Understanding ethnic disparities in uptake of HPV vaccination in England: A comparative qualitative study


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Alice Forster1,Lauren Rockliffe1,Laura Marlow1,Emily McBride1,Jo Waller1
1UCL

Abstract

Background

Uptake of human papillomavirus (HPV) vaccination for the prevention of HPV-related cancers is lower among girls from Black and Asian Minority Ethnic (BAME) backgrounds in the UK (Fisher et al. 2013). We aimed to shed light on this issue by exploring if 1) there are concerns expressed by non-vaccinating parents from BAME backgrounds that are not expressed by non-vaccinating parents from White British backgrounds, and 2) if any of these concerns are also expressed by vaccinating parents from BAME backgrounds.

Method

We interviewed 33 parents: 14 from BAME and 9 from White British backgrounds whose daughters had not received the HPV vaccine, and 10 from BAME backgrounds whose daughters had received the vaccine. Data were analysed using Framework Analysis.

Results

Only non-vaccinating parents from BAME backgrounds expressed doubt about the necessity of vaccination because of their preference for abstinence from sex before marriage. Fear and anticipation of regret about vaccinating were also only expressed by non-vaccinating parents from BAME backgrounds, adding further weight to their decisions to not vaccinate. Both vaccinating and non-vaccinating BAME parents felt that vaccine information should have been provided via workshops, but White British non-vaccinating parents did not express this view. Parents from all backgrounds expressed concerns about the safety and necessity of HPV vaccination. These concerns were partly driven by discussion with others, past experience of vaccines and distrust of health professionals, the government and pharmaceutical companies.

Conclusion

Low uptake of HPV vaccination among girls from BAME backgrounds may be explained, in part, by parents’ preferences for abstinence from sex before marriage, fear and anticipation of regret about vaccinating. Such factors may be targets for interventions to improve uptake among BAME groups. Face-to-face meetings may be a preferred means of information provision among BAME communities.