Implementation of a national school-based Human Papillomavirus (HPV) vaccine campaign in Fiji: knowledge, vaccine acceptability and information needs of parents

Abstract

Background: In 2008 Fiji implemented a nationwide Human Papillomavirus (HPV) vaccine campaign targeting all girls aged 9-12 years through the existing school-based immunisation program. Parents of vaccine-eligible girls were asked to provide written consent for vaccination. The purpose of this study was to describe parents' knowledge, experiences and satisfaction with the campaign, the extent to which information needs for vaccine decision-making were met, and what factors were associated with vaccine consent. Methods: Following vaccine introduction, a cross-sectional telephone survey was conducted with parents of vaccine-eligible girls from randomly selected schools, stratified by educational district. Factors related to vaccine consent were explored using Generalised Estimating Equations. Results: There were 560 vaccine-eligible girls attending the participating 19 schools at the time of the campaign. Among these, 313 parents could be contacted, with 293 agreeing to participate (93.6 %). Almost 80 % of participants reported having consented to HPV vaccination (230/293, 78.5 %). Reported knowledge of cervical cancer and HPV prior to the campaign was very low. Most respondents reported that they were satisfied with their access to information to make an informed decision about HPV vaccination (196/293, 66.9 %). and this was very strongly associated with provision of consent. Despite their young age, the vaccine-eligible girls were often involved in the discussion and decision-making. Most consenting parents were satisfied with the campaign and their decision to vaccinate, with almost 90 % indicating they would consent to future HPV vaccination. However, negative media reports about the vaccine campaign created confusion and concern. Local health staff were cited as a trusted source of information to guide decision-making. Just over half of the participants who withheld consent cited vaccine safety fears as the primary reason (23/44, 52.3 %).

Recommendations for cervical cancer prevention and control in Ghana: public education and human papillomavirus vaccination

“…[46][47][48] However, this conjecture has not been supported by studies that have reported no statistically significant increase in sexual behaviour and STIs in adolescents after HPV vaccination. 49,50 Although the acceptance of the HPV vaccine has been shown to be generally high in many countries [51][52][53][54][55] , these social concerns need to be considered if high coverage is to be achieved in Ghana.…”

Role of HPV Vaccination in Fighting Cervical Cancer

“…In some regions, "community influencers" (e.g., teachers, health workers, and other community members) are necessary for helping to raise awareness of cervical cancer as it is reported to play more important role than information given from health providers. Although the need of media in promoting the vaccines it is found that media has sometimes given negative perceptions like the adverse reactions (24) that would act as a hinder to willingness. Apparently, media does not influence the willingness to vaccinate.…”

“…Race is one of the factors, for instance, a study on African American girls shows vaccination series initiation and completion were lower than the national average (23) . In 2008, survey and campaign were conducted in Fiji (24) showed the participants knowledge about HPV were low prior to the campaign. Where only as low as 10.2% of the participants have heard about HPV vaccines, 21.2 % reported having heard of cervical cancer, and the majority of these knew someone who had the disease.…”

A pivotal time in global cervical cancer prevention: Examining young women's awareness about the human papillomavirous and attitudes towards the HPV vaccine in Durban, South Africa

“…The countries included: Turkey, Vietnam, Fiji, Malaysia, Indonesia, Eastern India, Thailand and China. From all articles in this geographical area, parental acceptability ranged from 44%-96%, with significant increases in acceptability in China, Fiji and Vietnam if some sort of government program was established in support specifically for the HPV vaccination (Alsaad, Shamsuddin, & Fadzil, 2012;Basu & Mittal, 2011;Dinh et al, 2007;Jaspers, Budiningsih, Wolterbeek, Henderson, & Peters, 2011;Kilic, Seven, Guvenc, Akyuz, & Ciftci, 2012;Kruiroongroj, Chaikledkaew, & Thavaorncharoensap, 2013;Madhivanan et al, 2009;Madhivanan et al, 2014;Mairaing, Suwannarakark, THaweekul, & Poomtavorn, 2012;Songthap, Pitisuttithum, Kaewkungwal, Gungladda, & Bussaratid, 2012;Vincente et al, 2015;Wang et al, 2015;Wong, 2009;Zhang et al, 2013). The most dominant predictor for parental acceptability in these countries was higher education and increased knowledge specifically around HPV, cervical cancer and protective measures the vaccine offers.…”

“…Research conducted in similar settings demonstrated caretaker HPV vaccine acceptance for their daughters between 44-96%. The most common reasons for caregivers (predominantly female) to refuse the HPV vaccine for their daughters included, fears about vaccine efficacy and safety, low education and awareness about HPV and its association to cervical cancer and the high cost of the vaccine (Mouallif et al, 2014;Perkins et al, 2011;Vincente et al, 2015;Zhang et al, 2013).…”