Academic journal article American Journal of Health Education

HPV Vaccine Acceptance in a Clinic-Based Sample of Women in the Rural South

Academic journal article American Journal of Health Education

HPV Vaccine Acceptance in a Clinic-Based Sample of Women in the Rural South

Article excerpt


Background: Human papillomavirus (HPV) is a very common sexually transmitted infection linked to cervical disease. Vaccines for some types of HPV were in development at the time of the study. Purpose: The study examined HPV vaccine acceptability among underserved women in a rural region of the southeastern U.S. with high rates of cervical cancer for development of future educational interventions. Methods: A clinic-based sample of women (aged 18-64; ASCUS or higher and tested for HPV DNA) completed a telephone interview (response rate = 78%). Results: Among participants who had ever heard of HPV (n=108), 81% were "very likely" to get the vaccine and 72% would have their daughter vaccinated. These participants desired information about vaccine safety (100%), efficacy (100%), side effects (100%), clinician recommendation (96%), cost (94%), and composition of the vaccine (94%). Cost was identified as the main barrier (55%). Among a subset of participants who reported HPV positivity (n=49), younger age, being single, and high HPV knowledge level were associated with specific types of desired information before getting the HPV vaccine. Discussion: Similar to previously reported vaccine acceptability studies, acceptance among participants in this rural region of the south was also high. Participants also desired more information about the vaccine. Translation to Health Education Practice: Public health educational efforts must address health education issues related to vaccine acceptability and increase HPV knowledge and understanding.


Genital human papillomavirus (HPV) infection is a very common sexually transmitted infection (STI) in the United States (US). (1) Persistent high-risk HPV infection is necessary, but not sufficient to cause the most common types of invasive cervical cancer. (2-6) Most genital HPV infections are transient and are resolved by a healthy immune system within nine months to a year. (7) However, the financial and psychosocial burden associated with cervical dysplasia and cervical cancer as a result of genital HPV infection is high. (8,9)

Two HPV vaccines (Cervarix[TM] by GlaxoSmithKline, Rixensart, Belgium and Gardasil[R] by Merck & Company, Rahway, NJ, United States) have undergone testing. (10) Results show the HPV vaccines to be highly efficacious in preventing short-term markers of cervical disease and genital warts. (10-15) Merck & Company, Inc. recently (June 2006) received FDA licensure for its HPV vaccine, Gardasil[R], which is a prophylactic, quadrivalent vaccine for two types of high-risk HPV (16 and 18) and two types of low-risk HPV (6 and 11). (16) These types are responsible for 90% of genital warts worldwide and found in 70% of cervical cancers. (10, 17) The CDC Advisory Committee on Immunization Practices (ACIP), which issues recommendations on vaccine administration in the U.S., recently recommended that the newly licensed vaccine be routinely given to girls when they are 11-12 years old. (16) The ACIP recommendation also allows for vaccination of girls beginning at nine years of age and catch up doses in females 13-26 years old. (16)

Recommendations for administering the vaccine to adolescent girls and young women have changed the target audience for cervical cancer prevention and control efforts to include parents, adolescents and pediatricians, in addition to gynecologists and primary care providers, who have been involved for years in cervical cancer screening efforts. (18) The success of HPV vaccines lies in the acceptability of the vaccine by the target audience as well as the ability of the public health and medical systems to deliver the vaccine effectively, which is a continued source of discussion. (15, 19-30) In South Carolina, rates of cervical cancer are high and innovations, such as HPV vaccines, have the potential to decrease mortality in the long term. (31,32)

Recent findings have shown relatively high levels of acceptance of HPV vaccines pre- and post-approval of the first vaccine, Gardasil[R]. …

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