Angela-Theresa C. Green
Dr Parrish
South University
NSG 6101 Nursing Research Methods
October 24, 2017
What is the Knowledge and Attitudes towards Gardasil Vaccination among Parents for Their Children?
Introduction
There are many cases concerning cervical cancer occurring all over the world annually (Osazuwa, 2013). Statistics suggest that there are increased numbers of 493,000 new cases of cervical cancers as well some not less than 274 women dying from the infection each year. Three-quarters of those deaths occur in the developing countries because of the unavailability or ineffective screening programs detecting cervical cancer. Furthermore, India bears almost roughly one-fifth of the cervical cancer burden in the whole world with more than 130,000 cases every year. The age-standardized incidence rate of cancer in India is 30.7 per 100,000 which is 300% higher than the rates in the U.S and other nations including Canada and the United Kingdom. The human papillomavirus is a world most widespread sexually transmitted infection. It is the primary causative agent for genital warts, cervical, anal and penile cancers in both female and male under the age of 25 years. It is estimated that 75 % of total underage Canadians experience the infection once in their lifetime (Osazuwa, 2013).
Literature Review
Vaccines that prevent human papillomavirus (HPV) infections provide dramatic opportunities for the reduction of cervical cancer associated deaths (Osazuwa, 2013). Since HPV vaccines have been recommended proceeding to the commencement of the sexual act, the adolescent girls have been primarily targeted. As a consequence, understanding parental HPV vaccination acceptability has been critical because governments think about the way the vaccination programs should be implemented. Parents have been found in many settings to possess low levels of understanding about cervical cancer and HPV. They have been seen expressing worries that vaccines provided against the sexually transmitted infections for instance HPV could promote early sexual unveiling as well as promoting amplified sexual threat behaviors.
HPV has been a commonly transmitted disease for many years, and it can result in cervical cancer as well as genital warts (Chawla, Chawla, and Chaudhary, 2016). HPV can be carried by both men and women, and it can also lead to other cancer for instance vulva, penis, anus, and throat and vaginal cancer. Because of the threat of cancer among young boys and girls due to premature engagement of sexual intercourse, HPV vaccination has been proposed to be a public health intervention program to reduce the threat of the infection among young girls. The HPV vaccination plan needed a symbiotic relationship between scientific interest in the reduction of mobility, mortality as well as the philosophical awareness in the promotion of morality. Moreover, the proposed program raises the matter of whether the government should use its powers to restrict parental autonomy and liberty to prevent harm to young people. Many questions have been targeted towards the HPV vaccination value. The program has been judged based on moral reasoning by many. The human papillomavirus is the most feared sexually transmissible infection (STI) in the States. Most of the parents in the United States of America are ignorant of human papillomavirus as a sexually transmitted disease (Ezenwa, Balogun, and Okafor, 2013).
A third of forty types of cancer are related to gynecological malignancies such as cervix cancer, ovarian, vulva, and uterus cancer (Ezenwa, Balogun, and Okafor, 2013). The pathogenesis of cervical cancer is activated by the reaction of the epithelial cell to human papillomavirus. The virus has been considered that 70 % of the cervix cancer occurs as result of the cervical mucosa by the high-risk HPV virus 16 and 18. Almost 15% of cases of cancer in the world and 26% of cases of cancer in the developing countries are to at a height probability of contracting infectious agents especially viruses. The leading result of mortality in the world among women is cervical cancer that is as a result of the Human papillomavirus. Gardasil and Cervarix are the two immunizations that have been approved to create a significant opportunity to control the burden of cervical cancer. HPV has over 100 genotypes although few of them are characterized as ‘’high risk’’. The genotypes are the result of the disease. Genotype 16 and 18 are known to be the high risks HPV-genotypes detected among the Norwegian women having cervical cancer (Ezenwa, Balogun, and Okafor, 2013).
HPV Vaccination Perspectives
A total of N=500 respondents were invited for the survey whereby 390 responded to the study. 72-89%) were the mothers who were the majority respondents (Mortensen, Adam, and Idtaleb, 2015). Overall parents were positive about the HPV male vaccination in order to reduce the HPV transmission in the communities (70-85) and of their own boys (49-75). Gender and number of children in household, level of education, gender and income were not the primary variable associated to acceptability. Girls’ parents showed more willingness to vaccination even if the vaccines were not free as compared to those of the boys ( OR: 1.35; CL:1.22-1.500). There was also a major interaction (p=0.004) between child’s as well as the parent’s sex, in a way that the difference in willingness between fathers and mothers pronounced for their girls than boys. Among the parents who considered HPV vaccination, 53% considered 15-17 years as the preferred age for immunization. Age 12-14 years of age was the preferable by 35% of the parents. Moreover, 18 years or more were preferable by 7% (Mortensen, Adam, and Idtaleb, 2015).
