a Département des risques biologiques et de la santé au travail, Institut national de santé publique du Québec (INSPQ) , Québec , QC , Canada.
b Axe maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec-Université Laval , Québec , QC , Canada.
Hum Vaccin Immunother. 2019;15(7-8):1650-1655. doi: 10.1080/21645515.2018.1564440. Epub 2019 Feb 20.
Primary prevention of human papillomavirus (HPV) through vaccination is a high priority in Canada's cancer prevention efforts. All Canadian provinces and territories have introduced publicly funded, school-based vaccination programs against HPV, but vaccine uptake remains suboptimal in some jurisdictions. We conducted a descriptive qualitative study to better understand the determinants of low HPV vaccine uptake and identify strategies to enhance vaccine acceptance using the socio-ecological model. In Quebec, interviews and focus groups were held in 2015-2016 with 70 key informants including immunization managers, school nurses, school principals, teachers and parents of Grade 4 students (9 years of age). Our findings showed that HPV vaccine uptake was dependent on many interrelated factors at the individual and interpersonal level (e.g. knowledge and attitudes of the different players involved in the vaccination system), at the community level (e.g. social group values and norms, media coverage around the HPV vaccine), at the organizational level (e.g. allocated resources, information provision, consent process, immunization setting and environment) and at the policy level (e.g. changes in provincial HPV vaccine program). We are using the data collection and interpretation tools and approaches developed by our team and used in Quebec to expand our study to four other provinces (British Columbia, Alberta, Ontario and Nova Scotia). We are conducting environmental scans, semi-structured interviews and a survey to better understand the determinants of low HPV vaccine uptake and identify strategies to enhance vaccine acceptance. Having an in-depth understanding of the determinants of HPV vaccination in school settings is critical in order to identify root causes of the suboptimal vaccine uptake and to develop tailored interventions to address these on both supply- and demand-side issues.
在加拿大的癌症预防工作中，通过疫苗接种对人乳头瘤病毒（HPV）进行初级预防是当务之急。加拿大所有省份和地区都推出了以学校为基础的 HPV 疫苗接种计划，但在一些司法管辖区，疫苗接种率仍然不理想。我们采用社会生态学模型，进行了一项描述性定性研究，以更好地了解 HPV 疫苗接种率低的决定因素，并确定增强疫苗接种接受度的策略。在魁北克，我们于 2015 年至 2016 年对 70 名主要信息提供者（包括免疫管理人员、学校护士、学校校长、教师和四年级学生（9 岁）的家长）进行了访谈和焦点小组讨论。我们的研究结果表明，HPV 疫苗接种率取决于许多相互关联的因素，包括个人和人际关系层面（例如，参与疫苗接种系统的不同人员的知识和态度）、社区层面（例如，社会群体价值观和规范、媒体对 HPV 疫苗的报道）、组织层面（例如，分配的资源、信息提供、同意程序、免疫接种环境）和政策层面（例如，省级 HPV 疫苗接种计划的变化）。我们正在使用我们团队在魁北克开发并使用的数据分析和解释工具与方法，将我们的研究扩展到其他四个省份（不列颠哥伦比亚省、艾伯塔省、安大略省和新斯科舍省）。我们正在进行环境扫描、半结构化访谈和调查，以更好地了解 HPV 疫苗接种率低的决定因素，并确定增强疫苗接种接受度的策略。深入了解学校环境中 HPV 疫苗接种的决定因素对于确定疫苗接种率不理想的根本原因以及制定针对供应和需求方面问题的有针对性的干预措施至关重要。
