Attitudes and Beliefs of Parents About HPV Vaccination in Their Daughters During COVID-19 Pandemic: A Cross Sectional Study

Abstract

Objective: This study aimed to determine parents’ current attitudes and beliefs using a standardised scale towards Human Papilloma Virus and its vaccine during COVID-19 Pandemic. Material and Methods: This is a descriptive cross sectional study including a total of 303 parents who applied to a training and research hospital pediatric clinic with a daughter aged 9-18 years old. A demographic variable questionnaire and The Turkish version of the Carolina Human Papilloma Virus Immunization Attitudes Scale (CHIAS) were assessed. Results: The Turkish version of the Carolina Human Papilloma Virus Immunization Attitudes Scale mean± SD scores of harms/barriers/effectiveness/uncertainty factors subgroup were calculated as 2.2±0.6, 2.5±0.7, 2.3±0.7, 2.9±0.8, respectively. 19.8% of parents were aware of Human Papilloma Virus and 22.5% of them declared to be willing to vaccinate their daughters against the infection. Human Papilloma Virus acceptance rate was still modest and lower than for vaccines in general during COVID-19 Pandemic. Conclusion: According to the result of this study, during COVID-19 Pandemic, the both female and male awareness and intention to vaccinate their daughters against Human Papilloma Virus is low. This is the first study analyzing parents’ current attitudes and beliefs using a standardised scale towards Human Papilloma Virus in Turkey and also is the first analyzing this subject during COVID-19 pandemic in the literature. Health education programs given by family doctors, pediatricians and community health professionals to parents is critically important in accepting this vaccine.

Keywords

• Human Papilloma Virus
• Vaccination
• Covid-19
• Parents
• Awareness

Ebeveynlerin COVİD-19 Pandemisi Sırasında Kız Çocuklarına HPV Aşısı Yaptırılmasına İlişkin Tutum ve İnançları: Kesitsel Bir Çalışma

Abstract

Amaç: Bu çalışma, COVİD-19 Pandemisi sırasında ebeveynlerin Human Papilloma Virüsü ve aşısına yönelik standart bir ölçek kullanarak mevcut tutum ve inançlarını belirlemeyi amaçlamıştır. Gereç ve Yöntemler: Bu çalışma, bir eğitim ve araştırma hastanesi çocuk kliniğine 9-18 yaşlarında kız çocuğu ile başvuran toplam 303 ebeveynin dahil edildiği tanımlayıcı kesitsel bir çalışmadır. Bir demografik veri anketi ve Carolina Human Papilloma Virüsü Bağışıklama Tutumları Ölçeğinin (CHIAS) Türkçe versiyonu ile değerlendirme yapılmıştır. Bulgular: Zararlar/engeller/etkililik/belirsizlik faktörleri alt grubunun Carolina Human Papilloma Virüsü Bağışıklama Tutumları Ölçeği’nin ortalama±SS puanları sırasıyla 2.2±0.6, 2.5±0.7, 2.3±0.7, 2.9±0.8 olarak hesaplandı. Ebeveynlerin %19.8’i Human Papilloma Virüsün’den haberdardı ve %22.5’i kızlarını enfeksiyona karşı aşılamak istediğini bildirdi. Human Papilloma Virüsü kabulü, COVİD-19 Pandemisi sırasında hala yetersiz ve rutinde uygulanan aşılardan daha düşüktü. Sonuç: Bu çalışmanın sonucuna göre, COVİD-19 Pandemisi sırasında hem kadınların hem de erkeklerin kız çocuklarını Human Papilloma Virüsü’ne karşı aşılama konusundaki farkındalıkları ve istekleri düşüktür. Bu çalışma, Türkiye’de ebeveynlerin Human Papilloma Virüsü’ne yönelik mevcut tutum ve inançlarını standart bir ölçek kullanarak analiz eden ilk çalışmadır ve aynı zamanda literatürde bu konuyu COVİD-19 Pandemisi sırasında analiz eden ilk çalışmadır. Aile hekimleri, çocuk doktorları ve toplum sağlığı uzmanları tarafından ebeveynlere verilen sağlık eğitim programları, bu aşının kabul edilmesinde kritik öneme sahiptir.

