??‘Why it’s not for us’: the views of parents and girls in the UK who declined the HPV vaccination – a qualitative study


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Alison Clements1,Lorna Henderson1,Joan Austoker1
1University of Oxford, Oxford, United Kingdom


The UK HPV vaccination programme for girls aged 12-13 years commenced in autumn 2008. At the time of implementation it was not known what the vaccination uptake would be, or on what basis decisions to accept or decline the vaccination would be made. As part of a larger study to develop and evaluate key HPV messages relevant to eligible girls, parents and health professionals, a qualitative study was conducted to explore the reasons for non-uptake among girls and their parents.  This is one of the first studies to examine and report on the behavioural responses to HPV vaccination invitation, and the underlying rationales.


Invitations to participate were sent via school nurses within one UK Primary Care Trust to all girls aged 12-13 years who had declined the offer of the HPV vaccination, and to their parents. In-depth, one-one interviews were carried out with all responding girls (15), and parents (20). Parents and girls were interviewed individually; a thematic analysis of verbatim transcripts was undertaken.


Reported reasons from the girls and parents for non-uptake of the HPV vaccination included: the behavioural relevance of vaccination; feeling pressured for an immediate decision with insufficient information; the perception of girls as ‘guinea pigs’ for an unproven vaccine; uncertainty about the duration of protection offered, and the impact of personal health histories and other health-related experiences. Information needs which underpinned the reasons for non-acceptance of the vaccination were identified. Decision-making was shown to be a considered and thorough process, with the desire for detailed rather than superficial information.


Information needs were identified either by the participants, or were apparent through their stated (mis)understandings.  These findings have the potential to assist in the development of interventions to ensure that vaccination decisions are made not on misunderstandings about HPV and the vaccine, but on an informed basis.