PDF(Pubmed)
Abstract：
Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; yet, despite the availability of safe and effective HPV vaccines, only half of eligible adolescents have completed the vaccine series. School-entry requirements are one proven strategy to increase vaccination rates among children and youth and reduce the burden of HPV-related cancer. This study investigated community perceptions of an HPV vaccine school-entry mandate in Virginia and the consequences of a low threshold exemption option included in the legislation. We conducted 40 interviews with community members including 15 interviews with parents, 19 with healthcare providers, and 6 with community leaders. Interviews asked about knowledge, beliefs, and attitudes concerning the HPV vaccine and mandate. Interviews were recorded, transcribed, and thematically analyzed. Despite healthcare provider support for the mandate, there was widespread confusion over the school-entry policy and concern that the exemption option undermined vaccination efforts. Understanding variations in community-level perceptions and response to school-based vaccination mandates is crucial for designing effective public health strategies. Findings suggest statewide vaccination initiatives should preemptively identify low uptake areas and provide targeted information to communities. Future mandates should avoid the use of ambiguous and contradictory language in vaccine-related legislation.
摘要：
人乳头瘤病毒(HPV)是美国最常见的性传播感染,尽管有安全有效的HPV疫苗，只有一半符合条件的青少年完成了疫苗系列。入学要求是提高儿童和青少年疫苗接种率并减轻HPV相关癌症负担的一种行之有效的策略。这项研究调查了社区对弗吉尼亚州HPV疫苗入学任务的看法，以及立法中包括的低门槛豁免选项的后果。我们对社区成员进行了40次采访，其中包括对父母的15次采访，19与医疗保健提供者一起，6与社区领袖。面试询问知识，信仰,以及对HPV疫苗和任务的态度。采访被记录下来，转录，并进行了主题分析。尽管医疗保健提供者支持这项任务，人们普遍对入学政策感到困惑，并担心豁免方案破坏了疫苗接种工作。了解社区层面的观念变化和对学校疫苗接种任务的反应对于设计有效的公共卫生策略至关重要。研究结果表明，全州范围内的疫苗接种计划应先发制人地确定低摄取地区，并向社区提供有针对性的信息。未来的任务应避免在与疫苗有关的立法中使用模棱两可和相互矛盾的语言。
