Was the anti – HPV vaccination campaign sufficiently organized?

Abstract

The fight against cervical cancer through vaccination and screening brings an important long-term benefit in controlling and decreasing this type of cancer. The purposes and objectives of the research were followed by a questionnaire composed of 6 questions that follows the awareness on primary prevention through vaccination of cervical cancer, of 484 parents whose children were recommended to get vaccinations. The results highlighted that although people did not know the benefits, contraindications, possible adverse reactions, and also the international use of the vaccine in a big number, they participated in taking a decision about vaccination of their own children anyway. The faulty organisation of these campaigns bring prejudicial actions of the vaccination campaigns, generally by forcing people to take decisions without the adequate information.

Introduction

The increased incidence of the neoplastic disorder occurrences, the high rate of their complications, their medical-surgical emergency appearance that they have and last but not least , the high cost of the treatment and the likelihood of recurrence that are aspects that highlight the medical world. Therefore, in recent years, efforts have been directed towards determining the precise pathogenesis, detection of the risk factors and the application of effective methods of prevention[1-4]. There are two elements of the application of effective prophylaxis against cervical cancer screening, through early identification of dysplastic changes and vaccination, which together lead to a cumulative reduction in the risk of cervical cancer up to 94%, fact that is calculated on advanced mathematical models . [5] The fight against cervical cancer has an advantage represented by the discovery and involvement in the etiology of this type of cancer: Human papilloma virus infection (HPV). The knowledge of one of the etiological factors of this condition can lead us to implement an effective prevention strategy that brings significant long-term benefits in controlling and decreasing number of cases of cervical cancer. Because vaccination actions need to have a significant impact on the population, it is necessary to fulfil two conditions: first, vaccination should include a larger number of people and secondary, the existence of a competent immune system in people vaccinated, enabling the production of a effective titer of antibodies anti HPV.[6,7]. At the same time, the success of a vaccination campaign can be reflected in the number of people who approved the vaccination and is even more successful if there was a full and proper public information about the importance of this medical act that is performed.[8]

The purpose and objectives of the research

The research is aimed to evaluate the level of awareness of primary prevention by vaccinating for cervical cancer of people, that, at a certain point, were put in position to take a decision for administering it to their children or not.

Material and Methods

To accomplish this work, we developed a number of 6 questions grouped in a questionnaire, which was applied to a sample of 484 people, respectively parents of schoolgirls in grades V-IX, in January – June 2010. The questionnaire was used to collect data relating to the information held by the interviewees on the primary prevention of cervical cancer vaccination. The batch included people of the city of Brasov, from General School no. 12 and from Nicolae Titulescu High School, but also from the rural areas from the General School of Hălchiu and General School of Satu Nou. The respondents were chosen randomly, every third person being selected from the ones that attended the parent meetings of those years. At the beginning of the meeting, people were instructed on how to properly complete the questionnaire. Initially 492 questionnaires were completed, of which we selected 484, 8 of them being excluded for various reasons (incomplete, unclear, unlysed).

Results

Characterization study group

From the sample studied, 308(64%) were female and 176(36%) remaining were males, as shown in Figure 1.

Figure 1. STRUCTURE OF THE ANALYSED GROUP BY GENDER

The average age of the group is 45 years, with minimum 30 years and maximum of 60 years. Framing parents in the age groups mentioned in the questionnaire can be viewed in Figure 2.

Figure 2. STRUCTURE OF THE ANALYSED GROUP BY AGE

Most parents of students in classes V to IX have elementary education, respectively 310 of them, and only one third have completed high school. The remaining 16 have a university degree. Graphical format depending on education level is found in Figure 3.

Figure 3. STRUCTURE OF THE ANALYSED GROUP BASED ON THE EDUCATION LEVEL

Of the 484 people surveyed, 246(51%) of them are from urban areas and 238(49%) in rural areas, aspect illustrated in Figure 4

Figure 4. STRUCTURE OF THE ANALYSED GROUP BASED ON THE DOMICILE

The results of the completed questionnaire

In taking a decision, it is extremely important to understand the action and the purpose of the action, so the answers on this issue in the perspective of parents are shown in Table 1 and Figure 5

Table 1. THE GOALS OF VACCINATION IN THE PERSPECTIVE OF PARENTS

Regarding the awareness of the parents about the international use of the vaccine, 291(60,1%) of the respondents were not informed about it and 3(0,6%) parents have failed to respond to results, results found in Figure 6.

