Introduction:
Human Papilloma Virus (HPV) is an oncogenic virus, known to cause a
range of malignancies, including cervical, anal and oropharyngeal.
[1]. Following World Health Organisation (WHO) recommendations, in
2010 Ireland introduced the quadrivalent HPV vaccine into its
school-based vaccination program, specifically for girls starting
second-level education. While this specific vaccine schedule started
successfully, 2016/17 saw a huge decline in uptake rates to about 50%,
far below the target uptake of 85% [2]. This decline was thought to
be secondary to lobbyist groups with emotive social media platforms
[3]. In response to this, the National Immunisation Office increased
their own social media presence and alliance groups to promote the
vaccine and 2019 saw the uptake rate increase back to 70% [4].
2019 also saw huge changes surrounding the HPV vaccine in Ireland, with
inclusion of boys starting second-level education to the schedule. It
also saw the change of the vaccine from the quadrivalent type, to the
non-valent type[5]. Uptake levels for the year 2018/19 are yet to be
released at the time of writing, other than a blanket uptake rate of
70% quoted.
Despite, being recognised as one of our most successful public health
measures [6], vaccination is no stranger to hesitancy and refusal,
with refusal seen as early as the 18th century to the
very first vaccine – the smallpox vaccine [7]. Ironically, a
vaccine’s success as a public health measure can only be achieved
with a certain level of uptake, for example 85% as is for the HPV
vaccine in Ireland. We require the public’s acceptance of vaccines for
there to be adequate uptake, and for their role to be successful
[8]. In fact, the SAGE working group for vaccine hesitancy
identified three key determinants for vaccine uptake amongst the public,
which were; 1). Confidence – that is confidence in health care
professionals and in the vaccine itself, 2). Complacency – that is a
low level of awareness of the risks of the disease for which the vaccine
prevents and 3). Convenience – easy access to and availability of the
vaccine [8]. While our school program offers convenience, do we have
an appropriate level of confidence amongst the public and a low level of
complacency?
As we come to the end of the first school year in which the HPV vaccine
has been made available to boys, we await the levels of uptake for
2019/20. Given this vaccine will be new to boys and vaccine uptake is
dependent on confidence, will our levels of uptake amongst boys reflect
that of their female counterparts? Do individuals have an adequate
understanding of the spectrum of malignancies caused by HPV, most
notably those that affect men?
From Ireland’s variable rate of uptake over the past decade, we have
also seen the role of social media in both increasing and decreasing
vaccine confidence and thus uptake. As social media’s use increases
amongst populations, will we also see its role in public health
promotion increase?
With these questions in mind, we sought to perform a study to determine
women’s knowledge surrounding the human papilloma virus and vaccine, as
well as assess where they gained this knowledge and information from.
Within our study, we also sought to specifically compare and contrast
women’s opinion of the HPV vaccine for girls and boys.