HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe

doi:10.1080/21645515.2018.1564436

. 2019;15(7-8):1615-1627.

doi: 10.1080/21645515.2018.1564436. Epub 2019 Feb 20.

HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe

Emilie Karafillakis¹, Clarissa Simas¹, Caitlin Jarrett^{2

3}, Pierre Verger^{4

5

6

7}, Patrick Peretti-Watel^{4

5

6

7}, Fadia Dib^{8

9

10}, Stefania De Angelis¹¹, Judit Takacs¹², Karam Adel Ali¹¹, Lucia Pastore Celentano¹¹, Heidi Larson^{1

13}

Affiliations

¹ a Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM) , London , UK.
² b Swiss Centre for International Health, Swiss Tropical and Public Health Institute , Basel , Switzerland.
³ c Universität Basel , Basel , Switzerland.
⁴ d Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection , Marseille , France.
⁵ e ORS PACA, Southeastern Health Regional Observatory , Marseille , France.
⁶ f Aix Marseille Université, UMR_S 912, IRD , Marseille , France.
⁷ g INSERM, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), GH Cochin Broca Hôtel Dieu , Paris , France.
⁸ h INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology , Paris , France.
⁹ i INSERM CIC 1417, F-CRIN, I-REIVAC , Paris , France.
¹⁰ j Assistance Publique Hopitaux de Paris (AP-HP), Hôpital Cochin, CIC Cochin , Pasteur, Paris , France.
¹¹ k Vaccine Preventable Disease Programme, European Centre for Disease Prevention and Control , Stockholm , Sweden.
¹² l Centre for Social Sciences, Hungarian Academy of Sciences , Budapest , Hungary.
¹³ m Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington , Seattle , USA.

PMID: 30633623
PMCID: PMC6783136
DOI: 10.1080/21645515.2018.1564436

HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe

Emilie Karafillakis et al. Hum Vaccin Immunother. 2019.

. 2019;15(7-8):1615-1627.

doi: 10.1080/21645515.2018.1564436. Epub 2019 Feb 20.

Authors

Affiliations

¹ a Department of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM) , London , UK.
² b Swiss Centre for International Health, Swiss Tropical and Public Health Institute , Basel , Switzerland.
³ c Universität Basel , Basel , Switzerland.
⁴ d Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection , Marseille , France.
⁵ e ORS PACA, Southeastern Health Regional Observatory , Marseille , France.
⁶ f Aix Marseille Université, UMR_S 912, IRD , Marseille , France.
⁷ g INSERM, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), GH Cochin Broca Hôtel Dieu , Paris , France.
⁸ h INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Department of Social Epidemiology , Paris , France.
⁹ i INSERM CIC 1417, F-CRIN, I-REIVAC , Paris , France.
¹⁰ j Assistance Publique Hopitaux de Paris (AP-HP), Hôpital Cochin, CIC Cochin , Pasteur, Paris , France.
¹¹ k Vaccine Preventable Disease Programme, European Centre for Disease Prevention and Control , Stockholm , Sweden.
¹² l Centre for Social Sciences, Hungarian Academy of Sciences , Budapest , Hungary.
¹³ m Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington , Seattle , USA.

PMID: 30633623
PMCID: PMC6783136
DOI: 10.1080/21645515.2018.1564436

Abstract

Europe is increasingly described as the region in the world with the least confidence in vaccination, and particularly in the safety of vaccines. The aim of this systematic literature review was to gather and summarise all peer-reviewed and grey literature published about determinants of Human Papillomavirus (HPV) vaccine hesitancy in Europe. Ten thematic categories were identified across the 103 articles which were included in the review. Participants from European studies most commonly reported issues with the quantity and quality of information available about HPV vaccination; followed by concerns about potential side effects of the vaccine; and mistrust of health authorities, healthcare workers, and new vaccines. Comparative analyses indicated that confidence determinants differed by country and population groups. This evidence supports the need to develop context-specific interventions to improve confidence in HPV vaccination and design community engagement strategies aiming to build public trust.

