Uptake of human papillomavirus (HPV) vaccination in Hong Kong: Facilitators and barriers among adolescent girls and their parents

Abstract

The present study is aimed at assessing the feasibility of delivering the HPV (human papillomavirus) vaccine to girls through a school-based program in Hong Kong, as well as to examine the facilitators and barriers associated with their participation. We approached 1,229 eligible girls aged 9 to 14 at eight schools in Hong Kong to join the program and then delivered the bivalent HPV vaccine at 0 and 6 months over the course of one school year. The students and their parents completed separate questionnaires to indicate their decision on whether or not to participate, and to assess their knowledge of cervical cancer and the HPV vaccine. The overall vaccine uptake was 81.4% (1,000/1,229) for the first dose and 80.8% (993/1,229) for the second dose. Parents and students were given separate questionnaires and asked whether or not they would like to participate in the vaccination program. 87.1% (1,010/1,160) of parents and 84.9% (974/1,147) of students indicated that they would join the program. The reasons associated with parents’ decision not to vaccinate their daughters primarily included concerns around side effects and safety. Multivariate regression analysis showed that parents who thought that the vaccine would protect their daughter from getting cervical cancer (OR = 3.16, 95% CI = 1.39–7.15, p < .01), and those who reported having a doctor’s recommendation (OR = 4.54, 95% CI = 1.05–19.57, p < .05) were more likely to join the program. In contrast, parents who had never heard of the vaccine (OR = .15, 95% CI = .03–.71, p < .02), those who were willing to pay more than HK$2,000 for the vaccine (OR = .39, 95% CI = .19–.81, p < .05), or had a preference to access it through a private clinic (OR = .44, 95% CI = .26–.75, p < .01) were significantly less likely to allow their daughter to join the program. Delivery of the HPV vaccine with high uptake rate in a school setting is feasible in Hong Kong. Engaging key stakeholders including school administrators, teachers and community physicians, and providing relevant information on safety and vaccine effectiveness to parents were important to the success of the program.

Rotavirus Infection and Vaccination: Knowledge, Beliefs, and Behaviors among Parents in Italy

“…As expected, those considering it dangerous for their children to contract rotavirus gastroenteritis and having positive perception toward the effectiveness of the vaccine were more likely to have immunized their children. These findings are consistent with several studies worldwide evaluating factors positively associated with vaccination [15,17,20,33,34,35]. These observations underlined the importance of not only adequately providing information about rotavirus infection to parents, but also explaining the utility of the vaccination in order to increase the coverage.…”

“…The low coverage rates are still public health challenges and various factors have been cited for why parents and informal caregivers’ declined childhood vaccinations, such as vaccine hesitancy [11,12], lack of appropriate information [13,14], and perception of vaccine safety and benefits [15,16,17]. Therefore, an understanding of the parents’ knowledge, beliefs, and behaviors regarding vaccination against rotavirus could provide useful information on the factors that influence the uptake and to design and to develop interventions to increase the coverage.…”

Effects of a multidisciplinary team-led school-based human papillomavirus vaccination health-promotion programme on improving vaccine acceptance and uptake among female adolescents

“…Adolescents’ and parents’ knowledge and attitudes towards HPV and HPV vaccine are crucial in their decision to vaccinate. [ 16 , 17 ] One systematic review of 25 studies found that vaccine uptake among female adolescents was associated with vaccine-related knowledge, attitudes, information provided by healthcare providers, health insurance coverage, age, and childhood vaccination. [ 18 ] Another systematic review of 28 qualitative studies and 44 surveys reported the consistent finding that adolescents and parents struggled with their decision due to limited information, declining vaccination for concerns over vaccine safety and low perception of risk of HPV infection.…”

“…The results showed an association between parents who did not want their daughters vaccinated and inadequate knowledge regarding the vaccine. [ 17 ]…”

“…[ 26 ] The only HK study in which an intervention was developed on the basis of HBM was a one-group pre/post-test study. [ 17 ] Further evaluation using a RCT is needed to demonstrate intervention effects on actual vaccine uptake instead of simply on intention to be vaccinated. Furthermore, although previous studies targeted adolescents and/or parents, it would be more comprehensive to include school personnel to better equip them to provide health information to students.…”