Parental decision-making on human papillomavirus vaccination for daughters in Japan

Abstract

BackgroundIn June 2013, the fear of adverse events compelled the government to withdraw its recommendation of the Human papillomavirus (HPV) vaccine.Since then, the rate of vaccination among Japanese girls has dropped dramatically.ObjectiveThis study aims to assess how the Japanese government’s policy change against HPV vaccination influenced the degree to which parents in remote areas in Japan accepted the vaccine for their daughters, and to analyze related factors. MethodsA self-administered questionnaire was distributed to parents with daughters attending secondary schools or high schools in two remote areas of the country. ResultsOut of 700 eligible parents, 246 (35%) responded. The percentage of parents in the “accept group” (those whose daughters had already been vaccinated or those who intended to have their daughters vaccinated) dropped from 54% before the government withdrew its HPV vaccine recommendation to only 4.5% after the withdrawal (1.5% of whom intended to vaccinate and 3% of whom had already had their daughters vaccinated). Vaccine acceptance was higher in parents who were employed as healthcare workers, had been educated through to the completion of high school, had good levels of knowledge about cervical cancer and the HPV vaccine, had low perceived barriers against the HPV vaccine, and received high levels of social support. ConclusionThe acceptance of HPV vaccination among parents was low overall. Higher acceptance may be possible if the government restores its recommendation and healthcare providers disseminate appropriate information about the HPV vaccination and cervical cancer.

Between Now and Later: A Mixed Methods Study of HPV Vaccination Delay Among Chinese Caregivers in Urban Chengdu, China

“…Our integrated health behaviour model offers a novel way of visualizing how these factors are interrelated. We found that perceived sexual inactivity of adolescents (34,(39)(40)(41), insu cient knowledge about vaccination timing, safety and effectiveness (24,(41)(42)(43) and preference for 9vHPV vaccine in uenced parents' individual decision and were consistent with determinants of vaccine hesitancy identi ed from studies conducted in the United States, Kenya and Japan. Furthermore, systemic barriers such as supply shortage, inadequate communication and dissemination of information (40)(41)(42) also contributed to hesitancy.…”

“…We found that caregivers who chose not to delay vaccination were more likely to have communicated with friends or family members. Similarly, studies in Japan found that high social support was related to greater parental acceptance (42,43).…”

Understanding confidence in the human papillomavirus vaccine in Japan: a web-based survey of mothers, female adolescents, and healthcare professionals

“…20 Similar results are supported by other studies, 21 including regarding mothers' perception of the HPV vaccine and their intentions to have their daughters vaccinated. 22,23 Acceptance of the HPV vaccine was higher among parents working in healthcare, who were knowledgeable about the HPV vaccine and cervical cancer. 22 Clear and unbiased information about HPV, cervical cancer, and the HPV vaccine, along with proactive recommendation by the MHLW, could thus be key determinants of parents' and female adolescents' willingness to accept HPV vaccination.…”

“…22,23 Acceptance of the HPV vaccine was higher among parents working in healthcare, who were knowledgeable about the HPV vaccine and cervical cancer. 22 Clear and unbiased information about HPV, cervical cancer, and the HPV vaccine, along with proactive recommendation by the MHLW, could thus be key determinants of parents' and female adolescents' willingness to accept HPV vaccination. This is especially true given that although trust in doctors and nurses in Japan is generally high, confidence in vaccines is low, underscoring wider issues relating to trust in the government and their policies.…”

“…This is especially true given that although trust in doctors and nurses in Japan is generally high, confidence in vaccines is low, underscoring wider issues relating to trust in the government and their policies. 24 Previous surveys [19][20][21][22][23] confirm the low levels of public trust, interest, and awareness of the HPV vaccine among parents, adolescents, and HCPs in Japan, although no nationwide data on HPV vaccine confidence and willingness with its timing have been published. Thus, investigating HPV vaccine confidence nationwide across Japan among the three important stakeholders-mothers, female adolescents, and HCPs-and identifying the factors that determine their willingness to receive or (for HCPs) recommend the HPV vaccine are crucial to better understand behavioral motives and the dynamics of the interaction and communication between them that could in turn be addressed by tailored interventions.…”