Keywords: HPV; HPV vaccination; cervical cancer; vaccine confidence vaccination; vaccine hesitancy.

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Figures

**Figure 2.**
Average proportions of hesitant participants who reported certain categories of determinants of HPV vaccine hesitancy, by country.

**Figure 3.**
Average proportions of hesitant participants who reported certain categories of determinants of HPV vaccine hesitancy, by population groups.

See this image and copyright information in PMC

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References

1. Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S.. Human Papillomavirus and related diseases in Europe. Summary report. Barcelona, Spain: ICO Information Centre on HPV and Cancer (HPV Information Centre); 2017. July 27.
1. Bruni L, Diaz M, Barrionuevo-Rosas L, Herrero R, Bray F, Bosch FX, de Sanjosé S, Castellsagué X. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. Lancet Glob Health. 2016;4(7):e453–e63. doi:10.1016/S2214-109X(16)30099-7. - DOI - PubMed
1. Karafillakis E, Larson HJ, Consortium A. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine. 2017;35(37):4840–50. Epub 2017/ 08/02. doi:10.1016/j.vaccine.2017.07.061. - DOI - PubMed
1. European Centre for Disease Prevention and Control Rapid literature review on motivating hesitant population groups in Europe to vaccinate. Stockholm, Sweden: ECDC; 2015.
1. Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007–2012. Vaccine. 2014;32(19):2150–59. doi:10.1016/j.vaccine.2014.01.081. - DOI - PubMed

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[1] Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S.. Human Papillomavirus and related diseases in Europe. Summary report. Barcelona, Spain: ICO Information Centre on HPV and Cancer (HPV Information Centre); 2017. July 27.

[2] Bruni L, Barrionuevo-Rosas L, Albero G, Serrano B, Mena M, Gómez D, Muñoz J, Bosch FX, de Sanjosé S.. Human Papillomavirus and related diseases in Europe. Summary report. Barcelona, Spain: ICO Information Centre on HPV and Cancer (HPV Information Centre); 2017. July 27.

[3] Bruni L, Diaz M, Barrionuevo-Rosas L, Herrero R, Bray F, Bosch FX, de Sanjosé S, Castellsagué X. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. Lancet Glob Health. 2016;4(7):e453–e63. doi:10.1016/S2214-109X(16)30099-7. - DOI - PubMed

[4] Bruni L, Diaz M, Barrionuevo-Rosas L, Herrero R, Bray F, Bosch FX, de Sanjosé S, Castellsagué X. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. Lancet Glob Health. 2016;4(7):e453–e63. doi:10.1016/S2214-109X(16)30099-7. - DOI - PubMed

[5] Karafillakis E, Larson HJ, Consortium A. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine. 2017;35(37):4840–50. Epub 2017/ 08/02. doi:10.1016/j.vaccine.2017.07.061. - DOI - PubMed

[6] Karafillakis E, Larson HJ, Consortium A. The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations. Vaccine. 2017;35(37):4840–50. Epub 2017/ 08/02. doi:10.1016/j.vaccine.2017.07.061. - DOI - PubMed

[7] European Centre for Disease Prevention and Control Rapid literature review on motivating hesitant population groups in Europe to vaccinate. Stockholm, Sweden: ECDC; 2015.

[8] European Centre for Disease Prevention and Control Rapid literature review on motivating hesitant population groups in Europe to vaccinate. Stockholm, Sweden: ECDC; 2015.

[9] Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007–2012. Vaccine. 2014;32(19):2150–59. doi:10.1016/j.vaccine.2014.01.081. - DOI - PubMed

[10] Larson HJ, Jarrett C, Eckersberger E, Smith DM, Paterson P. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007–2012. Vaccine. 2014;32(19):2150–59. doi:10.1016/j.vaccine.2014.01.081. - DOI - PubMed

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HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe

Affiliations

HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe

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