Figure 6. THE AWARENESS OF THE PARENTS ABOUT INTERNATIONAL USE OF THE VACCINE

Regarding the knowledge of the benefits of vaccination of the parents surveyed 148(30,5%) responded affirmative, 321(66,3%) negative and 15(3,2%) gave no response, these issues are exposed in Figure 7.

Figure 7. KNOWLEDGE OF THE BENEFITS OF VACCINATION

Contraindications and adverse reactions following vaccination, after evaluating the results of the questionnaire were listed as respondents as: unknown by 392(81%), known by 89(18%), and three parents(1%) who avoided to respond as shown in Figure 8.

Figure 8. KNOWLEDGE OF CONTRAINDICATIONS AND ADVERSE REACTIONS

A further question is aimed to outline a personal assessment on the perception of the level of knowledge on the subject of the anti-HPV vaccination. Most people surveyed, precisely 412 parents(85%) admitted that they do not have enough information to take a decision on HPV vaccination, 72(15%) felt they possess the necessary knowledge as shown in Figure 9.

Figure 9. THE LEVEL OF KNOWLEDGE ON THE SUBJECT OF THE ANTI-HPV VACCINATION

The last question was aimed at identifying the number of respondents who would recommend carrying out the vaccination of their children. 256(53%) of the respondents refused vaccination, while 222(46%) took part in the vaccination campaign, 6(1%) of them abstained or failed to respond, aspect illustrated in Figure 10.

Figure 10. THE INTENTION OF CARRYING OUT THE VACCINATION OF THEIR CHILDREN

Discussions

The evaluation of the responses of the parents of the schoolgirls classes V to IX have highlighted a clear disparity between the quantity and quality of information held by them in respect of the anti-HPV vaccine and the decision, often unfavourable to participate in the vaccination campaign. The lot that was questioned consisted predominantly of women (64%), the average age of the group is 45 years, half residing in rural areas and half in urban areas.

The aim of vaccination was found to protect against a deadly disease and vaccine testing in a proportion of 42% and 46%, which reveals from the beginning that the true objective of performing a vaccination campaign, namely the protection of persons target is unknown by the public. Moreover, for the respondent it is unknown that before marketing a vaccine and releasing it to the general public, there are carried out numerous clinical studies beforehand, whose results support or on contrary, they preclude the type of vaccine widely targeted populations for whom it is addressed. To not neglect the view of 10% of the respondents consider that it is strictly a business of the Ministry of Health.

The fact that the vaccine is already used internationally is only known by 39% of its respondents. Knowing this was a beneficial aspect by example, illustrating the fact that other countries administers this vaccine for several years.

The knowledge of the characteristics of a vaccine and related benefits, contraindications and / or possible side effects associated with vaccination could cause people to whom it is addressed pertinent to make a decision in favour of or against its implementation. The group to whom questions were addressed regarding this issue, has shown that up to 66% did not know the beneficial aspects of implementation of the vaccine and 81% were not informed of any contraindications and side effects that may occur.

The questions were intended to highlight if the population that was asked to take a decision to consider vaccination that is sufficiently informed or not. 84% of respondents admit they do not have sufficient arguments for or against vaccinations.

The last question was aimed to highlight the proportion of people who recommend vaccinating their own children in the context of knowing more or less the vaccination aspects. Interpretation of the results highlighted that 53% of the people do not wish to participate in the campaign.

Conclusion

In general, the aspects of vaccination are little known and this is more clear in the context of a fast ongoing campaign with lack of adequate information by any means (media, fliers, specialists). The group surveyed demonstrated that although they did not know the benefits, contraindications, adverse reactions possible, the international use of the vaccine, in a big proportion , they participated in taking a decision about immunizing their children. The success of such campaigns are ensured only through a rigorous organization involving all those entitled (specialists, family physicians, media) that provide pertinent information related to all aspects associated to the medical vaccination so that the decisions (positive or negative) are being acknowledged. In the opposite event it is a guaranteed failure, parents are forced to take important decisions about the future health of their children, without having minimum knowledge related to vaccination. Paradoxically, the majority of the parents surveyed refused vaccination, although they acknowledged that their decision is not based on medical reasons. A organisation like this one may have faulty remote effects and in time to see an increase that is more accentuated (because it is already manifesting) and the refusal of vaccinations in general.