Attitudes and Practices towards HPV Vaccination and Its Social Processes in Europe: An Equity-Focused Scoping Review

Alarcão, Violeta; Zdravkova, Bilyana

doi:10.3390/soc12050131

Cited by 8 publications

(4 citation statements)

References 60 publications

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“…This aligns with a recent systematic review which found acceptance barriers were mostly reported in Eastern European and Muslim migrant groups around HPV, measles and influenza vaccines (11). Another review highlighted sociodemographic and sociocultural barriers to HPV vaccination uptake (29). Providing primary care staff with specific training in motivational interviewing techniques to facilitate positive conversations around vaccination and encourage uptake is effective in some settings and for some vaccines.…”

Section: Discussionsupporting

confidence: 78%

Driving uptake of missed routine vaccines in adolescent and adult migrants: a prospective observational mixed-methods pilot study of catch-up vaccination in UK general practice

Crawshaw,

Goldsmith,

Deal

et al. 2023

Preprint

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Background Migrants in Europe may be vulnerable to vaccine preventable diseases (VPDs) because of missed routine vaccines in childhood in their country of origin and marginalisation from health and vaccine systems. To align with European schedules, migrants should be offered catch–up vaccinations, considering MMR, Td–IPV, and age–appropriate MenACWY and HPV. However, awareness and implementation of catch-up guidelines by primary care staff in the UK is considered to be poor, and there is a lack of research on effective approaches to strengthen the primary care pathway. Methods We conducted a prospective observational mixed methods pilot study ′Vacc on Track′ (May 2021-September 2022) to better understand and define new care pathways to increase catch –up vaccination for adolescent and adult migrants presenting to primary care (≥16 years, born outside Western Europe, North America, Australia, or New Zealand) in two London boroughs. We designed a standardised data collection tool to assess rates of under–vaccination in migrant populations and previous VPDs, which then prompted a referral to practice nurses to deliver catch–up vaccination for those with uncertain or incomplete immunisation status, following UK guidelines. We explored views of practice staff on delivering catch–up vaccination to migrant populations through focus group discussions and engaged migrants in in–depth interviews around approaches to catch–up vaccination. Data were analysed in STATA12 and Microsoft Excel. Results We recruited 57 migrant participants (mean age 41 [SD 7.2] years; 62% female; mean 11.3 [SD 9.1] years in UK) from 18 countries, with minimum 6 months follow–up. We did 3 focus groups with 30 practice staff and 39 qualitative in–depth interviews with migrants. Nearly all migrant participants required catch–up vaccination for MMR (86%) and Td/IPV (88%) and most reported not having been previously engaged in UK primary care around catch–up vaccination. 12 (55%) of 22 participants in Site 1 reported a past VPD, including measles and rubella. 53 (93%) of participants were referred for catch–up vaccination. However, although 43 (81%) had at least one dose (at follow–up) of a required vaccine, only 6 (12%) referred for Td–IPV and 33 (64%) of those referred for MMR had completed their required course and vaccination pathway at follow–up, suggesting there were a range of personal and environmental obstacles to migrants accessing vaccinations and all multiple doses of vaccines that need to be better considered. Staff identified seven barriers to delivering catch–up vaccines to migrants, including limited time for appointments and follow–up, language and literacy barriers when taking histories and to encourage vaccination, lack of staff knowledge of current guidelines, inadequate engagement routes, and the absence of primary care targets or incentives. Conclusions Our findings suggest adolescent and adult migrants are an under–vaccinated group and would benefit from being offered catch–up vaccination on arrival to the UK. Primary care is an important setting to deliver catch–up vaccination, but effective pathways are currently lacking, and improving vaccine coverage for key routine vaccines across a broader range of migrant groups will require designated staff champions, training, awareness–raising and financial incentives. Novel ways to deliver vaccinations in community settings should be explored, along with co–designing community-based interventions to raise awareness among these populations of the benefits of lifecourse immunisation.

