Acceptability of multipurpose human papillomavirus vaccines among providers and mothers of adolescent girls: A mixed-methods study in five countries

Abstract

Introduction Multipurpose vaccines (MPVs) could be formulated to prevent multiple sexually transmitted infections simultaneously. Little is known about acceptability of MPVs among vaccine health care providers (HCPs) or mothers of adolescent girls. Methods 151 adolescent vaccine providers and 118 mothers of adolescent girls aged 9-14 were recruited from five geographically-diverse countries: Argentina, Malaysia, South Africa, South Korea, and Spain. We assessed providers’ preferences for single-purpose human papillomavirus (HPV) vaccine versus MPVs (including HPV+herpes simplex virus (HSV)-2, HPV+HIV, or HPV+HSV-2+HIV) via quantitative surveys. Maternal MPV attitudes were assessed in four focus group discussions (FGDs) in each country. Results Most providers preferred MPVs over single-purpose HPV vaccination, with preference ranging from 61% in Malaysia to 96% in South Africa. HPV+HSV-2+HIV was the most preferred MPV formulation (56%-82%). Overall, 53% of the mothers preferred MPVs over single-purpose HPV vaccines, with strongest support in South Africa (90%) and lowest support in South Korea (29%). Convenience and trust in the health care system were commonly-cited reasons for MPV acceptability. Safety and efficacy concerns were common barriers to accepting MPVs, though specific concerns differed by country. Across FGDs, additional safety and efficacy information on MPVs were requested, particularly from trusted sources like HCPs. Conclusions Though maternal acceptability of MPVs varied by country, MPV acceptability would be enhanced by having HCPs provide parents with additional MPV vaccine safety and efficacy information. While most providers preferred MPVs, future health behavior research should identify acceptability barriers, and targeted provider interventions should equip providers to improve vaccination discussions with parents.

Parents’ knowledge, beliefs, and acceptance of the HPV vaccination in relation to their socio-demographics and religious beliefs: A cross-sectional study in Thailand

“…On the other hand, reasons as to why parents are reluctant to give consent for the vaccination include concerns about side effects and long-term safety of the vaccine, insufficient information prior to making informed consent, and the daughter’s young age [ 10 – 12 , 27 – 29 ]. Other common barriers are low perceived risk of getting an HPV-infection or HPV-related cancer [ 10 , 27 , 28 , 30 ].…”

Risk Perception in Childhood Vaccination Questionnaire: A Validation Study on Pregnant Mothers in Malaysia

“…Respondents fulfilling these characteristics were included: (a) Malaysian mothers, (b) pregnant, (c) married, and (d) able to read and write. Pregnant mother is one of the target population for intervention in National Immunisation Promotional Campaign and previous research has shown that empowering mothers lead to positive vaccination uptake 35,36 . Respondents with (a) sexual assault history or (b) active mental illness was excluded to prevent harm.…”

HPV Vaccination Recommendation Practices among Adolescent Health Care Providers in 5 Countries

“…Structured interviews were conducted face-to-face or via phone with adolescent vaccination providers between October 2013 and April 2014 using a standardized questionnaire, as previously reported. 22 Providers from Argentina, Malaysia, South Africa, South Korea, and Spain were identified via convenience sampling and recruited through mail, e-mail, phone, or in-person conversations. Specific methods included outreach to study staff contacts, review of databases from national professional organizations, national health insurance reviews, and assessments, Web sites, and lists from external consultants.…”