Abstract
BackgroundTo identify the barriers and facilitators to uptake of the HPV vaccine in an ethnically diverse group of young women in the south west of England.MethodsThree school-based vaccination sessions were observed. Twenty-three young women aged 12 to 13 years, and six key informants, were interviewed between October 2012 and July 2013. Data were analysed using thematic analysis and the Framework method for data management.ResultsThe priority given to preventing cervical cancer in this age group influenced whether young women received the HPV vaccine. Access could be affected by differing levels of commitment by school staff, school nurses, parents and young women to ensure parental consent forms were returned. Beliefs and values, particularly relevant to minority ethnic groups, in relation to adolescent sexual activity may affect uptake. Literacy and language difficulties undermine informed consent and may prevent vaccination.ConclusionsThe school-based HPV vaccination programme successfully reaches the majority of young women. However, responsibility for key aspects remain unresolved which can affect delivery and prevent uptake for some groups. A multi-faceted approach, targeting appropriate levels of the socio-ecological model, is required to address procedures for consent and cultural and literacy barriers faced by minority ethnic groups, increase uptake and reduce inequalities.
Highlights
To identify the barriers and facilitators to uptake of the human papillomavirus (HPV) vaccine in an ethnically diverse group of young women in the south west of England
The priority given to preventing cervical cancer in this age group influenced whether young women received the HPV vaccine
The school-based HPV vaccination programme successfully reaches the majority of young women
Summary
To identify the barriers and facilitators to uptake of the HPV vaccine in an ethnically diverse group of young women in the south west of England. Equitable uptake of UK HPV vaccination programmes has been demonstrated in relation to deprivation indices.[2,3,4] This is encouraging given that socioeconomically disadvantaged women are more likely to develop cervical cancer[5] yet less likely to attend for screening.[6,7] in the south west of England, the odds ratio of HPV vaccination initiation in young women belonging to minority ethnic groups is approximately half in comparison to White British young women.[4] Lower uptake has been shown in other UK settings.[3,8]. This is of concern as Asian and Black women aged over 65 years may be at increased risk of developing cervical cancer,[9] but less likely to attend for cervical cancer screening.[10,11]
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