Parental perceptions of human papillomavirus vaccination: Examining the bases of resistance using innovative reviewing methods [Abstract]

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection and is an essential cause of cervical cancer. A school-based vaccination programme will start in the United Kingdom targeting 12–13-year-old girls from September 2008. Uptake of novel vaccines is low and resistance to vaccination increasing. This project seeks to understand social and mass media that may influence parental resistance. Objectives: To examine the degree to which anti-vaccination beliefs can be generalised across vaccination contexts. To identify the main components of opposition to HPV vaccination in popular print and electronic media. To assess the degree of similarity of difference between anti-vaccination arguments and mass media coverage of HPV. Design: A systematic review of health and social science papers containing vaccination arguments screened by and included by two independent reviewers. Toulmin’s model of argument was used to break down arguments to component parts and to synthesise them according to themes arising. A framework analysis was used to compare changes or consistency in the arguments over time and vaccine context. A content analysis of a range of national (UK) newspapers, regional newspapers and web-based media was undertaken. A coding frame was developed by two researchers and occurrences of key concepts logged in qualitative analysis software. Themes were developed by examining the relationships between concepts and the contexts in which they emerged. Main Outcome Measures: Differences or similarities in anti-vaccination arguments across time and vaccine contexts. Differences or similarities between any anti-vaccination arguments and themes arising from popular media surveyed Results: The systematic review identified 345 potential papers of which 281 were excluded and 43 retrieved. Anti-vaccination beliefs formed a spectrum ranging from pragmatic concerns with safety, political concerns with public health “control” and spiritual and “alternative” beliefs. The nature of the anti-vaccination argument appears similar over time and across vaccine contexts. Nonetheless, anti-vaccination in the United Kingdom does not appear to be an organised movement as it has been when compulsory vaccination was introduced. Analysis of popular media is ongoing. Initial results suggest that opposition to HPV does not primarily reflect anti-vaccination beliefs. Popular media coverage of HPV vaccination is dominated by a “moral panic” concerning the effects of vaccinating against a sexually transmitted infection on the subsequent behaviours of young women. Conclusion: The range of beliefs and popular media influences described here provide the basis for targeting groups for primary research on anti-vaccination beliefs in the context of HPV vaccination