Department of Health Outcomes and Biomedical Informatics, University of Florida, P.O. Box 100177, Gainesville, FL, 32610, USA.
Institute for Child Health Policy, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
Matern Child Health J. 2020 Apr;24(4):456-461. doi: 10.1007/s10995-019-02856-8.
Parents' concerns about vaccine safety and side effects likely contribute to low rates of human papillomavirus (HPV) vaccination among adolescents. To facilitate parent-provider discussions about the HPV vaccine, we developed and tested the content of a clinical decision support application for implementation in pediatric clinical settings. This study sought to elicit perspectives of parents and providers on the best way to communicate information on vaccine side effects.
To understand the acceptability of the application's content, we conducted focus groups with parents (n = 11) and providers (n = 9) at three primary care clinics. Focus groups transcriptions were analyzed using iterations of deductive and inductive coding, with independent coding by two trained reviewers to improve inter-rater reliability.
Surprisingly, when parents reviewed screen shots of HPV vaccine safety and side effect messages, parents took exception to the expression "no evidence of serious side effects". Parents wanted side effects listed explicitly so they could decide for themselves which side effects were "serious". Parents also felt that the HPV vaccine did have serious side effects, and the wording undermined their trust in the vaccine messaging overall. Providers accepted the phrasing of side effects and did not express concerns that parents would object to the messaging.
Further research is needed to confirm parents' concerns with the phrasing "no serious side effects" for the HPV vaccine and to assess the impact on HPV vaccination deferral or delay.
父母对疫苗安全性和副作用的担忧可能导致青少年 HPV 疫苗接种率低。为了促进父母与提供者就 HPV 疫苗进行讨论，我们开发并测试了一种临床决策支持应用程序的内容，以便在儿科临床环境中实施。本研究旨在了解父母和提供者对传达疫苗副作用信息的最佳方式的看法。
为了了解应用程序内容的可接受性，我们在三个初级保健诊所对父母（n=11）和提供者（n=9）进行了焦点小组讨论。使用迭代的演绎和归纳编码对焦点小组的转录进行分析，并由两名经过培训的评审员进行独立编码，以提高评分者间的可靠性。
令人惊讶的是，当父母查看 HPV 疫苗安全性和副作用信息的屏幕截图时，父母对“没有严重副作用的证据”这一表述提出异议。父母希望明确列出副作用，以便他们自行决定哪些副作用是“严重的”。父母还认为 HPV 疫苗确实有严重的副作用，这种措辞削弱了他们对疫苗信息的整体信任。提供者接受了副作用的措辞，并不担心父母会对信息提出反对。
需要进一步研究来证实父母对 HPV 疫苗“没有严重副作用”这一措辞的担忧，并评估其对 HPV 疫苗接种推迟或延迟的影响。
