A human rights approach to understanding provider knowledge and attitudes toward the human papillomavirus vaccine in São Paulo, Brazil

Kruse, Meredith H; Bednarczyk, Robert A.; Evans, Dabney P.

doi:10.1016/j.pvr.2020.100197

Cited by 4 publications

(4 citation statements)

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“…The main reasons cited by the interviewees for not vaccinating their children were lack of information, followed by fear or refusal due to fear of side effects, and news stories seen on social media, as reported by others studies [ 14 , 20 ]. Using the same HBM method, other studies also suggest that knowledge of this subject is insufficient, influencing lower perception of HPV vaccine benefits as one of the main reason for not vaccinating [ 12 , 14 , 22 , 23 ]. Better awareness of HPV-transmitted infections and the importance of vaccination by parents and guardians, as well as children and adolescents, may increase the acceptability of vaccination [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although essential, encouraging vaccination against HPV prompted an ethical and social discussion about offering protection against a sexually transmitted virus for very young children or adolescents [ 11 ]. Some authors identify difficulties in accessing services and information about HPV vaccines [ 12 , 13 , 14 ] in addition to perceptions and behaviors that influence refusal in a different social context [ 14 ]. This reveals the heterogeneity of vaccination scope in Brazil, namely, higher with the first dose in urbanized areas and in groups with better socioeconomic status [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Parental Justifications for Not Vaccinating Children or Adolescents against Human Papillomavirus (HPV)

2023

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Vaccination coverage against Human Papillomavirus (HPV) is low compared with uptake of other vaccines in many countries, including Brazil. The aim of this study was to examine the main reasons provided by parents or guardians of a target population that did not have the first dose of HPV vaccine in a small rural Brazilian municipality, and to verify the factors associated with the reasons for non-vaccination. This is a cross-sectional study with interviews based on the Health Belief Model (HBM), conducted with parents and guardians of 177 unvaccinated children or adolescents. The outcome of interest was the main reason for not vaccinating the child/adolescent. The exposure factors of interest were knowledge about HPV and its prevention as well as sociodemographic characteristics. The main justifications for not vaccinating were lack of information (62.2%), fear or refusal (29.9%), and logistical issues (7.9%). The justifications associated with adolescents’ sex, fear, or refusal were mentioned by 39.3% (95% CI: 28.8–50.6%) of parents or guardians of girls and by 21.5% (95% CI: 13.7–31.2%) of parents or guardians of boys. The main barrier to HPV vaccination is lack of information. Further training of health professionals in clarifying the benefits of vaccination and differentiating the risks between boys and girls could encourage uptake.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Parental Justifications for Not Vaccinating Children or Adolescents against Human Papillomavirus (HPV)

2023

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“…At the individual level, several factors have been analyzed and reported as associated with low HPV vaccination coverage, especially low schooling, low income, living in a rural area, low access to information and health services, and barriers imposed by religious dogmas [10][11][12][13][14] . Meanwhile, population analyses, with aggregated data, contribute to understanding social or structural determinants connected to the vaccination coverage achieved in a geographic area.…”

Section: Rev Bras Epidemiol 2021; 24: E210001mentioning

confidence: 99%

Cobertura da vacina papilomavírus humano (HPV) no Brasil: heterogeneidade espacial e entre coortes etárias

Moura

Codeço

Luz

2021

Rev. bras. epidemiol.

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RESUMO: Objetivo: Estimar a cobertura da primeira e da segunda dose da vacina papilomavírus humano (HPV) no Brasil, conforme a microrregião, comparando-se as coortes de meninas com 14, 15 e 16 anos em 2017, e investigar a associação da heterogeneidade espacial na cobertura vacinal com variáveis sociodemográficas. Métodos: A informação sobre doses aplicadas nos anos de 2013 a 2017 por idade foi obtida do Programa Nacional de Imunizações. O número de meninas residentes com sete, oito e nove anos em 2010, em cada microrregião, é oriundo do censo brasileiro de 2010. Para a análise, a cobertura vacinal acumulada por microrregião (n = 558) foi categorizada em baixa (< 80%) e adequada (≥ 80%), e um modelo logístico com intercepto aleatório foi ajustado, tendo cobertura vacinal adequada como desfecho. O efeito aleatório (unidade da federação) foi incluído para captar a correlação entre microrregiões que pertencem ao mesmo estado. Resultados: O percentual de microrregiões que alcançou a cobertura vacinal adequada foi significativamente maior para a primeira dose (entre 91,8 e 159,2%), independentemente da coorte. Observou-se menor cobertura da segunda dose (entre 7 e 79,9%), com heterogeneidade associada ao grau de urbanização e à presença de domicílios com banheiro de uso próprio no município. O efeito aleatório mostrou forte poder explicativo, sugerindo importantes diferenças entre os estados brasileiros no alcance da cobertura vacinal. Conclusão: Apesar de a vacina HPV estar disponível no Programa de Imunização, os achados do presente estudo apontam para uma dificuldade do alcance da cobertura vacinal adequada.

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“…In the 1st year of vaccination (2014), 87% of the Brazilian municipalities had achieved the goal target of 80% coverage for the first dose among eligible girls; this number dropped to 32% of the cities for the second dose (18). Numerous individual factors have been described as associated with low HPV vaccine coverage, including low educational level, low income, countryside residence and low access to information and health services (19)(20)(21)(22). At a population level, social/structural determinants are paramount, such as living conditions, presence of sewage, piped water, garbage collection, etc.…”

Section: Cervical Cancer Mitigation Through Vaccination Screening And...mentioning

confidence: 99%

Cervical cancer screening, treatment and prophylaxis in Brazil: Current and future perspectives for cervical cancer elimination

et al. 2022

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As a middle-income country, Brazil has one of the largest public health systems worldwide, which deals with free and universal access to health care. Regarding cervical cancer, the country possesses a large infrastructure for the screening of premalignant and malignant lesions, but yet based on old technology, having Papanicolaou as the major screening method, followed by colposcopy and treatment. Also, large disparities in access are present, which makes effectiveness of screening and treatment in different regions of the country highly unequal. In this review, we describe and evaluate the current screening, treatment and prophylactic (HPV vaccination) strategies to combat cervical cancer in Brazil, and discuss potential incorporation of more recent technologies in these areas in the country to pave its way toward cervical cancer elimination.

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A human rights approach to understanding provider knowledge and attitudes toward the human papillomavirus vaccine in São Paulo, Brazil

Cited by 4 publications

References 15 publications

Parental Justifications for Not Vaccinating Children or Adolescents against Human Papillomavirus (HPV)

Parental Justifications for Not Vaccinating Children or Adolescents against Human Papillomavirus (HPV)

Cobertura da vacina papilomavírus humano (HPV) no Brasil: heterogeneidade espacial e entre coortes etárias

Cervical cancer screening, treatment and prophylaxis in Brazil: Current and future perspectives for cervical cancer elimination

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