Japanese physicians' attitudes and intentions regarding human papillomavirus vaccine compared with other adolescent vaccines

HPV vaccination knowledge, attitude, and practices among physicians in a teaching hospital, Karachi

Context

Cervical cancer is a global public health problem. It is the fourth most common cancer in women globally. Human papillomavirus (HPV) vaccine has reduced the incidence of HPV-related illness in the past decade. However, for the vaccination programs to be successful, recommendation by the primary care physicians is essential.

Aims

The aim of this study was to evaluate the knowledge, attitude, practices, and barriers toward HPV vaccination among physicians practicing at a teaching hospital in Karachi, Pakistan.

Settings and Design

This is a cross-sectional study carried out with a sample size of 165 among doctors practicing in Family medicine, Internal medicine, Pediatrics, and Gynecology outpatient clinics at a teaching hospital.

Methods and Material

Physicians were approached in outpatient clinics, and a pilot-tested coded questionnaire was filled by them. Statistical Analysis Used: Data were analyzed using SPSS version 19.

Results

Results show 22.4% males and 77.6% females participated in the study. 20% were internists, 35.2% were family physicians, 18.8% were pediatricians, and 26.1% were gynecologists. In terms of knowledge, 67.2% physicians showed good knowledge. In terms of attitude, it was found that 90.9% of physicians showed positive attitude toward prescribing HPV vaccine. However, only 37.5% physicians prescribed HPV vaccine to patients. Cost of vaccine, time constraints, and lack of knowledge among female patients were recognized as the most common barriers against prescribing the vaccine.

Conclusions

From these results, we can infer that overall practices of our physicians are lacking, with respect to prescribing the HPV vaccine. Positive attitude should be taken as an advantage, and overcoming the barriers should be considered as the next step for improvement of our practice.

Effect of information awareness on attitudes toward human papillomavirus vaccination intentions in Japan

Background

The Human Papillomavirus (HPV) vaccination rate among Japanese high school girls remains critically low, reflecting ongoing public apprehension and misinformation. This study explores the relationship between information presentation and attitudes toward HPV vaccination in Japan.

Methods

We conducted a web-based survey of female high school students aged 15 to 16 and mothers of daughters of similar age across Japan. The first screening questionnaire investigated the vaccine uptake among eligible students. The detailed questions assessing awareness of HPV vaccination information, including vaccine eligibility and its cost, effectiveness, lifetime prevalence of HPV infection, and vaccine safety, were asked to the respondents. After presenting each piece of information, we investigated how the information influenced the vaccination attitudes of unvaccinated students and mothers of unvaccinated girls.

Results

Data collection occurred from August 20 to August 24, 2021. Of 473 students, 68 (14.4 %) had already been vaccinated before the study. Over half of the 245 participating students were aware of vaccine eligibility and cost (68.7 %) and effectiveness (63.6 %), but fewer understood lifetime prevalence (28.7 %) and safety (45.3 %). In contrast, awareness of the same questions in 245 mothers was higher than that in the students: 90.2 %, 92.5 %, 55.4 %, and 61.1 %, respectively. Among unvaccinated students and mothers of unvaccinated girls, the intention to get vaccinated increased the most after being informed about the lifetime risks of HPV infection; 50.5 % of students and 38.8 % of mothers showed a positive attitude toward the HPV vaccination.

Conclusions

Bridging the awareness gap between students and mothers is crucial for improving HPV vaccination rates. The findings underscore the potential of specific, targeted information to influence vaccination intentions, particularly regarding the HPV infection rate.

Healthcare worker practices for HPV vaccine recommendation: A systematic review and meta-analysis

Healthcare workers (HCWs) are trusted sources of information for vaccination and their attitude toward vaccination is thus critical. We aimed to synthesize existing literature on healthcare workers' HPV vaccine confidence and their practices of recommending this vaccine. We conducted a systematic literature review and meta-analysis, with the search conducted last in March 2024. For the inclusion criteria, the studies needed to include healthcare worker practices or behaviors on recommending the HPV vaccination. Seventy-three articles were included. The proportions of HCWs recommending varied considerably by region and gender of the recipient, but there was no statistically significant difference in income level or pre- or post-HPV vaccine introduction into the national vaccination program. The main barriers to recommending HPV vaccination were concerns around safety and efficacy, cost, parental concerns, and systemic barriers. The results illustrate the importance of contextually adapted approaches to improving vaccine acceptance and recommendation.

