The aim of the presents study was to compare the level of knowledge about Human Papilloma Virus (HPV) in vaccinated and non-vaccinated girls and to highlight the reasons why non-vaccinated girls refuse vaccination.
A cross-sectional study was conducted from October 2012 to June2013 inTurin (Piemonte Region, Italy). Questionnaires were administered to girls attending secondary and high schools randomly selected.
A total of 576 were compiled. The principle sources of information were parents and health workers. The main reported reasons for non-adherence to vaccination were the disagreement of the parents among the 11-12 years group (45.3%) and the lack of evidence on efficacy among the 18 years group (26.8%). By comparing the level of knowledge there was a statistically significant difference between groups: vaccinated girls reported higher score than the unvaccinated group in several questions (p≤0.05).
Our findings show a lack of information about HPV infection. Parents, school and health care workers have a central role in girlâs education and choices about HPV vaccination.
The communication campaign for the prevention of cervical cancer must therefore be characterised by messages able to clarify and consolidate messages that may have been partially received or misunderstood.
Guidelines to assure the quality, safety and efficacy of recombinant human papillomavirus virus-like particles vaccines [http://www.who.int/immunization/hpv/learn/guidelines_to_assure_the_quality_safety_and_efficacity_ecbs_2006.pdf]
Strategy for the active offer of the HPV vaccine in Italy [http://www.statoregioni.it/Documenti/DOC_016696_264%20csr.pdf ]
Gold MS, McIntyre P: Human papillomavirus vaccine safety in Australia: experience to date and issues for surveillance. Sexual health 2010, 7:320-324.
Liddon N, Hood J, Wynn BA, Markowitz LE: Acceptability of human papillomavirus vaccine for males: a review of the literature. J Adolesc Health 2010, 46:113-123.
Progress of the HPV vaccination campaign: Coverage data as of 31/12/2013 [http://www.epicentro.iss.it/problemi/hpv/pdf/Aggiornamento_HPV_31122013.pdf]
Vaccination report for Piedimont Region in 2011 [http://www.epicentro.iss.it/temi/vaccinazioni/DocumentazioneRegioni.asp]
Kessels SJ, Marshall HS, Watson M, Braunack-Mayer AJ, Reuzel R, Tooher RL: Factors associated with HPV vaccine uptake in teenage girls: a systematic review. Vaccine 2012, 30:3546-3556.
Lloyd GP, Marlow LA, Waller J, Miles A, Wardle J: An experimental investigation of the emotional and motivational impact of HPV information in adolescents. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2009, 45:532-534.
Zimet GD: Improving adolescent health: focus on HPV vaccine acceptance. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2005, 37:S17-23.
Gerend MA, Magloire ZF: Awareness, knowledge, and beliefs about human papillomavirus in a racially diverse sample of young adults. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2008, 42:237-242.
Grant LA, Dunne EF, Chesson H, Markowitz LE: Considerations for human papillomavirus (HPV) vaccination of mid-adult women in the United States. Vaccine 2011, 29:2365-2370.
Marlow LA, Forster AS, Wardle J, Waller J: Mothers' and adolescents' beliefs about risk compensation following HPV vaccination. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2009, 44:446-451.
Baxter CE, Barata PC: The paradox of HPV vaccines: how to reach sexually inexperienced women for protection against a sexually transmitted infection. Women's health issues : official publication of the Jacobs Institute of Women's Health 2011, 21:239-245.
Tozzi A.: The fear of vaccination: the motivations of the opposition and the hesitation of parents. In Book The fear of vaccination: the motivations of the opposition and the hesitation of parents. (Editor ed.^eds.). pp. 87-93. City; 2013:87-93.
Hendry M, Lewis R, Clements A, Damery S, Wilkinson C: "HPV? Never heard of it!": a systematic review of girls' and parents' information needs, views and preferences about human papillomavirus vaccination. Vaccine 2013, 31:5152-5167.
Gillespie L, Hicks CW, Santana M, Worley SE, Banas DA, Holmes S, Rome ES: The acceptability of human papillomavirus vaccine among parents and guardians of newborn to 10-year-old children. Journal of pediatric and adolescent gynecology 2011, 24:66-70.
Kahn JA, Ding L, Huang B, Zimet GD, Rosenthal SL, Frazier AL: Mothers' intention for their daughters and themselves to receive the human papillomavirus vaccine: a national study of nurses. Pediatrics 2009, 123:1439-1445.
Anhang Price R, Koshiol J, Kobrin S, Tiro JA: Knowledge and intention to participate in cervical cancer screening after the human papillomavirus vaccine. Vaccine 2011, 29:4238-4243.
Dillard JP, Ye S: The perceived effectiveness of persuasive messages: questions of structure, referent, and bias. Journal of health communication 2008, 13:149-168.
Klug SJ, Hukelmann M, Blettner M: Knowledge about infection with human papillomavirus: a systematic review. Preventive medicine 2008, 46:87-98.
McRee AL, Reiter PL, Brewer NT: Parents' Internet use for information about HPV vaccine. Vaccine 2012, 30:3757-3762.
