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      Not the right time: why parents refuse to let their daughters have the human papillomavirus vaccination

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          Abstract

          Aim

          To explore why parents refused to allow their 10- to 12-year-old daughters to receive the human papillomavirus (HPV) vaccination from the Swedish school-based vaccination programme.

          Methods

          Individual interviews with 25 parents who had been offered, but not consented to, their daughters receiving the HPV vaccination.

          Results

          Five themes emerged through the interviews: 1) she is just a little girl, 2) inadequate information, 3) not compatible with our way of life, 4) scepticism about the vaccination and 5) who can you trust? The parents made their decisions with their child's best interests in mind. This was not considered the right time, and the vaccine was perceived as unnecessary and different from other vaccines. Mistrust in Government recommendations and a lack of evidence or information were other reasons to decline.

          Conclusion

          The decision-making process was complex. These parents preferred to wait until their daughter was older and believed the information they received from the school health system was insufficient. The results indicate that a more flexible HPV vaccination schedule may improve vaccine uptake. This includes more transparent information about the virus and the vaccine and information about who to contact to get the daughter vaccinated at a later date.

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          Most cited references22

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          Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a phase III double-blind, randomised controlled trial

          The Lancet, 369(9580), 2161-2170
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            Analysing and presenting qualitative data.

            This paper provides a pragmatic approach to analysing qualitative data, using actual data from a qualitative dental public health study for demonstration purposes. The paper also critically explores how computers can be used to facilitate this process, the debate about the verification (validation) of qualitative analyses and how to write up and present qualitative research studies.
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              Human papillomavirus vaccine introduction--the first five years.

              The availability of prophylactic human papillomavirus (HPV) vaccines has provided powerful tools for primary prevention of cervical cancer and other HPV-associated diseases. Since 2006, the quadrivalent and bivalent vaccines have each been licensed in over 100 countries. By the beginning of 2012, HPV vaccine had been introduced into national immunization programs in at least 40 countries. Australia, the United Kingdom, the United States, and Canada were among the first countries to introduce HPV vaccination. In Europe, the number of countries having introduced vaccine increased from 3 in 2007 to 22 at the beginning of 2012. While all country programs target young adolescent girls, specific target age groups vary as do catch-up recommendations. Different health care systems and infrastructure have resulted in varied implementation strategies, with some countries delivering vaccine in schools and others through health centers or primary care providers. Within the first 5 years after vaccines became available, few low- or middle-income countries had introduced HPV vaccine. The main reason was budgetary constraints due to the high vaccine cost. Bhutan and Rwanda implemented national immunization after receiving vaccine through donation programs in 2010 and 2011, respectively. The GAVI Alliance decision in 2011 to support HPV vaccination should increase implementation in low-income countries. Evaluation of vaccination programs includes monitoring of coverage, safety, and impact. Vaccine safety monitoring is part of routine activities in many countries. Safety evaluations are important and communication about vaccine safety is critical, as events temporally associated with vaccination can be falsely attributed to vaccination. Anti-vaccination efforts, in part related to concerns about safety, have been mounted in several countries. In the 5 years since HPV vaccines were licensed, there have been successes as well as challenges with vaccine introduction and implementation. Further progress is anticipated in the coming years, especially in low- and middle-income countries where the need for vaccine is greatest. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. Published by Elsevier Ltd.
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                Author and article information

                Journal
                Acta Paediatr
                Acta Paediatr
                apa
                Acta Paediatrica (Oslo, Norway : 1992)
                BlackWell Publishing Ltd (Oxford, UK )
                0803-5253
                1651-2227
                April 2014
                08 January 2014
                : 103
                : 4
                : 436-441
                Affiliations
                [1 ]Department of Public Health and Caring Sciences, Uppsala University Uppsala, Sweden
                [2 ]School of Health and Caring Sciences, Linneus University Kalmar, Sweden
                [3 ]Department of Women's and Children's Health, Uppsala University Uppsala, Sweden
                Author notes
                Correspondence M Grandahl, Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22 Uppsala, Sweden., Tel: +46184716672 |, Fax: +46 18 471 6675 |, Email: maria.grandahl@ 123456pubcare.uu.se
                Article
                10.1111/apa.12545
                4383348
                24460679
                8cb09eb2-2cca-4ef3-b7a3-624766730ab0
                ©2013 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

                This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 07 August 2013
                : 11 November 2013
                : 16 December 2013
                Categories
                Regular Articles

                Pediatrics
                decision-making,human papillomavirus,parents,school,vaccination programmes
                Pediatrics
                decision-making, human papillomavirus, parents, school, vaccination programmes

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