Keywords

• Human Papilloma Virüsü
• Aşılama
• Ebeveynler
• COVİD-19

References

1. Cheng L, Wang Y and Du J. Human Papillomavirus Vaccines. An updated review. Vaccines 2020; 8: 391.
2. Chesson HW, Dunne EF, Hariri SS and Markowitz LE. The estimated lifetime probability of acquiring human papillomavirus in the United States. Sex Transm Dis 2014;41: 660-4.
3. Freddie Bray, Jacques Ferlay, Isabelle Soerjomataram, Siegel R, Torre LA and Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2018; 68: 394-24.
4. Sanjosé S, Diaz M, Castellsagué X, Gary C, Bruni L, Munoz N and Bosch FX. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: A meta-analysis. Lancet Infect Dis 2007;7: 453–9.
5. OMS. Guide to introducing HPV vaccine into national immunization programmes. World Health Organization: Geneva, Switzerland, 2016. (https://apps.who.int/iris/handle/10665/253123)
6. US Centers for Disease Control and Prevention. HPV | who should get vaccine | human papillomavirus. Available at: https://www.cdc.gov/hpv/parents/vaccine.html. Accessed June 21, 2019.
7. Acampora A, Grossi A, Barbara A, Colamesta V, Causio FA, Calabro GE, et al. Increasing HPV vaccination uptake among adolescents: A systematic review. Int J Environ Res Public Health 2020; 17: 7997.
8. Shah PD, Calo WA, Gilkey MB, Boynton MH, Dailey SU, Todd KG, et al. Questions and concerns about HPV vaccine: A Communication Experiment. Pediatrics 2019; 143: e20181872.

9. Grandahl M, Paek CS, Grisurapong S, Sherer P, Tyden T, Lundberg P. Parents’ knowledge, beliefs, and acceptance of the HPV vaccination in relation to their socio-demographics and religious beliefs: A cross-sectional study in Thailand. PLoS One 2018;13: e0193054.
10. Griffioen AM, Glynn S, Mullins TK, Zimmet GD, Rosenthal SL, Fortenberry JD, et al. Perspectives on decision making about human papillomavirus vaccination among 11- to 12-year-old girls and their mothers. Clin Pediatr (Phila) 2012;51: 560–8.
11. Zimet GD, Rosenthal SL. HPV vaccine and males: issues and challenges. Gynecol Oncol 2010;117: S26–31.
12. Özdemir S, Akkaya R, Karaşahin KE. Analysis of community-based studies related with knowledge, awareness, attitude, and behaviors towards HPV and HPV vaccine published in Turkey: A systematic review. J Turk Ger Gynecol Assoc 2020; 21: 111-23.
13. Gür E. Vaccine hesitancy - vaccine refusal. Turk Pediatr Ars 2019; 4: 1–2.
14. Turkish medical association- press briefing; (2018) Vaccine rejection and hesitancy https://dosyasb.saglik.gov.tr .https://doi.org/10.1080/21645515.2020.1717182. Accessed November 7, 2019.
15. Ryan G, Gilbert PA, Ashid S, Charlton ME, Scherer A and Askelson NM. Challenges to adolescent HPV vaccination and implementation of evidence-based interventions to promote vaccine uptake during the COVID-19 pandemic “HPV is probably not at the top of our list”. Prev Chronic Dis 2022;19: E15.
16. McRee AL, Brewer NT, Reiter PL, Gottlieb SL, Smith JS. The Carolina HPV immunization attitudes and beliefs scale (CHIAS): scale development and associations with intentions to vaccinate. Sex Transm Dis 2010; 37: 234-9.
17. Sunar S, Süt HK. Carolina Turkish validity and reliability study of the HPV vaccination attitudes and beliefs scale. Gynecology - Obstetrics and Neonatology Medical Journal 2019; 2: 82-8.
18. Cuschieri S. The STROBE guidelines. Saudi J Anaesth 2019; 13(Suppl 1): S31-S34.
19. Seven M, Güvenç G, Şahin E, Akyüz A. Attitudes to HPV vaccination among parents of children aged 10-13 years. J Pediart Adolesc Gynecol 2015; 28: 382-6.
20. Kilic A, Seven M, Guvenc G, Akyüz A and Ciftci S. Acceptance of Human Papillomavirus Vaccine by adolescent girls and their parents in Turkey. Asian Pac J Cancer Prev 2012; 13: 4267-72.
21. Lopez N, Sancez MG, Panizo MB, de la Cueva IS, Artes MT, Ramos B, et al. HPV knowledge and vaccine acceptance among European adolescents and their parents: a systematic review. Public Health Reviews 2020; 41:10.
22. Zhu L, Zhai S, Siu PT, Xia HY, Lai S, Zambrona CN, et al. Factors related to Chinese parents’ HPV vaccination intention for children. Am J Health Behav 2019; 43: 994-1005.
23. Liebermann E, Devanter NV, Gúzman NF, Ompad D, Shirazian T and Healton C. Parent-Level Barriers and Facilitators to HPV Vaccine Implementation in Santo Domingo, Dominican Republic. J Community Health 2020; 45: 1061-6.