Cervical cancer vaccination for my daughter, no thanks: A research synthesis on parental explained barriers to delayed or non-acceptance of HPV vaccination in high-income (OECD) nations. Parental expressed reasons on why they delay or rejected HPV vaccination for their daughters aged 9-17 within OECD nations between 2008 and 2016

Abstract

Background: The World Health Organization including high income nations recommends that Human Papillomavirus (HPV) vaccination should be given to young girls as they believe it’s the best available method to reduce cervical cancer morbidity and mortality. HPV vaccination remains lower than anticipated within OECD nations. Through responses, we may understand the main reasons to why parents delayed or declined to accept their daughters to be vaccinated. Objective: To determine and identify themes, factors and barriers explaining why parents decide to delay or refuse to accept HPV vaccination for their daughter’s aged 9-17. To ascertain whether social media and religion plays a central role in parental decline or delay a decision on HPV vaccination. Methods: Qualitative Meta-summary was used and it consisted of extraction, separation of findings, editing of findings, grouping of similar findings, abstraction and Size effect calculation. Results:Twenty-three studies consisting of ten quantitative and 13 qualitative were synthesized. There were 246 reasons identified with a total of 31740 responses. The responses were categorized into twenty groups which were further abstracted into seven broad categories. Conclusion: Vaccine related responses including drug safety, unknown future adverse effect and doubts on the vaccine was a major reason for non-vaccination. Parental concerns, girl child related reasons and luck of information played a role in parental decision. The health provider, pharmaceutical and government related reasons adding to social media though were of less effect, they were part of reasons for refusal to accept HPV vaccination.