Malawian caregivers' experiences with HPV vaccination for preadolescent girls: A qualitative study.

Autor:	Moucheraud C; Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California Los Angeles, 650 Charles E Young Drive S, Los Angeles, CA 90095, USA., Whitehead HS; Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA., Songo J; Partners in Hope, Area 36 Plot 8, Lilongwe, Malawi., Szilagyi PG; Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA., Hoffman RM; Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA., Kaunda-Khangamwa BN; MAC-Communicable Diseases Action Centre, Kamuzu University of Health Sciences, Queen Elizabeth Central Hospital, Chipatala Avenue, Blantyre, Malawi.; School of Public Health, University of the Witwatersrand, Wits Education Campus, 27 St Andrews Road, Parktown 2193, Johannesburg, South Africa.
Jazyk:	angličtina
Zdroj:	Vaccine: X [Vaccine X] 2023 May 16; Vol. 14, pp. 100315. Date of Electronic Publication: 2023 May 16 (Print Publication: 2023).
DOI:	10.1016/j.jvacx.2023.100315
Abstrakt:	Introduction: Many low- and middle-income countries have introduced the human papillomavirus (HPV) vaccine, but uptake remains extremely low. Malawi has the second-highest incidence of cervical cancer globally, and launched a national HPV vaccination program in 2019. We sought to understand attitudes about, and experiences with, the HPV vaccine among caregivers of eligible girls in Malawi. Methods: We conducted qualitative interviews with 40 caregivers (parents or guardians) of preadolescent girls in Malawi to understand their experiences with HPV vaccination. We coded the data informed by the Behavioural and Social Drivers of vaccine uptake model and recommendations from WHO's Strategic Advisory Group of Experts Working Group on Vaccine Hesitancy. Results: In this sample, 37% of age-eligible daughters had not received any HPV vaccine doses, 35% had received 1 dose, 19% had received 2 doses, and 10% had an unknown vaccination status. Caregivers were aware of the dangers of cervical cancer, and understood that HPV vaccine is an effective prevention tool. However, many caregivers had heard rumors about the vaccine, particularly its alleged harmful effect on girls' future fertility. Many caregivers, especially mothers, felt that school-based vaccination was efficient; but some caregivers expressed disappointment that they had not been more engaged in the school-based delivery of HPV vaccine. Caregivers also reported that the COVID-19 pandemic has been disruptive to vaccination. Conclusions: There are complex and intersecting factors that affect caregivers' motivation to vaccinate their daughters against HPV, and the practical challenges that caregivers may encounter. We identify areas for future research and intervention that could contribute to cervical cancer elimination: better communicating about vaccine safety (particularly to address concerns about loss of fertility), leveraging the unique advantages of school-based vaccination while ensuring parental engagement, and understanding the complex effects of the COVID-19 pandemic (and vaccination program). Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Corrina Moucheraud reports financial support was provided by University of California Los Angeles Jonsson Comprehensive Cancer Center. (© 2023 The Author(s).)
Databáze:	MEDLINE
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