HPV vaccination rate in French adolescent girls: an example of vaccine distrust

Archives of Disease in Childhood - Tập 103 Số 8 - Trang 740-746 - 2018
Hervé Lefèvre1,2,3,4,5, Cécile Schrimpf1,6, Marie Rose Moro1,3,6,5, Jonathan Lachal1,3,6,5
1AP-HP, Cochin Hospital
2Adolescent Medicine and Health
3CESP, Faculty de médecine - UVSQ, INSERM
4French Clinical Research Group
5Université Paris-Saclay
6Université Paris Descartes, Sorbonne Paris Cité

Tóm tắt

ObjectivesTo explore the clinical issues of human papillomavirus (HPV) vaccination to develop explanatory hypotheses for the low level of vaccination among adolescent girls in France where the full course coverage is low (<15%).DesignWe used semistructured interviews. Our qualitative and phenomenological procedure applied interpretative phenomenological analysis.Participants16 physicians regularly faced with the prescription of HPV vaccine, represented several medical specialties (paediatrics, general practice, internal medicine, gynaecology), with hospitalist or private practices.Main outcome measuresThe results connect three superordinate themes grouping three concentric levels: within society, during the consultation and in the individual doctor’s feelings.ResultsThe modalities and contents of the information about HPV vaccination raise questions about the limitations of the information doctors receive. The ineluctable association between sexuality and HPV vaccination explains their reluctance to raise topics considered to be private. The reasons for HPV vaccination illustrate the difficulty of arguing in favour of it. In view of the frequent parental reluctance, which weakens the parent–physician alliance, physicians must take responsibility for defending the benefits of vaccination. They nonetheless remain citizens whose opinions may implicitly echo the general reluctance, promoted by disinformation. In delaying or avoiding the subject of vaccination, they involuntarily become an instrument of anti-vaccination discourse.ConclusionsIt is imperative to improve the distribution of credible information about vaccination, unbiased and scientifically supported by a strong institutional position and to rethink the place of the clinician in the system of adolescent health and disease prevention in France.

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Tài liệu tham khảo

10.1002/ijc.29210

10.1002/cncr.23764

Fischer A , Rambaud C . Comité d’orientation de la concertation citoyenne sur la vaccination. [Report on vaccination]. Rapport sur la Vaccination. Paris: Ministère des affaires sociales, de la santé et des droits des femmes, 2016. http://acces.ens-lyon.fr/acces/ressources/immunite-et-vaccination/rapport-de-la-concertation-citoyenne-sur-la-vaccination-1.pdf.

Holman, 2014, Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature, JAMA Pediatr, 168, 76, 10.1001/jamapediatrics.2013.2752

10.1186/1471-2458-14-700

Smith J . Interpretative phenomenological analysis. Qualitative Psychology: A Practical Guide to Research Methods. Sage Publications Ltd, 2008.

Smith JA , Flowers P , Larkin M . Interpretative phenomenological analysis: theory, method and research. Los Angeles: SAGE, 2009.

10.2807/1560-7917.ES2013.18.44.20623

10.1016/S0140-6736(11)60678-8

Larson, 2016, The State of Vaccine Confidence 2016: Global Insights Through a 67-Country Survey, EBioMedicine, 12, 295, 10.1016/j.ebiom.2016.08.042

Dubé E , Gagnon D , Zhou Z , et al . Parental Vaccine Hesitancy in Quebec (Canada). PLoS Curr 2016;8.doi:10.1371/currents.outbreaks.9e239605f4d320c6ad27ce2aea5aaad2

Smith, 2016, HPV vaccination coverage of teen girls: the influence of health care providers, Vaccine, 34, 1604, 10.1016/j.vaccine.2016.01.061

10.1542/peds.2014-0442

Rutten, 2017, Clinician knowledge, clinician barriers, and perceived parental barriers regarding human papillomavirus vaccination: Association with initiation and completion rates, Vaccine, 35, 164, 10.1016/j.vaccine.2016.11.012

Raude, 2016, Opening the ’Vaccine Hesitancy' black box: how trust in institutions affects French GPs' vaccination practices, Expert Rev Vaccines, 15, 937, 10.1080/14760584.2016.1184092

Verger, 2015, Vaccine Hesitancy Among General Practitioners and Its Determinants During Controversies: A National Cross-sectional Survey in France, EBioMedicine, 2, 891, 10.1016/j.ebiom.2015.06.018

Collange, 2016, General practitioners' attitudes and behaviors toward HPV vaccination: A French national survey, Vaccine, 34, 762, 10.1016/j.vaccine.2015.12.054

10.1016/j.vaccine.2011.07.082

10.5694/mja13.10272

10.1016/S1473-3099(15)00055-9

Das, 2016, Systematic Review and Meta-Analysis of Interventions to Improve Access and Coverage of Adolescent Immunizations, J Adolesc Health, 59, S40, 10.1016/j.jadohealth.2016.07.005

Haut Conseil de la santé publique. Vaccination contre les infections à papillomavirus humains. Paris: Haut Conseil de la Santé Publique, 2014. http://www.hcsp.fr/Explore.cgi/Telecharger?NomFichier=hcspr20140710_vachpvdonneesactualisees.pdf (accessed 20 Oct 2017).

10.1377/hlthaff.24.3.755

10.1136/bmj.c6882

10.1016/j.vaccine.2011.03.107

Haut Conseil de la santé publique. Vaccination des garçons contre les infections à papillomavirus. Paris: Haut Conseil de la Santé Publique, 2016. https://www.mesvaccins.net/textes/hcspr20160219_recovaccinfhpvhommes.pdf (accessed 23 Oct 2017).