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.