The domino effect: adolescent girls’ response to human papillomavirus vaccination

Abstract

Objectives: To examine the experience of fear, the fear response, and factors affecting fear in adolescents undergoing school‐based human papillomavirus (HPV) vaccination. Design, participants and setting: A purposive sampling strategy and qualitative methods, including observation and face‐to‐face interviews. Focus groups comprised adolescent girls who were involved in HPV vaccination in 2007 at schools in Sydney, New South Wales. Individual interviews were conducted with parents, teachers and vaccination nurses. Results: Data from observing vaccination days at three schools and from interviewing 130 adolescents in 20 focus groups, 38 parents, 10 teachers and seven nurses were included in the analysis. All participants discussed the issue of fear and distress experienced by adolescent girls in relation to HPV vaccination. Observations corroborated the focus group and interview data. Our results indicated that fear was promoted by witnessing the fear reactions of peers; perceived judgement by peers; lack of information or misinformation; and being vaccinated later in the day. Fear was moderated by procedural factors, the support of peers, appropriate knowledge, and nurses’ distraction techniques or approach. Fear also affected acceptance of HPV vaccination. Conclusions: Fear of HPV vaccination was a near universal experience among adolescents in the school setting and was often associated with significant distress that had an adverse impact on the vaccination process. School vaccination could be improved by proactively managing fear and distress.

Urban/Rural Differences in Breast and Cervical Cancer Incidence: The Mediating Roles of Socioeconomic Status and Provider Density

“…The USDA continuum codes can be treated as continuous or categorical (1–3=metropolitan/urban, and 4–9=non-metropolitan/rural) indicators (United States Department of Agriculture, 2013). Previous studies of the USDA continuum codes have analyzed the association between urbanicity and cancer outcomes, including screening (Litaker & Tomolo, 2007), incidence (Bernard, Cooper Robbins, McCaffery, Scott, & Skinner, 2011), stage of diagnosis (Paquette & Finlayson, 2007), and survival (Modesitt, Huang, Shelton, & Wyatt, 2006), treating the codes as either continuous or categorical.…”

HPV vaccine for teen boys: Dyadic analysis of parents' and sons' beliefs and willingness

“…6-12 Generally, parents and adolescents have similar HPV vaccine beliefs, 11,13,14 including their risk appraisals, which predict their vaccination intentions and behaviors. However, some beliefs affect parents' and adolescents' motivations differently: The promise of preventing cancer encourages parents, 15,16 while fear of needles or pain discourages adolescents 6,9,11,17 from seeking vaccination.…”

“…However, vaccination side effects are intrinsically more proximal to sons, and avoidance of discomfort is a powerful motivator of health behaviors, 25 including vaccination. 6,9,11,17 Finally, we examined whether the relationship between beliefs and vaccination willingness varied by the age of adolescent sons, hypothesizing that parents' beliefs would be less closely related to HPV vaccination willingness among older sons than younger sons (Hypothesis 3). We examined these hypotheses in a national sample of adolescent boys and their parents.…”

Psychological reactions of adolescent schoolgirls to human papillomavirus vaccination in western Uganda: A comparative cross-sectional study

“…This suggestion is informed by this study’s qualitative findings showing that some vaccinated girls were mainly encouraged by their friends to get vaccinated against the HPV without fully understanding the vaccination, implying that peer influence may have mitigated some of the fears associated with the vaccination. Moreover, in the study by Bernard and colleagues (Bernard et al, 2011), girls’ concern about their possible reactions in front of peers seemed to amplify fear in some cases, yet having friends available in the vaccination room to support them by holding arms or talking to them had the reverse effect. Peer influence is a known positive and negative factor in shaping adolescent attitudes about HPV vaccine (Gamble et al, 2010; Katz et al, 2013).…”

“…Our qualitative results showed that the introduction of the HPV vaccine had triggered several negative rumors that were likely to worry the targeted adolescents. Apparently, much of the reported worry especially concerning pain and possible physical harm from injection was anticipatory, which is a normal response to a perceived threat but an unnecessary psychological trauma if no real threat exists (Bernard et al, 2011). Qualitative findings indicated that the fear of pain and possible physical harm from injection was usually short-lived, suggesting that time was protective.…”