DOI QR코드

DOI QR Code

Vaccine Misconceptions and Low HPV Vaccination Take-up Rates in Singapore

  • Tay, SK (Department of Obstetrics and Gynaecology, Singapore General Hospital) ;
  • Tesalona, KC (Department of Obstetrics and Gynaecology, Singapore General Hospital) ;
  • Mohamed Rashid, N (Department of Obstetrics and Gynaecology, Singapore General Hospital) ;
  • Tai, EYS (Department of Obstetrics and Gynaecology, Singapore General Hospital) ;
  • Mohd Najib, S (Department of Obstetrics and Gynaecology, Singapore General Hospital)
  • Published : 2015.07.13

Abstract

Background: HPV vaccination in Singapore is voluntary and physician prescription-based. This study investigated the current status and intention for HPV vaccination among Singapore nurses. Materials and Methods: All female nurses in a general hospital were given an anonymous questionnaire on HPV vaccination experience and intention of vaccinating their daughters. The influence of age, knowledge and perceived-risk of cervical cancer, and cultural background on mother's intention of vaccinating their daughters was analyzed. Results: Of 2,000 nurses, 1,622 (81.1%) responded and analysis was performed on 1,611 with valid data. They showed good awareness on association of cervical cancer with multiple sexual partners (81.9%), history of sexually transmissible diseases (78.2%), and history of genital warts/HPV infection (73.5%), and on cervical cancer preventive effects of HPV vaccination (54.6%). The prevailing misconceptions of the vaccines were: investigational nature (38.9%), side effects (27.9%) and indicated for women at high risk for cervical cancer (20.5%). Conclusions: Misconceptions on the nature, role and safety of HPV vaccines low vaccine up-take rates and daughters. Dissemination of adequate and accurate HPV vaccine information and a review for school-based vaccination are needed for optimal delivery of HPV vaccines in Singapore.

Keywords

Cancer prevention;cervical cancer;culture;knowledge;school-based mass vaccination;vaccine safety

