Acceptability of multipurpose human papillomavirus vaccines among providers and mothers of adolescent girls: A mixed-methods study in five countries

Nadja A Vielot; Shoshana K Goldberg; Gregory Zimet; Sara B Smith; Mary Anne McDonald; Silvina Ramos; Karen Morgan; Chan Joo Kim; Karin L Richter; Merce Peris; Kevin J Whaley; Jennifer S Smith

doi:10.1016/j.pvr.2017.04.001

Acceptability of multipurpose human papillomavirus vaccines among providers and mothers of adolescent girls: A mixed-methods study in five countries

Papillomavirus Res. 2017 Jun:3:126-133. doi: 10.1016/j.pvr.2017.04.001. Epub 2017 Apr 6.

Authors

Affiliations

¹ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB# 7435, Chapel Hill, NC 27599, USA. Electronic address: nadjavielot@unc.edu.
² Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB# 7435, Chapel Hill, NC 27599, USA.
³ Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
⁴ Center on Genomics, Race, Identity, Difference (GRID), Duke University, Durham, NC, USA.
⁵ Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina.
⁶ Perdana University, Royal College of Surgeons in Ireland School of Medicine, Kuala Lumpur, Malaysia; Royal College of Surgeons in Ireland, Dublin, Ireland, UK.
⁷ Department of Obstetrics and Gynecology, The Catholic University of Korea, Medical College, St Paul's Hospital, Seoul, Korea.
⁸ Department of Medical Virology, University of Pretoria and National Health Laboratory Services, Pretoria, South Africa.
⁹ Unit of Infections and Cancer, Cancer Epidemiology Research Programme, Institut Català d'Oncologia, Barcelona, Spain.
¹⁰ Mapp Biopharmaceutical, Inc., San Diego, CA, USA.
¹¹ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB# 7435, Chapel Hill, NC 27599, USA; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.

Abstract

Introduction: Multipurpose vaccines (MPVs) could be formulated to prevent multiple sexually transmitted infections simultaneously. Little is known about acceptability of MPVs among vaccine health care providers (HCPs) or mothers of adolescent girls.

Methods: 151 adolescent vaccine providers and 118 mothers of adolescent girls aged 9-14 were recruited from five geographically-diverse countries: Argentina, Malaysia, South Africa, South Korea, and Spain. We assessed providers' preferences for single-purpose human papillomavirus (HPV) vaccine versus MPVs (including HPV+herpes simplex virus (HSV)-2, HPV+HIV, or HPV+HSV-2+HIV) via quantitative surveys. Maternal MPV attitudes were assessed in four focus group discussions (FGDs) in each country.

Results: Most providers preferred MPVs over single-purpose HPV vaccination, with preference ranging from 61% in Malaysia to 96% in South Africa. HPV+HSV-2+HIV was the most preferred MPV formulation (56-82%). Overall, 53% of the mothers preferred MPVs over single-purpose HPV vaccines, with strongest support in South Africa (90%) and lowest support in South Korea (29%). Convenience and trust in the health care system were commonly-cited reasons for MPV acceptability. Safety and efficacy concerns were common barriers to accepting MPVs, though specific concerns differed by country. Across FGDs, additional safety and efficacy information on MPVs were requested, particularly from trusted sources like HCPs.

Conclusions: Though maternal acceptability of MPVs varied by country, MPV acceptability would be enhanced by having HCPs provide parents with additional MPV vaccine safety and efficacy information. While most providers preferred MPVs, future health behavior research should identify acceptability barriers, and targeted provider interventions should equip providers to improve vaccination discussions with parents.

Keywords: Acceptability; Adolescents; Human papillomavirus; Multipurpose; Sexually transmitted infections; Vaccines.

Abstract

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