Actions speak louder than words; pediatricians, gynecologists, nurses, and other mothers' perspectives on the human papillomavirus vaccine: an Istanbul multicenter study

Introduction

Gynecologists and pediatricians have an essential duty to prevent cervical cancer. In this study, we compared the compliance of gynecologists (n = 22) and pediatricians (n = 49) with nurse/midwife (n = 66) and non-medical moms (n = 120) with regards to cervical cancer precautions.

Methods

A questionnaire was used to gather data on their demographics, personal vaccination and screening practices, children's immunization status, and awareness of cervical cancer prevention.

Results

The findings demonstrated that gynecologists and pediatricians were better than others at understanding the risk factors and prevention of cervical cancer. It was noted that compared to other groups, physician mothers and their offspring had higher vaccination rates (n = 13, 18.3%; n = 10, 29.4%, respectively). Medical professionals typically provided thorough and accurate answers to informational questions. More frequent Pap smear tests were performed by gynecologists. It was noted that mothers who worked as pediatricians and nurses/midwives neglected their own screening needs.

Discussion

This questionnaire survey sought to ascertain Istanbul's health professionals' present opinions regarding HPV vaccination. Healthcare professionals should be the first to receive information on HPV vaccination and cervical cancer incidence reduction. The public could then readily use them as an example.

Knowledge, attitude, and practices regarding human papilloma virus vaccination among physicians in Qatar

BACKGROUND

The human papilloma virus is a global problem that affects sexually active women and men, with cervical cancer being the most serious associated disease. Most cervical cancer cases can be prevented by vaccination against the human papilloma virus early in life. The objective of this study was to assess the knowledge, attitudes, and practices among physicians working in Qatar, regarding the human papilloma virus, infection, and prevention using vaccines.

STUDY-DESIGN

This was a cross-sectional study using quantitative data collection.

METHODOLOGY

An online survey targeting physicians working in Qatar was conducted, using a web-based pretested questionnaire. The questionnaire comprised four sections capturing a few demographic details, 33 questions in the Knowledge Section, 12 questions eliciting the attitude, and 14 practice-related questions. Mean knowledge score was calculated and those with a score more than the mean score were considered to have sufficient knowledge. Association between knowledge and attitude/practices/independent variables were looked for using bivariate and multivariate analysis. Logistic regression was used to identify the predictors for recommending human papilloma virus vaccines.

RESULTS

Of the 557 physicians who participated, 83.7% had sufficient knowledge, but only 69.1% knew that human papilloma virus vaccines were available in Qatar. The majority (89.4%) knew that human papilloma virus infection could be asymptomatic and 96.1% knew at least one symptom; 77% believed the human papilloma virus vaccine would substantially decrease the chances of human papilloma virus infection and related cancers and 46.5% felt physicians were less motivated to promote the human papilloma virus vaccine. The perceived barriers to community acceptance of the human papilloma virus vaccine were lack of awareness regarding the relationship between human papilloma virus and cervical cancer (61.6%), doubts regarding efficacy (32.5%), fear regarding safety (26.9%), concern that the human papilloma virus vaccination may encourage risky sexual behavior (26.8%), and perceived low-risk (23.3%) and cost (24.6%). Only 21.5% commonly discussed sexual health with their clients. More than one-third were not interested in recommending the human papilloma virus vaccine. Bivariate analysis showed nationality, specialization, discussing with patients, and recommending vaccine to be significantly associated with knowledge. Bivariate and regression analysis identified that female gender and physician's religion were significant predictors to recommend the human papilloma virus vaccine.

CONCLUSION

Most physicians have good knowledge. Less than one-fourth commonly discussed sexual health with their clients. More than one-third were not interested in recommending the human papilloma virus vaccine. This issue might affect the human papilloma virus vaccination program implementation if not well addressed.

Importance of human papillomavirus vaccination leaflets focusing on the safety profile targeted pediatricians in Japan

OBJECTIVES

To investigate the association between providing leaflets to support pediatricians in explaining the safety of the human papillomavirus (HPV) vaccine and mother's decision to vaccinate their daughters in Japan.

METHODS

In this cross-sectional study, we conducted a survey of mothers to evaluate the effect of leaflets that were created to support pediatricians in explaining the safety profile of the HPV vaccine. Mothers who provided consent for vaccination before receiving an explanation were excluded from the study. The primary outcome was the mother's decision to vaccinatetheir daughters with the HPV vaccine after receiving an explanation from pediatricians using our leaflets.

RESULTS

Among 161 eligible mothers, 101 decided on HPV vaccination (decided group) and 60 did not (decided against group). There was no difference in the maternal background between the 2 groups. The decided group had a significantly more positive impression of the leaflets than the undecided group. In multivariable logistic regression analysis, a detailed explanation for possible adverse events and specific solutions to them was associated with the mother's decision to have their daughters vaccinated (odds ratio 2.35, 95% confidence interval 1.02-5.44), but not the pathology of cervical cancer and the HPV vaccination process.

