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. 2024 Jan 4;24(1):91.
doi: 10.1186/s12889-023-17540-4.

Information needs of ethnically diverse, vaccine-hesitant parents during decision-making about the HPV vaccine for their adolescent child: a qualitative study

Harriet Fisher  1 , Sarah Denford  2 , Suzanne Audrey  2 , Adam Finn  2   3 , Huda Hajinur  4 , Matthew Hickman  2 , Sandra Mounier-Jack  5   6 , Asha Mohamed  4 , Marion Roderick  7 , Leanne Tucker  8 , Julie Yates  9 , Tracey Chantler  5   6
Affiliations

Information needs of ethnically diverse, vaccine-hesitant parents during decision-making about the HPV vaccine for their adolescent child: a qualitative study

Harriet Fisher et al. BMC Public Health. .

Abstract
in English, German

Background: The English schools-based human papillomavirus (HPV) vaccination programme has the potential to eliminate HPV-related cancers if high uptake is achieved. However, unmet information needs among some parents may contribute to persisting lower uptake among minority ethnic groups. Through this study we aimed to understand the information needs of vaccine-hesitant, ethnically diverse parents during decision-making about the HPV vaccine for their adolescent child, to inform the future development of tailored communication materials.

Methods: Recruitment was facilitated thorough healthcare and community organisations within London and the South West of England. Semi-structured interviews took place between April and August 2023. Thematic analysis was undertaken, assisted by NVivo software.

Results: Of the 29 parents interviewed, the majority were mothers (79%), belonged to a minority ethnic group (88%), and had an adolescent child unvaccinated against HPV (72%). Five of the interviews were undertaken in the participants' primary language with translation support. Most parents interviewed had limited knowledge about the HPV vaccine and appeared conflicted as to whether vaccines could offer benefits to health. Misunderstanding around the potential of developing serious side-effects (e.g. fertility issues, developing cancer) were factors that could negatively impact decision-making by parents. Stigma associated with the sexual transmissibility of HPV did not always negatively impact decision-making. However, some parents chose not to vaccinate on the basis of perceptions of low risk and a preference to provide education about sexual behaviours to their adolescent child.

Conclusions: Tailoring communication materials to address misunderstandings could support informed decision-making by vaccine hesitant parents for their adolescent children to be vaccinated against HPV. Future communication materials about the HPV vaccine should highlight the benefits of protection against cancer to increase parents' motivation for protect their adolescent child; provide accurate convincing information in relation to the excellent safety profile; and emphasise the importance of providing HPV vaccine at the recommended age, all alongside communicating the universality and commonality of HPV infection.

Trial registration: N/A.

Uptake of the English schools-based HPV vaccination programme has decreased in recent years, and is especially low among young people from minority ethnic groups.Addressing vaccine hesitant parents’ information needs may support positive HPV vaccine decision-making and improve uptake.Information needs about the HPV vaccine were elicited through interviews with vaccine hesitant, ethnically diverse parents.Tailoring communication materials to address misunderstandings could support informed decision-making about the HPV vaccine.Future communication materials should highlight the benefits of the HPV vaccine, provide transparent information about the safety profile and side-effects, and emphasise the universality and commonality of HPV infection.

Keywords: Ethnic minority; HPV vaccine; Information needs; Parents; Qualitative; Vaccine hesitant.

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Conflict of interest statement

AF is a member of the Joint Committee on Vaccination and Immunization (JCVI) and was, until December 2022 chair of the World Health Organization European Technical Advisory Group of Experts on Immunization (ETAGE) committee. The other authors have no relevant conflicts of interest to declare.

References

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