Reasons for receiving or not receiving HPV vaccination in primary schoolgirls in Tanzania: a case control study.

<h4>Background</h4>There are few data on factors influencing human papillomavirus (HPV) vaccination uptake in sub-Saharan Africa. We examined the characteristics of receivers and non-receivers of HPV vaccination in Tanzania and identified reasons for not receiving the vaccine.<h4>M...

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Main Authors: Deborah Watson-Jones, Keith Tomlin, Pieter Remes, Kathy Baisley, Riziki Ponsiano, Selephina Soteli, Silvia de Sanjosé, John Changalucha, Saidi Kapiga, Richard J Hayes
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0045231
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author Deborah Watson-Jones
Keith Tomlin
Pieter Remes
Kathy Baisley
Riziki Ponsiano
Selephina Soteli
Silvia de Sanjosé
John Changalucha
Saidi Kapiga
Richard J Hayes
author_facet Deborah Watson-Jones
Keith Tomlin
Pieter Remes
Kathy Baisley
Riziki Ponsiano
Selephina Soteli
Silvia de Sanjosé
John Changalucha
Saidi Kapiga
Richard J Hayes
author_sort Deborah Watson-Jones
collection DOAJ
description <h4>Background</h4>There are few data on factors influencing human papillomavirus (HPV) vaccination uptake in sub-Saharan Africa. We examined the characteristics of receivers and non-receivers of HPV vaccination in Tanzania and identified reasons for not receiving the vaccine.<h4>Methods</h4>We conducted a case control study of HPV vaccine receivers and non-receivers within a phase IV cluster-randomised trial of HPV vaccination in 134 primary schools in Tanzania. Girls who failed to receive vaccine (pupil cases) and their parents/guardians (adult cases) and girls who received dose 1 (pupil controls) of the quadrivalent vaccine (Gardasil™) and their parents/guardians (adult controls) were enrolled from 39 schools in a 1∶1 ratio and interviewed about cervical cancer, HPV vaccine knowledge and reasons why they might have received or not received the vaccine. Conditional logistic regression was used to determine factors independently associated with not receiving HPV vaccine.<h4>Results</h4>We interviewed 159 pupil/adult cases and 245 pupil/adult controls. Adult-factors independently associated with a daughter being a case were older age, owning fewer household items, not attending a school meeting about HPV vaccine, and not knowing anyone with cancer. Pupil-factors for being a case included having a non-positive opinion about the school de-worming programme, poor knowledge about the location of the cervix, and not knowing that a vaccine could prevent cervical cancer. Reasons for actively refusing vaccination included concerns about side effects and infertility. Most adult and pupil cases reported that they would accept the HPV vaccine if it were offered again (97% and 93% respectively).<h4>Conclusions</h4>Sensitisation messages, especially targeted at older and poorer parents, knowledge retention and parent meetings are critical for vaccine acceptance in Tanzania. Vaccine side effects and fertility concerns should be addressed prior to a national vaccination program. Parents and pupils who initially decline vaccination should be given an opportunity to reconsider their decision.
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spelling doaj-art-d34d8ef3e82145f09d617e80579855b02025-08-20T02:34:54ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01710e4523110.1371/journal.pone.0045231Reasons for receiving or not receiving HPV vaccination in primary schoolgirls in Tanzania: a case control study.Deborah Watson-JonesKeith TomlinPieter RemesKathy BaisleyRiziki PonsianoSelephina SoteliSilvia de SanjoséJohn ChangaluchaSaidi KapigaRichard J Hayes<h4>Background</h4>There are few data on factors influencing human papillomavirus (HPV) vaccination uptake in sub-Saharan Africa. We examined the characteristics of receivers and non-receivers of HPV vaccination in Tanzania and identified reasons for not receiving the vaccine.<h4>Methods</h4>We conducted a case control study of HPV vaccine receivers and non-receivers within a phase IV cluster-randomised trial of HPV vaccination in 134 primary schools in Tanzania. Girls who failed to receive vaccine (pupil cases) and their parents/guardians (adult cases) and girls who received dose 1 (pupil controls) of the quadrivalent vaccine (Gardasil™) and their parents/guardians (adult controls) were enrolled from 39 schools in a 1∶1 ratio and interviewed about cervical cancer, HPV vaccine knowledge and reasons why they might have received or not received the vaccine. Conditional logistic regression was used to determine factors independently associated with not receiving HPV vaccine.<h4>Results</h4>We interviewed 159 pupil/adult cases and 245 pupil/adult controls. Adult-factors independently associated with a daughter being a case were older age, owning fewer household items, not attending a school meeting about HPV vaccine, and not knowing anyone with cancer. Pupil-factors for being a case included having a non-positive opinion about the school de-worming programme, poor knowledge about the location of the cervix, and not knowing that a vaccine could prevent cervical cancer. Reasons for actively refusing vaccination included concerns about side effects and infertility. Most adult and pupil cases reported that they would accept the HPV vaccine if it were offered again (97% and 93% respectively).<h4>Conclusions</h4>Sensitisation messages, especially targeted at older and poorer parents, knowledge retention and parent meetings are critical for vaccine acceptance in Tanzania. Vaccine side effects and fertility concerns should be addressed prior to a national vaccination program. Parents and pupils who initially decline vaccination should be given an opportunity to reconsider their decision.https://doi.org/10.1371/journal.pone.0045231
spellingShingle Deborah Watson-Jones
Keith Tomlin
Pieter Remes
Kathy Baisley
Riziki Ponsiano
Selephina Soteli
Silvia de Sanjosé
John Changalucha
Saidi Kapiga
Richard J Hayes
Reasons for receiving or not receiving HPV vaccination in primary schoolgirls in Tanzania: a case control study.
PLoS ONE
title Reasons for receiving or not receiving HPV vaccination in primary schoolgirls in Tanzania: a case control study.
title_full Reasons for receiving or not receiving HPV vaccination in primary schoolgirls in Tanzania: a case control study.
title_fullStr Reasons for receiving or not receiving HPV vaccination in primary schoolgirls in Tanzania: a case control study.
title_full_unstemmed Reasons for receiving or not receiving HPV vaccination in primary schoolgirls in Tanzania: a case control study.
title_short Reasons for receiving or not receiving HPV vaccination in primary schoolgirls in Tanzania: a case control study.
title_sort reasons for receiving or not receiving hpv vaccination in primary schoolgirls in tanzania a case control study
url https://doi.org/10.1371/journal.pone.0045231
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