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Section: Discussionsupporting

confidence: 78%

Driving uptake of missed routine vaccines in adolescent and adult migrants: a prospective observational mixed-methods pilot study of catch-up vaccination in UK general practice

Crawshaw,

Goldsmith,

Deal

et al. 2023

Preprint

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“…The characteristics of the participants (conducted in high income countries) and education interventions (almost all are self-directed) reported in the included studies may explain the non-significant effect of digital education interventions. Interventions that raise the basic level of parental knowledge are therefore more effective in areas where understanding and awareness is low compared to countries where it is comparatively higher and educational barriers to HPV vaccination may be more subtle and linked to vaccine belief 23 , 26 , 67 . The utility of educational strategies within standard practice may be further questioned when examined alongside the results of trials that provided parents with both vaccination education and reminders.…”

Section: Discussionmentioning

confidence: 99%

“…School-based vaccination programs 12 , 13 , education about HPV and the vaccine at the outpatient clinic 14 , 15 , reminder letters to students and parents about upcoming vaccination appointments 16 , 17 , and incentives for vaccination can promote HVU 18 , 19 . However, these existing strategies face several obstacles, including undervaluation, misunderstanding, attitudinal barriers 20 – 23 , structural barriers such as scheduling challenges 12 , 13 , and expensive incentives 16 , 17 , 20 . Digital interventions leveraging technology and online platforms offer solutions to these challenges 24 – 27 .…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis comparing educational and reminder digital interventions for promoting HPV vaccination uptake

Chandeying,

Thongseiratch

2023

npj Digit. Med.

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Global Human papillomavirus (HPV) vaccination rates remain low despite available WHO-approved vaccines. Digital interventions for promoting vaccination uptake offer a scalable and accessible solution to this issue. Here we report a systematic review and meta-analysis examining the efficacy of digital interventions, comparing educational and reminder approaches, for promoting HPV vaccination uptake (HVU). This study also identifies factors influencing the effectiveness of these interventions. We searched PubMed, PsycInfo, Web of Science, and the Cochrane Library from each database’s inception to January 2023. Three raters independently evaluate the studies using a systematic and blinded method for resolving disagreements. From 1929 references, 34 unique studies (281,280 unique participants) have sufficient data. Client reminder (OR, 1.41; 95% CI, 1.23–1.63; P < 0.001), provider reminder (OR, 1.39; 95% CI, 1.11–1.75; P = 0.005), provider education (OR, 1.18; 95% CI, 1.05–1.34; P = 0.007), and client education plus reminder interventions (OR, 1.29; 95% CI, 1.04–1.59; P = 0.007) increase HVU, whereas client education interventions do not (OR, 1.08; 95% CI, 0.92–1.28; P = 0.35). Digital intervention effectiveness varies based on participants’ gender and the digital platform used. Interventions targeting male or mixed-gender participants demonstrate greater benefit, and reminder platforms (SMS, preference reminders, or electronic health record alerts) are more effective in increasing HVU. Digital interventions, particularly client and provider reminders, along with provider education, prove significantly more effective than client education alone. Incorporating digital interventions into healthcare systems can effectively promote HPV vaccination uptake. Reminder interventions should be prioritized for promoting HVU.

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“…Alarcão and Bilyana [21] present a comprehensive scoping review investigating the attitudes and practices related to HPV vaccination in Europe, with a particular focus on identifying social differences and understanding the social determinants of HPV vaccination. The authors found 28 studies discussing facilitators and barriers to immunization that took place in Europe and conclude that health-equity-focused programming is essential in promoting universal vaccination from the top down.…”

mentioning

confidence: 99%

Old and New Actors and Phenomena in the Three-M Processes of Life and Society: Medicalization, Moralization and Misinformation

Alarcão

Pintassilgo²

2023

Societies

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Attitudes and Practices towards HPV Vaccination and Its Social Processes in Europe: An Equity-Focused Scoping Review

Cited by 8 publications

References 60 publications

Driving uptake of missed routine vaccines in adolescent and adult migrants: a prospective observational mixed-methods pilot study of catch-up vaccination in UK general practice

Driving uptake of missed routine vaccines in adolescent and adult migrants: a prospective observational mixed-methods pilot study of catch-up vaccination in UK general practice

Systematic review and meta-analysis comparing educational and reminder digital interventions for promoting HPV vaccination uptake

Old and New Actors and Phenomena in the Three-M Processes of Life and Society: Medicalization, Moralization and Misinformation

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