“THOSE WHO LOVE, VACCINATE”: PARENTAL PERCEPTIONS OF HPV VACCINATION
DOI:
https://doi.org/10.7322/jhgd.106013Palavras-chave:
Brazil, papillomavirus, vaccination, parental perceptions, adolescent health.Resumo
Introduction: In March 2014, Brazil began its national HPV immunization campaign targeting girls ages 9-13. Objective: Describe determinants of parental decisions to vaccinate their daughters against HPV.Method: In this qualitative study, thirty semi-structured interviews were conducted at five health posts in São Paulo, Brazil. Interview questions explored parental opinions of disease prevention methods, vaccines in general, and the HPV vaccine. Interviews were analyzed using grounded theory. Results: Overall, parental knowledge about HPV and the vaccine was low, yet most eligible daughters had been vaccinated. Parents perceived the HPV vaccine to be normal, preventative, and protective. Parents viewed themselves as accountable for their children’s health, and saw the vaccine as a parenting tool for indirect control. Trust in healthcare professionals and an awareness of the dangers of “nowadays” (uncertainties regarding disease and sexual behavior) were also important in vaccine decision-making. These factors held more explanatory power for decisions to vaccinate than parental knowledge levels. This was the first study to qualitatively examine the perception of publically provided HPV vaccination among parents with eligible daughters in Brazil. The findings help interpret the greater than 90% coverage for the first HPV vaccine dose in Brazil. The results indicate that attempts to understand, maintain, or modify vaccination rates require the consideration of context specific factors, which influence both parent perspectives and vaccination decisions. Conclusion: HPV knowledge levels are not predictive of parental decisions to vaccinate daughters. Context specific factors from the sociocultural dimensions of parenting, sexuality, gender, and the healthcare system are more influential in vaccine decision-making.Downloads
Referências
Hopkins TG, Wood N. Female human papillomavirus (HPV)vaccination: global uptake and the impact of attitudes. Vaccine. 2013;31(13):1673-9. DOI: http://dx.doi.org/1016/j.vaccine. 2013. 01.028.
Bosch FX, Lorincz A, Munoz N, Meijer CJLM, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol. 2002; 55(4):244-65.
Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsagué X, Shah K V, et al. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 348(6): 518-27. DOI: http://dx.doi.org/10.1056/NEJMoa021641.
Bruni L, Barrionuevo-Rosas L, Albero G, Aldea M, Serrano B, Valencia S, et al. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in India. Summary Report; 2015.
Organização Pan-Americana da Saúde (OPAS). Organização Mundial da Saúde. (OMS). Cervical Cancer. [cited 2014 aug 26] Available from: http://www.paho.org/ hq/index.php?option=com_content&view= category&layout=blog&id=3595&Itemid=3637
Sistema de Informação do Programa Nacional de Imunizações (SI-PNI). Estratégia de vacinação contra HPV: Percentual da população de 10 a 14 anos vacinada contra HPV em anos anteriores a implantação da vacina HPV pelo PNI-total Brasil-2013. [cited 2014 aug 26] Available from: http://pni.datasus.gov.br/consulta_hpv_14_C07.php
Sistema de Informação do Programa Nacional de Imunizações (SI-PNI). Estratégia de vacinação contra HPV: vacinômetro D1; total Brasil-2014. [cited 2014 aug 26] Available from: http://pni.datasus.gov.br/consulta _hpv_ 14_C01.phphttp:///h.
Ministério da Saúde. Secretaria de Vigilância em Saúde Departamento de Vigilância de Doenças Transmissíveis. Guia pratico HPV perguntas e respostas. Brasília: Coordenação Geral do Programa Nacional de Imunizações; 2014.
Caetano ME, Linhares IM, Pinotti JA, da Fonseca AM, Wojitani MD, Giraldo PC. Sexual behavior and knowledge of sexually transmitted infections among university students in Sao Paulo, Brazil. Int J Gynecol Obstet. 2010;110(1):43-6. DOI: http://dx.doi.org/10.1016/j.ijgo.2010.02.012.
Costa LA, Goldenberg P. Human papillomavirus (HPV) among youth: a warning sign. Saúde Soc. 22(1):249-61. DOI: http://dx.doi.org/10.1590/S0104-12902013000100022.
Rama CH, Villa LL, Pagliusi S, Andreoli MA, Costa MC, Aoki AL, et al. Awareness and knowledge of HPV, cervical cancer, and vaccines in young women after first delivery in São Paulo, Brazil- a cross-sectional study. BMC Women’s Health. 2010;10:35. DOI: http://dx.doi.org/10.1186/1472-6874-10-35.
Fregnani JH, Carvalho AL, Eluf-Neto J, Ribeiro Kde C, Kuil Lde M, da Silva TA, et al. A schoolbased human papillomavirus vaccination program in barretos, Brazil: final results of a demonstrative study. PLoS One. 2013;8(4):e62647. DOI: http://dx.doi.org/10.1371/journal.pone.0062647.
Osis MJD, Duarte GA, de Sousa MH. SUS users’ knowledge of and attitude to HPV virus and vaccines available in Brazil. Rev Saúde Publica. 2014;48(1):123-33. DOI: http://dx.doi.org/10.1590/S0034-8910.2014048005026.
Couto MT, Barbieri CLA. Care and (non)- vaccination in the context of highincome and well-schooled families in São Paulo in the state of São Paulo, Brazil. Ciênc Saúde Coletiva. 2015;20(1):105-14. DOI: http://dx.doi.org/10.1590/1413-81232014201.21952013
Davis K, Dickman ED, Ferris D, Dias JK. Human papillomavirus vaccine acceptability among parents of 10-to 15-yearold adolescents. J Low Genit Tract Dis. 2004;8(3):188-94.