References

  1. Australian Health Authority (2014). Immunisation coverage, 2012. CDI 2014; 38, 226. (Access on 4 December 2014).
  2. Baldur-Felskov B, Dehlendorff C, Munk C, Kjaer SK (2014). Early impact of human papillomavirus vaccination on cervical neoplasia-nationwide follow-up of young danish women. JNCI J Natl Cancer Inst, 106, 460. https://doi.org/10.1093/jnci/djt460
  3. Bosch FX, Lorincz A, Munoz N, Meijer CJ, Shah KV (2002). The causal relation between human papillomavirus and cervical cancer. J Clin Pathol, 55, 244-65. https://doi.org/10.1136/jcp.55.4.244
  4. Brotherton JM, Fridman M, May CL, et al (2011). Early effect of the HPV vaccination programme on cervical abnormalities in Victoria, Australia: an ecological study. Lancet, 377, 2085-92. https://doi.org/10.1016/S0140-6736(11)60551-5
  5. Canfell K, Sitas F, Beral V (2006). Cervical cancer in Australia and the United Kingdom: comparison of screening policy and uptake, and cancer incidence and mortality. Med J Aust, 185, 482-6.
  6. Cates JR, Brewer NT, Fazekas KI, Mitchell CE, Smith JS (2009). Racial differences in HPV knowledge, HPV vaccine acceptability, and related beliefs among rural, Southern women. J of Rural Health, 25, 93-7. https://doi.org/10.1111/j.1748-0361.2009.00204.x
  7. de Sanjose S, Quint WGV, Alemany L, et al (2010). Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol, 11, 1048-56. https://doi.org/10.1016/S1470-2045(10)70230-8
  8. Department of Health (2012). Annual HPV vaccine coverage in England in 2010/2011. https://www.wp.dh.gov.uk/immunisation/files/2012/03/120319_HPV_UptakeReport2010.11-revised_acc.pdf
  9. Ezat SWP, Hod R, Mustafa J, Dali AZHM, et al (2013). National HPV immunisation programme: knowledge and acceptance of mothers attending an obstetrics clinic at a teaching hospital, Kuala Lumpur. Asian Pac J Cancer Prev, 14, 2991-9. https://doi.org/10.7314/APJCP.2013.14.5.2991
  10. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917. https://doi.org/10.1002/ijc.25516
  11. Fu LY, Bonhomme LA, Cooper SC, Joseph JG, Zimet GD (2014). Educational interventions to increase HPV vaccination acceptance: a systematic review. Vaccine, 32, 1901-20. https://doi.org/10.1016/j.vaccine.2014.01.091
  12. Gamble HL, Klosky JL, Parra GR, Randolph ME (2010). Factors Influencing familial decision-making regarding human papillomavirus vaccination. J Pediat Psychol, 35, 704-15. https://doi.org/10.1093/jpepsy/jsp108
  13. Ganry O, Bernin-Mereau AS, Gignon M, Merlin-Brochard J, Schmit JL (2013). Human papillomavirus vaccines in Picardy, France: Coverage and correlation with socioeconomic factors. Epidemiol Pub Health, 61, 447-54.
  14. Garland S, Skinner SR, Brotherton JM (2011). Adolescent and young adult HPV vaccination in Australia: achievements and challenges. Prev Med, 53, 29-35. https://doi.org/10.1016/j.ypmed.2011.05.008
  15. Gefenaite G, Smit M, Nijman HW, et al (2012). Comparatively low attendance during Human Papillomavirus catch-up vaccination among teenage girls in the Netherlands: Insights from a behavioral survey among parents. BMC Public Health, 12, 498. https://doi.org/10.1186/1471-2458-12-498
  16. Hughes J, Cates JR, Liddon N, et al (2009). Disparities in how parents are learning about the human papillomavirus vaccine. Cancer Epidemiol Biomarkers Prev, 18, 363-72. https://doi.org/10.1158/1055-9965.EPI-08-0418
  17. Jaspers L, Budiningsih S, Wolterbeek R, Henderson FC, Peters AAW (2011). Parental acceptance of human papillomavirus (HPV) vaccination in Indonesia: A cross-sectional study Vaccines, 29, 7785-93. https://doi.org/10.1016/j.vaccine.2011.07.107
  18. Kavanagh K, Pollock KGJ, Potts A, et al (2014). Introduction and sustained high coverage of the HPV bivalent vaccine leads to a reduction in prevalence of HPV 16/18 and closely related HPV types. British J Cancer, 110, 2804-11. https://doi.org/10.1038/bjc.2014.198
  19. Koh JY, Fock CL, Thilagaratnam S (2013). Education efforts to drive uptake of HPV vaccination in Singapore. EUROGIN 4 November2013;Abstract P16-7. (Access on 4 December 2014).
  20. Laemmle-Ruff I, Barbaro B, Brotherton J (2013). Human papillomavirus vaccine national catch-up program-insights into under-notification. Aust Fam Physician, 42, 880-4.
  21. Lai JY, Tinker AV, Cheung WY (2013). Factors influencing the willingness of US women to vaccinate their daughters against the human papillomavirus to prevent cervical cancer. Med Oncol, 30, 582. https://doi.org/10.1007/s12032-013-0582-z
  22. Lechuga J, Swain GR, Weinhardt LS (2011). The cross-cultural variation of predictors of human papillomavirus vaccination intentions. J Women's Health, 20, 225-30. https://doi.org/10.1089/jwh.2010.1993
  23. Lee VJ, Tay SK, Teoh YL, Tok MY (2011). Cost-effectiveness of different human papillomavirus vaccines in Singapore. BMC Public Health, 11, 203. https://doi.org/10.1186/1471-2458-11-203
  24. Ministry of Health Singapore (2014). Preventive health screening. http://www.moh.gov.sg/content/moh_web/home/statistics/Health_Facts_Singapore/Preventive_Health_Screening.html
  25. Marlow L (2011). HPV vaccination among ethnic minorities in the UK: knowledge, acceptability and attitudes. British J Cancer, 105, 486-92. https://doi.org/10.1038/bjc.2011.272
  26. Mesher D, Soldan K, Howell-Jones R, et al (2013). Reduction in HPV 16/18 prevalence in sexually active young women following the introduction of HPV immunisation in England. Vaccine, 32, 26-32. https://doi.org/10.1016/j.vaccine.2013.10.085
  27. Mortensen GL (2010). Drivers and barriers to acceptance of human-papillomavirus vaccination among young women: a qualitative and quantitative study. BMC Public Health, 10, 68. https://doi.org/10.1186/1471-2458-10-68
  28. National Registry of Diseases Office (2014). Trends in cancer incidence in Singapore 2007-2011. Page 10.
  29. Paavonen J, Naud P, Salmeron J, et al (2009). Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Lancet, 374, 301-14. https://doi.org/10.1016/S0140-6736(09)61248-4
  30. Pollock KG, Kavanagh K, Potts A, et al (2014). Reduction of low- and high-grade cervical abnormalities associated with high uptake of the HPV bivalent vaccine in Scotland. Br J Cancer, 111, 1824-30. https://doi.org/10.1038/bjc.2014.479
  31. Sacks RJ, Andrew J, Copas AJ, Wilkinson DM, Robinson AJ (2014). Uptake of the HPV vaccination programme in England: a cross-sectional survey of young women attending sexual health services. Sex Transm Infect, 90, 315-21. https://doi.org/10.1136/sextrans-2013-051179
  32. Sasieni P, Adams J, Cuzick J (2003). Benefit of cervical screening at different ages: evidence from the UK audit of screening histories. Br J Cancer, 89, 88-93. https://doi.org/10.1038/sj.bjc.6600974
  33. Schiller JT, Castellsague X, Garland S (2012). A review of clinical trials of human papillomavirus prophylactic vaccines. Vaccine, 30, 123-38. https://doi.org/10.1016/j.vaccine.2012.04.108
  34. Slade BA, Leidel L, Vellozzi C, et al (2009). Post-licensure safety surveillance for quadrivalent human papillomavirus recombinant vaccine. JAMA, 302, 750-7. https://doi.org/10.1001/jama.2009.1201
  35. The Future II Study Group (2007). Effect of prophylactic human papillomavirus L1 virus-like-particle vaccine on risk of cervical intraepithelial neoplasia grade 2, grade 3, and adenocarcinoma in situ: a combined analysis of four randomised clinical trials. Lancet, 369, 1861-68. https://doi.org/10.1016/S0140-6736(07)60852-6
  36. Waller J, Jackowska M, Marlow L, et al (2012). Exploring age differences in reasons for Non attendance for cervical screening: a qualitative study. BJOG, 119, 26-32.
  37. WHO (2014). Global advisory committee on vaccine safety statement on the continued safety of HPV vaccination. http://www.who.int/vaccine_safety/committee/topics/hpv/GACVS_Statement_HPV_12_Mar_2014.pdf
  38. Wong MCS, Lee A, Ngai KLK, Chor JCJ, Chan PKS (2013). Knowledge, attitude, practice and barriers on vaccination against human papillomavirus infection: a cross-sectional study among primary care physicians in Hong Kong. PLOS ONE, 8, 71827. https://doi.org/10.1371/journal.pone.0071827

Cited by

  1. Perspectives of young Chinese Singaporean women on seeking and processing information to decide about vaccinating against human papillomavirus pp.1541-0331, 2017, https://doi.org/10.1080/03630242.2017.1342741