TY  - JOUR
T1  - SOciocultural issues in the introduction of human papillomavirus vaccine in low-resource settings
AU  - Bingham A, Drake J, LaMontagne D
Y1  - 2009/05/04
N1  - 10.1001/archpediatrics.2009.50
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 455
EP  - 461
VL  - 163
IS  - 5
N2  - Objectives 
    (1) To synthesize sociocultural results from diverse populations related to vaccine decision-making, understanding of cervical cancer and its etiology, experience with previous vaccinations, human papillomavirus (HPV) vaccine concerns, and information needed to foster acceptance; (2) to contextualize findings in light of recent studies; and (3) to discuss implications for communication strategies to facilitate vaccine acceptance.Design 
    Descriptive qualitative synthesis of sociocultural studies in 4 countries using iterative theme-based analyses.Setting 
    Four developing countries: India, Peru, Uganda, and Vietnam.Participants 
    Criterion-based sample of 252 focus-group discussions and 470 in-depth interviews with children, parents, teachers/administrators, health workers/managers, and community/religious leaders. A knowledge, attitudes, and practices survey was administered to 879 children and 875 parents in Vietnam.Results 
    We found that vaccine decision-making was primarily done by parents, with children having some role. Understanding of cervical cancer and HPV was limited; however, the gravity of cancer and some symptoms of cervical cancer were recognized. Vaccination and government-sponsored immunization programs were generally supported by respondents. Sentiments toward cervical cancer vaccines were positive, but concerns about quality of delivery, safety, adverse effects, and the effect on fertility were raised. Communities requested comprehensive awareness-raising and health education to address these concerns.Conclusion 
    Sociocultural studies help elucidate the complexities of introducing a new vaccine from the perspective of children, parents, and communities. Strategies for introducing the HPV vaccine should address community concerns through effective communication, appropriate delivery, and targeted advocacy to make the program locally relevant.
SN  - 1072-4710
M3  - doi: 10.1001/archpediatrics.2009.50
UR  - http://dx.doi.org/10.1001/archpediatrics.2009.50
ER  -