Bednarczyk RA, Birkhead GS, Morse DL, Doleyres H, McNutt LA: Human papillomavirus vaccine uptake and barriers: association with perceived risk, actual risk and race/ethnicity among female students at a New York State university, 2010. Vaccine 2011, 29:3138-3143.
Zimet GD, Liddon N, Rosenthal SL, Lazcano-Ponce E, Allen B: Chapter 24: Psychosocial aspects of vaccine acceptability. Vaccine 2006, 24 Suppl 3:S3/201-209.
Smith JS, Gilbert PA, Melendy A, Rana RK, Pimenta JM: Age-specific prevalence of human papillomavirus infection in males: a global review. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2011, 48:540-552.
Di Giuseppe G, Abbate R, Liguori G, Albano L, Angelillo IF: Human papillomavirus and vaccination: knowledge, attitudes, and behavioural intention in adolescents and young women in Italy. British journal of cancer 2008, 99:225-229.
Ogilvie GS, Remple VP, Marra F, McNeil SA, Naus M, Pielak K, Ehlen T, Dobson S, Patrick DM, Money DM: Intention of parents to have male children vaccinated with the human papillomavirus vaccine. Sexually transmitted infections 2008, 84:318-323.
Korfage IJ, Essink-Bot ML, Daamen R, Mols F, van Ballegooijen M: Women show mixed intentions regarding the uptake of HPV vaccinations in pre-adolescents: a questionnaire study. European journal of cancer (Oxford, England : 1990) 2008, 44:1186-1192.
Bair RM, Mays RM, Sturm LA, Zimet GD: Acceptability of the human papillomavirus vaccine among Latina mothers. Journal of pediatric and adolescent gynecology 2008, 21:329-334.
Vallely LA, Roberts SA, Kitchener HC, Brabin L: Informing adolescents about human papillomavirus vaccination: what will parents allow? Vaccine 2008, 26:2203-2210.
Brewer NT, Fazekas KI: Predictors of HPV vaccine acceptability: a theory-informed, systematic review. Preventive medicine 2007, 45:107-114.
Harper DM, Paavonen J: Age for HPV vaccination. Vaccine 2008, 26 Suppl 1:A7-11.
Lee S.J. YHJ, Lee K.H., Kim C.J., Park J.S.. What questions do people ask on a Human Papillomavirus website? Acomparative analysis of public and private questions. Int J Med Sci 2012, 9:142-147.
Donati S, Giambi C, Declich S, Salmaso S, Filia A, Ciofi degli Atti ML, Alibrandi MP, Brezzi S, Carozzi F, Collina N, et al: Knowledge, attitude and practice in primary and secondary cervical cancer prevention among young adult Italian women. Vaccine 2012, 30:2075-2082.
Lifestyles of the Italian youth between 11-15 years.Report on the data of the Italian international HBSC study. [http://www.hbsc.unito.it/hbsc/files/stilidivita1_file%20stampa.pdf]
HBSC 2010 Presentation of the italian national data [http://www.epicentro.iss.it/focus/guadagnare_salute/pdf/Hbsc2010.pdf]
ISS Istituto Superiore di SanitÃ¡: Project VALORE: Local Regional Assessment of vaccination campaigns for HPV. 2011.
Italian women and the prevention of HPV. The knowledge of the disease from human papillomavirus vaccination and the propensity to vaccination [http://www.censis.it/14?shadow_ricerca=113853]
Kimmel SR: Adolescent Vaccination: Physician Challenges and Solutions. Journal of Adolescent Health 2010, 46:S16-S23.
Pelucchi C, Esposito S, Galeone C, Semino M, Sabatini C, Picciolli I, Consolo S, Milani G, Principi N: Knowledge of human papillomavirus infection and its prevention among adolescents and parents in the greater Milan area, Northern Italy. BMC public health 2010, 10:378.
Caskey R, Lindau ST, Alexander GC: Knowledge and early adoption of the HPV vaccine among girls and young women: results of a national survey. The Journal of adolescent health : official publication of the Society for Adolescent Medicine 2009, 45:453-462.
Hilton S, Patterson C, Smith E, Bedford H, Hunt K: Teenagers' understandings of and attitudes towards vaccines and vaccine-preventable diseases: a qualitative study. Vaccine 2013, 31:2543-2550.
Holman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S: Barriers to human papillomavirus vaccination among US adolescents: a systematic review of the literature. JAMA pediatrics 2014, 168:76-82.
Ozyer S, Uzunlar O, Ozler S, Kaymak O, Baser E, Gungor T, Mollamahmutoglu L: Awareness of Turkish female adolescents and young women about HPV and their attitudes towards HPV vaccination. Asian Pacific journal of cancer prevention : APJCP 2013, 14:4877-4881.
Navarro-Illana P, Diez-Domingo J, Navarro-Illana E, Tuells J, Aleman S, Puig-Barbera J: "Knowledge and attitudes of Spanish adolescent girls towards human papillomavirus infection: where to intervene to improve vaccination coverage". BMC public health 2014, 14:490.
s. B: The charm of risk in adolescents. Milan: Edizioni Giunti; 2009.