Why do some parents choose not to vaccinate against HPV?

What is HPV?

Human papillomavirus, also known as HPV, is a common virus that affects the skin and moist areas that line the body, such as the cervix. It is spread by skin-to-skin contact and can be transmitted through sexual activity. Most people will come into contact with HPV at some point in their life, and in most cases the body will get rid of the virus on its own. However, in some cases the virus can cause cell changes which can increase the risk of some cancers, such as cervical cancer. There are over 100 different types of HPV, but two types in particular (types 16 and 18) cause 70% of cases.

In 2008 a vaccination was introduced which protects against these two types of HPV. It also protects against two other types of HPV that don’t cause cancer, but do cause genital warts. The vaccination is mainly given through schools to girls aged 12-13 (in school year 8). The vaccine is given in two separate injections.

Why was this study done?

Most girls get the vaccination but as we’ve written before, there are some girls who do not. Research has shown that girls from ethnic minority backgrounds are less likely to have the vaccination than White British girls. In our new study, published this week, we investigated why this might be the case.

What did we do?

We did thirty-three face-to-face interviews with parents from ethnic minority backgrounds, whose daughters both had and had not got the vaccine. We also did interviews with parents from White British backgrounds, whose daughters had not got the vaccine, so that we could see whether there were any differences between what parents from different ethnic backgrounds were saying. All but one of the people we interviewed were mothers.

What did we find?

Parents have concerns about the vaccine

Parents had concerns about side effects of the vaccine and its effectiveness, despite the vaccine being recognised as safe by the UK government and World Health Organisation. Some parents were worried that the benefits of having the vaccination might not outweigh the risks. Other parents worried that it might encourage girls to be more sexually active.

Other people’s opinions and experiences are important

Some parents’ vaccination decisions were affected by things they had heard from other people about the vaccination. A number of parents had got information from others about the vaccine and some parents had heard about girls who happened to become unwell after having the vaccine and whose parents thought this must have been caused by the vaccine.

Parents need more information

Many parents had not heard about the vaccine before their daughter was invited to have it. Some parents felt like they had not been provided with enough information about the vaccine and others chose to research it themselves.

 Some parents prefer to protect their daughters using other methods

Although there isn’t any evidence that complementary medicines can prevent HPV, some parents preferred to use them instead of vaccination and some encouraged a healthy lifestyle to prevent illness. Others thought that better ways to prevent their daughter from getting an HPV infection would be to encourage them to have safe sex, to educate them about sex or for their daughters to not have sex before marriage. A few parents believed illness was caused by things outside their control, such as God.

Some parents don’t trust authorities

A number of parents believed that the introduction of the vaccine was driven by pharmaceutical companies wanting to make money. Some of these parents lacked faith in the government and why it had chosen to introduce the vaccine.

Emotions influence vaccination decisions

Some parents felt that they might regret the decision if they vaccinated, whilst others felt they might regret their decision if they did not.

What did we conclude?

In general, many of the things parents spoke to us about were said by parents from all different ethnic backgrounds. However, there were some issues that were only brought up by parents from ethnic minority backgrounds. These included preferring their daughters to wait until marriage before having sex and believing that cervical cancer is caused by things that are out of their control.

The results of this study suggest to us that any future attempts to try and increase uptake of the vaccination need to consider issues that are important to parents from ethnic minority backgrounds. It may be helpful to involve community group leaders and religious leaders when designing future interventions, to ensure that it is appropriate and well considered.