CONCLUSION

Leaflets emphasizing an explanation of adverse events may contribute to mothers' decision making for HPV vaccination.

A survey of healthcare workers’ recommendations about human papillomavirus vaccination

Purpose

The human papillomavirus (HPV) vaccine is safe and effective for preventing HPV-related diseases. However, HPV vaccination rates in Japan are low because the “Ministry of Health, Labour and Welfare” had stopped recommending vaccination. We assessed healthcare workers’ (HCWs) current recommendations regarding the HPV vaccine and how the provision of information about HPV vaccination affected their recommendations.

Materials and Methods

A survey was conducted among nurses and physicians in Nara prefecture from March 2021 to July 2021. The questionnaire asked about their understanding, recommendations, and opinions regarding HPV vaccination. Before answering the last two questions (optional), the HCWs read evidence-based information quantifying the risks and benefits of HPV vaccination.

Results

A total of 441 HCWs completed the questionnaire. Only 19% of HCWs always recommended HPV vaccination for girls aged 12–16 years. The evidence-based information significantly improved the percentage of HCWs who would “always recommend” vaccination.

Conclusion

This study showed that the proportion of HCWs who recommend HPV vaccination to adolescent girls remains low in Japan. However, we found that evidence-based information describing the causal relationship between adverse events and vaccination, quantifying the risks and benefits, noting the importance of HCW communications with families, and reporting the recommendations of national societies, might increase HCWs’ recommendations for HPV vaccination.

Access to HPV vaccination in Japan: Increasing social trust to regain vaccine confidence

Vaccine hesitancy is a growing concern in global public health, and illustrates serious problems arising from loss of social trust. Japan is experiencing a human papillomavirus (HPV) vaccine crisis that started with a rapid decline in the vaccination rate in 2013 from approximately 70% to less than 1% and lasting for 7 years. We analyze Japan's case of vaccine hesitancy for HPV vaccine, using a framework for examining barriers to access and use of health technologies according to four categories: architecture, availability, affordability, and adoption. Significant problems were identified in the architecture of the decision-making body, public information availability, adoption of evidence in policy-making process, knowledge and confidence among providers, education to the public, and communication with end-users. We propose a series of actions to address these barriers. The national government should diversify the advisory committee to include broader scientific evidence and various viewpoints. Municipalities should actively distribute information cooperating with local providers. Professional associations should create an alliance to influence policy makers and deliver education to health care providers and end-users. Politicians should integrate opinions from citizens and scientists to implement an up-to-date policy. Civil society should share individual stories from cervical cancer patients and positive experiences of vaccinated girls. Mass media should use more diverse sources of information to report more comprehensive and science-based views. These actions would help build mutual trust among stakeholders, which is required to increase social trust in the HPV vaccine in Japan and thereby regain vaccine confidence and reduce preventable deaths and complications.

Understanding confidence in the human papillomavirus vaccine in Japan: a web-based survey of mothers, female adolescents, and healthcare professionals

Vaccine confidence reflects social, individual, and political factors indicating confidence in vaccines and associated health systems. In Japan, the government ceased proactive recommendation of the human papillomavirus (HPV) vaccine in June 2013, only several months after the recommendation had begun. Seven years later, as of October 2020, the suspension persists and vaccine coverage has precipitously declined, resulting in many young women being continually exposed to the risk of preventable HPV-related diseases. Accordingly, understanding stakeholder opinions on HPV vaccination issues is critical for informing strategies to improve HPV vaccine confidence and acceptance. In October 2019, we performed a nationwide, web-based survey of 1646 mothers of HPV-vaccination–eligible girls, 562 female adolescents aged 15–19 years, and 919 healthcare professionals (HCPs) in Japan. This survey captured key elements of vaccine confidence (i.e., importance, effectiveness, and safety of the HPV vaccine), awareness, and the willingness to receive (in HPV-vaccination–eligible girls) or recommend (in HCPs) the HPV vaccine, and the factors responsible for these decisions. HPV vaccine confidence was generally higher among HCPs than among mothers or female adolescents. Nearly half of all stakeholders were neutral regarding their willingness to receive/recommend the HPV vaccine. The seriousness of cervical cancer and the HPV vaccine’s effectiveness or safety were important deciding factors for receiving/recommending the HPV vaccine. Besides these factors, sufficient information and free vaccination were crucial. Our results suggest several factors that could help shape public policy and communication strategies to improve HPV vaccine confidence and acceptance in Japan.