Managing Uncertainty: Healthcare Professionals' Meanings Regarding the HPV Vaccine

Abstract

The introduction of a vaccine to prevent HPV infection, and by implication, possibly cervical and other cancers, created hope, and at the same time, intensified confusion and uncertainty. Providers have been frustrated for years with the rising mortality from cervical cancer in Bulgaria, and their perceived powerlessness in affecting this. HPV vaccination, on the other hand, seems relatively simple and "taming uncertainty" positions them as instrumental in limiting (or even eliminating) morbidity and mortality in future generations.

HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe

“…25,37,71 Concerns about side effects were particularly prevalent among hesitant participants from studies in the Netherlands (2009-2011, 69%), 26,28 Romania (2010, 60%), 79 and Greece (2005-2014, 54%). 31,34,40,42,78 Qualitative results Almost all qualitative articles described concerns about potential side effects of HPV vaccination, [52][53][54][55][56][57]59,60,62,64,66,69,[98][99][100][101][102][103][104][105][106][107] often described as fears of long-term side effects not yet identified through trials. 54,55,59,60,62,64,66,69,81,[98][99][100][101][102][103]…”

“…54,55,59,60,62,64,66,69,81,[98][99][100][101][102][103][104]106 In qualitative studies, the most commonly reported perceived side effect by parents was infertility. 52,57,59,60,65,100,102,106 Other perceived side effects included: autoimmune complications, 56,57,64,99,104,108 resistance of the virus to vaccines and/or treatment, 99,102,105 cancer, 52 menstrual complications, 65 HPV infection, 59 and death. 65 In France, mothers and HCWs in studies conducted between 2007-2010 discussed rumours about Hepatitis B vaccination allegedly causing multiple sclerosis and some expressed worries HPV vaccination could have similar side effects.…”

“…Beliefs that governments were not transparent, 57,59 influenced by vaccine manufacturers 52,98 or were withholding information about side effects 65,98 were reported in some qualitative studies. Some participants shared concerns about transparency, 52,59 commercial influences from pharmaceutical companies, 52,98,104,113 and perceptions that doctors were dismissive and deliberately withheld information about side effects. 52,65,98,104 Mistrust of pharmaceutical companies due to their underlying profitmaking motives and doubts about the trustworthiness of vaccine trials and safety claims were also reported in studies in Bulgaria (2009-2014), 98,104 Romania (2010-2012), 52 Sweden (2010, 2012), 55,56 Ireland (2012), 63 the Netherlands (2008), 60 Spain (2014), 98 and the UK (2014).…”

“…Some participants shared concerns about transparency, 52,59 commercial influences from pharmaceutical companies, 52,98,104,113 and perceptions that doctors were dismissive and deliberately withheld information about side effects. 52,65,98,104 Mistrust of pharmaceutical companies due to their underlying profitmaking motives and doubts about the trustworthiness of vaccine trials and safety claims were also reported in studies in Bulgaria (2009-2014), 98,104 Romania (2010-2012), 52 Sweden (2010, 2012), 55,56 Ireland (2012), 63 the Netherlands (2008), 60 Spain (2014), 98 and the UK (2014). 98 Finally, conspiracy theories about the vaccine allegedly contributing to reducing world population or being an experiment on young girls were reported in studies in Bulgaria (2010-2013), 104 Romania (2010-2012), 52 Sweden (2014), 57 the Netherlands (2015), 65 and the UK (2007-2016).…”

Will they lead by example? Assessment of vaccination rates and attitudes to human papilloma virus in millennial medical students

“…Although several studies have examined vaccination practices and attitudes toward HPV vaccination in practicing physicians [14, 16–18] and in international medical students and residents [8, 9, 11–13, 19], the authors only found one study reporting HPV vaccination rates in US medical students [10]. However, in that study all health care professional students were lumped into a single student category so there was no way to separate out medical student data [10].…”