Human papillomavirus, HPV, vaccination, cervical cancer, school nurse, school health, immigrants, parents, adolescents, belief, attitude, decision, prevention, public health, randomised controlled trial, intervention, focus group interviews, vaccine hesitancy
National Category
Research subject
Medical Science; Caring Sciences
urn:nbn:se:uu:diva-263252 (URN)978-91-554-9354-7 (ISBN)
Public defence
2015-11-20, Gustavianum, Auditorium Minus, Akademigatan 3, Uppsala, 13:15 (Swedish)
Swedish Cancer Society, 130744
Available from: 2015-10-29 Created: 2015-09-29 Last updated: 2015-11-10

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