Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, 450 Brookline Ave., LW 633, Boston, MA, 02215, USA.
University of South Florida College of Public Health, 13201 Bruce B. Downs Bld., MDC 56, Tampa, FL, 33612, USA.
Cancer Causes Control. 2021 Aug;32(8):793-802. doi: 10.1007/s10552-021-01431-3. Epub 2021 Apr 28.
Vaccine requirements are effective population-based strategies to increase vaccination rates. In 2018, Puerto Rico's DOH announced that the HPV vaccine would be required for school entrance. This study explored arguments in favor of and against the HPV vaccine school-entry requirement in PR.
We conducted a content analysis of two Puerto Rican newspapers. Articles (n = 286) published between 1/1/2015 and 7/31/2018 containing the Spanish terms for "HPV" and "human papillomavirus" were included. Data were summarized using descriptive statistics. Articles that mentioned the HPV vaccine school-entry requirement (n = 33) were reviewed qualitatively using applied thematic analysis.
The top five primary focus areas were education about HPV and the HPV vaccine, advertisements promoting the HPV vaccine, general vaccine information, cervical cancer and screening information, and the HPV vaccine school-entry requirement. Of the 33 articles that mentioned the requirement, 61% presented arguments in favor, 15% presented arguments against, 12% presented both arguments, and 12% only mentioned the existence of the requirement or were the DOH announcement. Arguments in favor centered on cancer prevention, high rates of HPV-associated cancers, and population wellness. Arguments against included worries about sexual transmission of HPV, HPV vaccine's side effects, issues related to the policy (e.g., mandatory), and lack of education.
Understanding reasons people support or oppose an HPV vaccine school-entry requirement is important for the policy processes to be successful. Education efforts must continue to change the HPV vaccine narrative. Messages should be crafted to educate and gain support among parents and stakeholders towards this population-based cancer prevention strategy.
疫苗接种要求是提高疫苗接种率的有效人群策略。2018 年，波多黎各卫生部门宣布 HPV 疫苗将作为入学要求。本研究探讨了波多黎各支持和反对 HPV 疫苗入学要求的论点。
我们对两份波多黎各报纸进行了内容分析。纳入 2015 年 1 月 1 日至 2018 年 7 月 31 日期间发表的包含西班牙语术语“HPV”和“人乳头瘤病毒”的文章（n=286）。使用描述性统计对数据进行总结。使用应用主题分析对提到 HPV 疫苗入学要求的 33 篇文章进行定性审查。
前五个主要焦点领域是 HPV 和 HPV 疫苗教育、推广 HPV 疫苗的广告、一般疫苗信息、宫颈癌和筛查信息以及 HPV 疫苗入学要求。在提到该要求的 33 篇文章中，61%的文章提出了支持的论点，15%的文章提出了反对的论点，12%的文章同时提出了正反两方面的论点，12%的文章只提到了该要求的存在或波多黎各卫生部门的公告。支持的论点集中在癌症预防、HPV 相关癌症的高发病率和人群健康上。反对的论点包括对 HPV 性传播的担忧、HPV 疫苗的副作用、与政策相关的问题（如强制性）以及缺乏教育。
了解人们支持或反对 HPV 疫苗入学要求的原因对于成功实施政策过程非常重要。教育工作必须继续改变 HPV 疫苗的叙述。应该精心制作信息，在家长和利益相关者中教育和争取支持，以实施这一基于人群的癌症预防策略。
