Comprehensive Cancer Center-University of Puerto Rico, Cancer Control and Population Sciences, San Juan, Puerto Rico.
Department of Health Services Administration, Graduate School of Public Health, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico.
BMC Public Health. 2021 Oct 25;21(1):1938. doi: 10.1186/s12889-021-11952-w.
The Human papillomavirus vaccine (HPV) is an essential tool for the prevention of HPV-related cancers. In Puerto Rico, the Secretary of Health established a school entry requirement of at least one dose of HPV vaccination in girls and boys aged 11 and 12 years, taking effect in August 2018. Our study aimed to examine parents' and guardians' views of unvaccinated children about the process of implementation of the new HPV vaccination school entry policy in Puerto Rico and identify potential barriers and facilitators related to the implementation of this requirement.
During April through November 2019, we conducted three focus groups (n = 12) and eight in-depth semi-structured interviews with parents of children aged 11 and 12 who had not yet initiated the HPV vaccine series. The interview topics addressed were: perception of vaccination, HPV vaccine and it is inclusion as new school entry requirement practice, procedure of the sources of information, influencers, and willingness to change. The interviews were recorded and transcribed by our staff members. We identified emergent themes through thematic analysis.
The participants' perspective on the HPV vaccine school requirement was mixed. Lack of information of the HPV vaccines and lack of communication about the school-entry requirement were the themes most mentioned in the interviews. Moreover, previous negative experiences from friends or family members and adverse effects deterred some participants from vaccinating their kids. We discussed barriers in the process of soliciting an exemption.
Most barriers mentioned by study participants are modifiable. Information about the HPV vaccine mandate's implementation and educational materials regarding HPV vaccine safety need to be provided to address parents' concerns related to the vaccine's side effects. Schools (teachers, principal directors, and administrative staff), the government, and parent organizations need to be part of these efforts. This multilevel approach will help to improve disseminating information about HPV vaccination to clarify doubts and misinformation among parents.
人乳头瘤病毒疫苗（HPV）是预防 HPV 相关癌症的重要工具。在波多黎各，卫生部长规定了 11 岁和 12 岁女孩和男孩接种 HPV 疫苗的最低剂量要求，该要求于 2018 年 8 月生效。我们的研究旨在检查父母对未接种疫苗的儿童的看法，了解在波多黎各实施新的 HPV 疫苗接种学校入学政策的过程，并确定与实施这一要求相关的潜在障碍和促进因素。
在 2019 年 4 月至 11 月期间，我们对 11 岁和 12 岁尚未开始 HPV 疫苗系列接种的儿童的父母进行了三次焦点小组（n=12）和八次深入的半结构化访谈。访谈主题包括：对疫苗接种的看法、HPV 疫苗及其作为新入学要求的纳入情况、信息来源、影响者和改变意愿的程序。我们的工作人员对访谈进行了录音和转录。我们通过主题分析确定了出现的主题。
参与者对 HPV 疫苗学校要求的看法喜忧参半。缺乏 HPV 疫苗的信息以及缺乏有关入学要求的沟通是访谈中最常提到的主题。此外，来自朋友或家人的先前负面经历和不良反应使一些参与者不愿意给孩子接种疫苗。我们讨论了在申请豁免时遇到的障碍。
研究参与者提到的大多数障碍都是可以改变的。需要提供有关 HPV 疫苗授权实施的信息和有关 HPV 疫苗安全性的教育材料，以解决父母对疫苗副作用的担忧。学校（教师、校长和行政人员）、政府和家长组织需要参与这些努力。这种多层次的方法将有助于改善 HPV 疫苗接种信息的传播，以澄清父母的疑虑和误解。
