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      “We brought our culture here with us”: A qualitative study of perceptions of HPV vaccine and vaccine uptake among East African immigrant mothers

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          Abstract

          Background

          HPV vaccine studies in East African communities are few and focus mainly on Somali women and girls. We examined how HPV vaccine perceptions and uptake are shaped among Somali, Ethiopian, and Eritrean mothers.

          Methods

          We convened three focus groups in Somali, Amharic, and Tigrinya with mothers of 11–17 year old children. The Socio-Context Framework (social, cultural, and religious factors) and Andersen's Behavioral Model (predisposing, enabling, and need for care factors) informed question development.

          Results

          Negative vaccine perceptions, lack of HPV vaccine knowledge, and concerns about side effects emerged as predisposing factors. Having a provider who engages parents on HPV vaccination and takes responsibility for vaccine-related risks emerged as enabling factors. Availability of vaccine information resources (e.g., person-to-person, word of mouth education for parents) were also enabling factors. Need for care factors included having comprehensive vaccine information, strong recommendation from a doctor, and validation from a co-ethnic medical professional. Women exerted strong social influence on vaccine uptake (social), had concerns about pork gelatin in vaccines (religious), and felt discussions about sex with children were culturally unacceptable (cultural).

          Conclusion

          Strategies for vaccine uptake among East African immigrants need to address factors that shape HPV vaccine perceptions for adolescents, caregivers, and providers.

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          Most cited references30

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          Qualitative content analysis: a guide to paths not taken.

          D. Morgan (1993)
          Counting codes makes qualitative content analysis a controversial approach to analyzing textual data. Several decades ago, mainstream content analysis rejected qualitative content analysis on the grounds that it was not sufficiently quantitative; today, it is often charged with not being sufficiently qualitative. This article argues that qualitative content analysis is distinctively qualitative in both its approach to coding and its interpretations of counts from codes. Rather than argue over whether to do qualitative content analysis, researchers must make informed decisions about when to use it in analyzing qualitative data.
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            National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2017

            The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of persons aged 11–12 years with human papillomavirus (HPV) vaccine, quadrivalent meningococcal conjugate vaccine (MenACWY), and tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap). A booster dose of MenACWY is recommended at age 16 years ( 1 ), and catch-up vaccination is recommended for hepatitis B vaccine (HepB), measles, mumps, and rubella vaccine (MMR), and varicella vaccine (VAR) for adolescents whose childhood vaccinations are not up to date (UTD) ( 1 ). ACIP also recommends that clinicians may administer a serogroup B meningococcal vaccine (MenB) series to adolescents and young adults aged 16–23 years, with a preferred age of 16–18 years ( 2 ). To estimate U.S. adolescent vaccination coverage, CDC analyzed data from the 2017 National Immunization Survey–Teen (NIS-Teen) for 20,949 adolescents aged 13–17 years.* During 2016–2017, coverage increased for ≥1 dose of HPV vaccine (from 60.4% to 65.5%), ≥1 dose of MenACWY (82.2% to 85.1%), and ≥2 doses of MenACWY (39.1% to 44.3%). Coverage with Tdap remained stable at 88.7%. In 2017, 48.6% of adolescents were UTD with the HPV vaccine series (HPV UTD) compared with 43.4% in 2016. † On-time vaccination (receipt of ≥2 or ≥3 doses of HPV vaccine by age 13 years) also increased. As in 2016, ≥1-dose HPV vaccination coverage was lower among adolescents living in nonmetropolitan statistical areas (MSAs) (59.3%) than among those living in MSA principal cities (70.1%). § Although HPV vaccination initiation remains lower than coverage with MenACWY and Tdap, HPV vaccination coverage has increased an average of 5.1 percentage points annually since 2013, indicating that continued efforts to target unvaccinated teens and eliminate missed vaccination opportunities might lead to HPV vaccination coverage levels comparable to those of other routinely recommended adolescent vaccines.
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              Editorial: Popular concerns about medical research projects in sub-Saharan Africa--a critical voice in debates about medical research ethics.

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                Author and article information

                Contributors
                Journal
                Papillomavirus Res
                Papillomavirus Res
                Papillomavirus Research
                Elsevier
                2405-8521
                27 December 2018
                June 2019
                27 December 2018
                : 7
                : 21-25
                Affiliations
                [a ]Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N, M3-B232, Seattle, WA 98102 USA
                [b ]Department of Health Services, University of Washington School of Public Health, 1959 NE Pacific Street, Magnuson Health Sciences Bldg. Box 357660, Seattle, WA 98195 USA
                [c ]Department of Epidemiology, University of Washington, Box 359933, 325 9th Ave, Seattle, WA 98104 USA
                [d ]Department of Pediatrics, University of Washington, Harborview Medical Center, 325 9th Ave, Seattle, WA 98104, USA
                [e ]Somali Health Board, 7050 32nd AVE S. Seattle, WA 98118 USA
                Author notes
                [* ]Correspondence to: Department of Epidemiology, University of Washington, Box 359933, 325 9th Ave, Seattle, WA 98104, USA. rlw@ 123456uw.edu
                Article
                S2405-8521(18)30019-3
                10.1016/j.pvr.2018.12.003
                6319298
                30594650
                41ccc617-95a1-4d85-9d5d-f0e2aea9bd2f
                © 2018 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 17 March 2018
                : 29 October 2018
                : 26 December 2018
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