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Acceptability of two- versus three-dose human papillomavirus vaccination schedule among providers and mothers of adolescent girls: a mixed-methods study in five countries

Islam JY 1 , Hoyt AM 2 , Ramos S 3 , Morgan K 4 , Kim CJ 5 , de Sanjose S 6 Show all authors , Butera N 7 , Senkomago V 2 , Richter KL 8 , McDonald MA 9 , Vielot NA 10 , Smith JS 11

Affiliations 

  • 1 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
  • 2 Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
  • 3 Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
  • 4 Perdana University School of Medicine, Seri Kembangan, Malaysia
  • 5 Department of Obstetrics and Gynecology, The Catholic University of Korea College of Medicine, St. Paul's Hospital, Seoul, South Korea
  • 6 Infections and Cancer, Cancer Epidemiology Research Programme, Institut Català d'Oncologia, Barcelona, Spain
  • 7 Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
  • 8 Department of Medical Virology, University of Pretoria, National Health Laboratory Service, Pretoria, South Africa
  • 9 Center on Genomics, Race, Identity, Difference, Duke University, Durham, NC, USA
  • 10 Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
  • 11 Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA. JenniferS@unc.edu
Cancer Causes Control, 2018 Nov;29(11):1115-1130.
PMID: 30284670 DOI: 10.1007/s10552-018-1085-1

Abstract

PURPOSE: The World Health Organization revised its human papillomavirus (HPV) vaccination recommendations to include a two (2-) dose schedule for girls aged ≤ 15 years. We investigated acceptability of 2- versus 3-dose schedule among adolescent vaccination providers and mothers of adolescent girls in five countries.

METHODS: Adolescent vaccination providers (N = 151) and mothers of adolescent girls aged 9-14 years (N = 118) were recruited from Argentina, Malaysia, South Africa, South Korea, and Spain. We assessed providers' preference for a 2- versus 3-dose HPV vaccination schedule via quantitative surveys. Mothers' attitudes towards a 2-dose schedule were assessed through focus group discussions.

RESULTS: Most adolescent providers preferred a 2- over a 3-dose HPV vaccination schedule (overall: 74%), with preference ranging from 45.2% (South Africa) to 90.0% (South Korea). Lower cost, fewer clinic visits, and higher series completion were commonly cited reasons for 2-dose preference among providers and mothers. Safety and efficacy concerns were commonly cited barriers to accepting a 2-dose HPV vaccination schedule among providers and mothers. Mothers generally accepted the reduced schedule, however requested further information from a trusted source.

CONCLUSIONS: Adolescent vaccination providers and mothers preferred the 2-dose over 3-dose HPV vaccination schedule. Acceptability of a 2-dose HPV vaccination could be improved with additional information to providers and mothers on HPV vaccination safety and efficacy.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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