Abstract
BackgroundSweden introduced a school-based human papillomavirus (HPV) vaccination programme in 2012, and school nurses are responsible for managing the vaccinations. The aim of the present study was to investigate the attitudes and experiences of school nurses regarding the school-based HPV vaccination programme 1 year after its implementation.MethodsData were collected using a web-based questionnaire in the spring of 2013, and 83.1% (851/1024) of nurses responded.ResultsThere were strong associations between the nurses’ education about the HPV vaccine and their perceived knowledge about the vaccine and a favourable attitude towards vaccination (both p < 0.001). School nurses who received a high level of education were more likely to have a positive attitude to HPV vaccination compared with nurses with little education about HPV vaccination (adjusted odds ratio [OR] = 9.8; 95% confidence interval [CI]: 3.797–25.132). Nurses with high perceived knowledge were more likely to have a positive attitude compared with those with a low level of perceived knowledge (OR = 2.5; 95% CI: 1.299–4.955). If financial support from the government was used to fund an additional school nurse, nurses were more likely to have a positive attitude than if the financial support was not used to cover the extra expenses incurred by the HPV vaccination (OR = 2.1; 95% CI: 1.051–4.010). The majority, 648 (76.1%), had been contacted by parents with questions about the vaccine, mostly related to adverse effects. In addition, 570 (66.9%) stated that they had experienced difficulties with the vaccinations, and 337 (59.1%) of these considered the task to be time-consuming.ConclusionsA high level of education and perceived good knowledge about HPV are associated with a positive attitude of school nurses to the HPV vaccination programme. Thus, nurses require adequate knowledge, education, skills and time to address the questions and concerns of parents, as well as providing information about HPV. Strategic financial support is required because HPV vaccination is a complex and time-consuming task.
Highlights
Sweden introduced a school-based human papillomavirus (HPV) vaccination programme in 2012, and school nurses are responsible for managing the vaccinations
There were statistically significant differences in attitudes to HPV vaccination related to perceived knowledge about HPV vaccination (p < 0.001) and education received about HPV (p < 0.001)
The majority of nurses strongly or partially agreed that it was appropriate that HPV vaccinations were introduced into the general childhood vaccination programme and that school nurses should be responsible for the vaccinations
Summary
Sweden introduced a school-based human papillomavirus (HPV) vaccination programme in 2012, and school nurses are responsible for managing the vaccinations. The aim of the present study was to investigate the attitudes and experiences of school nurses regarding the school-based HPV vaccination programme 1 year after its implementation. Human papillomavirus (HPV) vaccination programmes for girls aged 9–14 years have been implemented in many countries worldwide [1,2]. In 2012, the quadrivalent HPV vaccine was introduced in a Swedish school-based vaccination programme for girls aged 10–12 years. All school-based vaccinations are free of charge, but parents must provide consent [8]. School nurses are responsible for managing all aspects of the vaccinations, including the logistics, providing information to parents and girls, and administration of the vaccine. The principal of each school is responsible for the distribution of this funding
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