Kahn JA, Rosenthal SL, Hamann T, Bernstein DI. Attitudes about human papillomavirus vaccine in young women. Int J STD AIDS. 2003;14(5):300-6. DOI: http://dx.doi.org/10.1258/095646203321605486.
Brewer NT, Fazekas KI. Predictors of HPV vaccine acceptability: a theory-informed, systematic review. Prev Med. 2007;45(2-3):107-14. DOI: http://dx.doi.org/10.1016/j.ypmed.2007.05.013.
Dursun P, Altuntas B, Kuscu E, Ayhan A. Women’s knowledge about human papillomavirus and their acceptance of HPV vaccine. Aust N Z J Obstet Gynaecol. 2009;49(2):202-6. DOI: http://dx.doi.org/10.1111/j.1479-828X.2009.00947.x.
Jaspers L, Budiningsih S, Wolterbeek R, Henderson FC, Peters AAW. Parental acceptance of human papillomavirus (HPV) vaccination in Indonesia: a cross-sectional study. Vaccine. 2011;29(44): 7785-93. DOI: http://dx.doi.org/10.1016/j.vaccine.2011.07.107.
Lenselink CH, Gerrits MM, Melchers WJ, Massuger LF, van Hamont D, Bekkers RL. Parental acceptance of Human Papillomavirus vaccines. Eur J Obstet Gynecol Reprod Biol. 2008;137(1):103-7. DOI: http://dx.doi.org/10.1016/j.ejogrb.2007.02.012.
Perkins RB, Pierre-Joseph N, Marquez C, Iloka S, Clark JA. Why do lowincome minority parents choose human papillomavirus vaccination for their daughters? J Pediatr. 2010; 157(4): 617-22. DOI: http://dx.doi.org/10.1016/j.jpeds.2010.04.013.
Walsh CD, Gera A, Shah M, Sharma A, Powell JE, Wilson S. Public knowledge and attitudes towards Human Papilloma Virus (HPV) vaccination. BMC public Health. 2008;8:368. DOI: http://dx.doi.org/10.1186/1471-2458-8-368.
Dempsey AF, Zimet GD, Davis RL, Koutsky L. Factors that are associated with parental acceptance of human papillomavirus vaccines: a randomized intervention study of written information about HPV. Pediatrics. 2006;117(5): 1486-93. DOI: http://dx.doi.org/10.1542/peds.2005-1381
Lazcano-Ponce E, Rivera L, Arillo-Santillán E, Salmerón J, Hernández-Avila M, Muñoz N. Acceptability of a humanpapillomavirus (HPV) trial vaccine amongmothers of adolescents in Cuernavaca, Mexico. Arch Med Res. 2001;32(3): 243-7.
Benin AL, Wisler-Scher DJ, Colson E, Shapiro ED, Holmboe ES. Qualitative analysis of mothers’ decisionmaking about vaccines for infants: the importance of trust. Pediatrics. 2006; 117(5):1532-41. DOI: http://dx.doi.org/10.1542/peds.2005-1728.
Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;(esp): 80-94.
Streefland P, Chowdhury AM, Ramos-Jimenez P. Patterns of vaccination acceptance. Soc Sci Med. 1999;49(12): 1705-16.
Cover JK, Nghi NQ. LaMontagne DS, Huyen DTT, Hien NT, Nga LT. Acceptance patterns and decision-making for human papillomavirus vaccination among parents in Vietnam: an indepth qualitative study post-vaccination. BMC Public Health. 2012;12:629. http://dx.doi.org/10.1186/1471-2458-12-629.
Marlow LA, Forster AS, Wardle J, Waller J. Mothers’ and adolescents’ beliefs about risk compensation following HPVvaccination. J Adolesc Health. 2009; 44(5):446-51. DOI: http://dx.doi.org/10.1016/j.jadohealth.2008.09.011
Downloads
Publicado
Edição
Seção
Licença
CODE OF CONDUCT FOR JOURNAL PUBLISHERS
Publishers who are Committee on Publication Ethics members and who support COPE membership for journal editors should:
- Follow this code, and encourage the editors they work with to follow the COPE Code of Conduct for Journal Edi- tors (http://publicationethics.org/files/u2/New_Code.pdf)
- Ensure the editors and journals they work with are aware of what their membership of COPE provides and en- tails
- Provide reasonable practical support to editors so that they can follow the COPE Code of Conduct for Journal Editors (http://publicationethics.org/files/u2/New_Code.pdf_)
Publishers should:
- Define the relationship between publisher, editor and other parties in a contract
- Respect privacy (for example, for research participants, for authors, for peer reviewers)
- Protect intellectual property and copyright
- Foster editorial independence
Publishers should work with journal editors to:
- Set journal policies appropriately and aim to meet those policies, particularly with respect to:
– Editorial independence
– Research ethics, including confidentiality, consent, and the special requirements for human and animal research
– Authorship
– Transparency and integrity (for example, conflicts of interest, research funding, reporting standards
– Peer review and the role of the editorial team beyond that of the journal editor
– Appeals and complaints
- Communicate journal policies (for example, to authors, readers, peer reviewers)
- Review journal policies periodically, particularly with respect to new recommendations from the COPE
- Code of Conduct for Editors and the COPE Best Practice Guidelines
- Maintain the integrity of the academic record
- Assist the parties (for example, institutions, grant funders, governing bodies) responsible for the investigation of suspected research and publication misconduct and, where possible, facilitate in the resolution of these cases
- Publish corrections, clarifications, and retractions
- Publish content on a timely basis