Mothers' attitudes towards preventing cervical cancer through human papillomavirus vaccination: a qualitative study

Abstract

Prophylactic vaccines against human papillomavirus (HPV) types causing cervical cancer will soon be available. Success of the vaccine relies on parents' willingness to vaccinate their prepubescent daughters. We explored mothers' attitudes towards vaccination. Twenty-four mothers of girls ages 8 to 14 years took part in four focus groups. Discussions covered attitudes to vaccination in general, cancer vaccines, vaccines for sexually transmitted infections (STI), and the HPV vaccine. Discussions were recorded, transcribed, and analyzed thematically. Mothers were broadly provaccination. Some were excited about a cancer vaccine, although there were fears that it might lead to unhealthy behaviors (e.g., smoking). STI vaccines got a mixed reception. Enthusiasm was moderated by concerns about an increase in risky sexual behavior. When provided with information about the HPV vaccine, women were in favor of protecting their daughters from cervical cancer, abnormal Papanicolaou results and, potentially, from cervical screening. Some worried about an increase in promiscuity and risk of other STIs. There was disagreement about the age at which girls should be vaccinated. Although some women thought this question should be medically driven, others were concerned about discussing the vaccine with young girls and preferred to wait until they were older. In conclusion, mothers were broadly in favor of HPV vaccination but had reservations, particularly about vaccinating girls as young as 10. Larger-scale quantitative work is needed to assess acceptability at the population level. If the vaccine is introduced, information provision is likely to be key to ensuring parents understand the rationale for vaccinating at a young age.