Not the right time: why parents refuse to let their daughters have the human papillomavirus vaccination

Abstract

AimTo explore why parents refused to allow their 10- to 12-year-old daughters to receive the human papillomavirus (HPV) vaccination from the Swedish school-based vaccination programme.MethodsIndividual interviews with 25 parents who had been offered, but not consented to, their daughters receiving the HPV vaccination.ResultsFive themes emerged through the interviews: 1) she is just a little girl, 2) inadequate information, 3) not compatible with our way of life, 4) scepticism about the vaccination and 5) who can you trust? The parents made their decisions with their child's best interests in mind. This was not considered the right time, and the vaccine was perceived as unnecessary and different from other vaccines. Mistrust in Government recommendations and a lack of evidence or information were other reasons to decline.ConclusionThe decision-making process was complex. These parents preferred to wait until their daughter was older and believed the information they received from the school health system was insufficient. The results indicate that a more flexible HPV vaccination schedule may improve vaccine uptake. This includes more transparent information about the virus and the vaccine and information about who to contact to get the daughter vaccinated at a later date.

To Consent or Decline HPV Vaccination: A Pilot Study at the Start of the National School‐Based Vaccination Program in Sweden

“…Declining parents were significantly less likely to have agreed to the vaccine against influenza A (H1N1), popularly known as swine flu. The parents declined the vaccine as they believed the risks outweighed the benefits and this backs up the results of our recent qualitative study, where parents expressed fear of side effects, especially narcolepsy, was one reason why they declined the HPV vaccination 9. General attitudes toward vaccines have an impact on the attitude to HPV vaccination in particular 37.…”

“…In Sweden, all children are offered vaccinations free of charge in the national vaccination program. The vaccinations are nonmandatory and parents have to consent and mothers are often the decision‐makers 8, 9, 10. Inoculation with the quadrivalent HPV vaccine was introduced to the Swedish school‐based vaccination program in 2012 for girls from 10 to 12 years of age.…”

“…We recently carried out 2 qualitative studies8, 9 exploring why parents refused or agreed to let their daughters have the HPV vaccination 8. The main reasons why parents agreed were that they trusted the recommendations from the authorities and that they wanted to protect their daughter from a severe disease 8.…”

“…The main reasons why parents agreed were that they trusted the recommendations from the authorities and that they wanted to protect their daughter from a severe disease 8. Refusal was more complex 9. Parents who declined the vaccination believed their daughters were too young and not physically or psychologically mature enough.…”

“…Parents who declined the vaccination believed their daughters were too young and not physically or psychologically mature enough. Other reasons were a lack of information and not pleased with the information from the school health, doubts regarding the safety and efficacy of the vaccine, and mistrust in the government's recommendation 9. The previous recommendation by the Swedish government to vaccinate against influenza type A (H1N1) was the main reason,9 as it was recently linked to an increased risk of narcolepsy, especially in children and adolescents 26…”