Literacy
In another study conducted by (Ezenwa, Balogun, and Okafor, 2013), Most of the parents had no knowledge and awareness of the HPV vaccines or HPV; with only 27.9% of respondents had an awareness of the HPV. Moreover, just 13% of mothers knew HPV as well as its vaccines, but their vaccination perspective for their daughters was very high. Even if the literacy for the HPV and the vaccines were low, most of the respondents (79.6%) had cervical cancer awareness. However, they did not know the connection between cervical cancers; only 21% were aware that HPV is transmitted sexually (Ezenwa, Balogun, and Okafor, 2013).
Resources and knowledge
The bivalent immunization defends HPV genotypes 16 as well as the 18 (Mortensen, Adam, and Idtaleb, 2015). Oncogenic HPV especially 16 and 18 also result to other cancers on top of cervical cancer. HPV is the cause of around 50% of vaginal, vulva, and penile diseases as well as 60-70% of the oropharyngeal cancers. The men who are infected with HPV are at a higher risk of getting the HPV associated infections, and they increase the dangers of infecting women. HPV normalization vaccines uptake can increase the herd-immunity/spread of the contagious disease known as HPV in men and women. The Gardasil vaccine has been the super preventive drug against the genital cancers since its approval. Besides, it has been observed by the physicians can prevent more of the cancer subtypes. The dose is administered three times within six months though FDA has come up with an alternative two-dose series but having the same positive impact on carcinogenic inhibition. Both trials are entirely effective in kicking away the feared disease. The inquiry adopts that the challenges facing the preventive measures against the genital cancers are constant.
The problem is only mere knowledge and attitude of the parents and once they understand the benefit of the vaccine the children will be fully immunized (Mortensen, Adam, and Idtaleb, 2015).
Self-efficacy
‘The Advisory Committee on Immunization Practices’ records routine vaccinations of boys and girls aged between 11 and 12 years of age (Hussain, Alkhenizan, McWalter, and Qazi, 2016). The goals of these recommendations are to prevent HPV infections as well as the occurrence of anogenital warts that starts from the time of exposure, no matter what the age. There is an intention to expound the parents' reluctance toward the preventive measures of the genital carcinogenic agents. Meanwhile, middle and administration faculty of the school will be assessing their knowledge to determine whether the attitude concerning the vaccine can limit its uptake. Gardasil vaccine is a new medical breakthrough and therefore lack of understanding of human papillomavirus toward sexual health. As a result, the guardians could not comprehend whether the vaccine could prevent cervical cancer and other HPV interrelated menaces. Gardasil vaccine is a preventive drug meant to deter carcinogenic genital infections such as cervical and other human papillomavirus diseases. The vaccine contains four antivirus antigens which put off cancer causative agents in the human body. The vaccine targets children in their late pubertal and early adolescent stages.
Adherence to a plan and active participation
In the conduction of a systematic survey, a group of 6 persons were employed who were to assist the researcher in the collection of the required data (Mortensen, Adam, and Idtaleb, 2015). The researcher invited parents of 300 boys and 400 girls in the study. To have their attention the researcher prepared to send Posts across the town telling them of the importance of the community participating in the research to get the voice concerning the vaccination. A qualitative type of analysis was the perception of the study whereby questions were provided to the parents to use. Questionnaires were distributed among the group of 700 parents of boys and girls. These parents were recruited by a conducted advertisement through some Posters. The parents were divided into six groups were by each team was run by an individual with whom the researcher had contracted. The researcher was the one in charge of the research (Mortensen, Adam, and Idtaleb, 2015).
Informed-decision making
The participation for this study relied on the self-determined decision making. The parents participated in the research voluntarily (Ezenwa, Balogun, and Okafor, 2013). They were emailed before the study started to provide the consent and two days before the survey they were contacted through a phone call to get full confirmation from the participating individuals. Otherwise, they were not to give consent to participate in the research or even refuse to fill the forms. Before recruiting any member to engage in the study, approval was granted through email which was indicated we were advertising about the survey (Ezenwa, Balogun, and Okafor, 2013).
Research Perspectives
The interviews were recorded into a single table reflecting on qualitative data. A recording matrix was created according to the literature question and literature (Osazuwa-Peters, 2013). Following the methodology, coding structure was modified as required with the returns in the information to provide additional data to the parents. The descriptive statistics for this research will evaluate the qualitative data to conclude on the general awareness of the parents towards the acceptability of the HPV vaccines. The descriptive statistics should be able to answer the research questions. The conclusion concerning the performed test in this study will be the majority of the people in willingness to vaccinate regardless of the cost as well as the number of age limit being picked by the parents (Osazuwa-Peters, 2013).
Factors that Affect HPC Vaccination
Some of the factors that affect the HPV vaccination rates among the young adults in the United States are the differences in the educational status since it positively affects the vaccination acceptability (Osazuwa-Peters, 2013). Secondly, we have the quantity of the involvement of general pediatricians and Practitioners in providing the vaccination. Lastly is the lifting of the HPC vaccination eligibility age is significant to be considered since it would raise the vaccination eligibility (Osazuwa-Peters, 2013).
Summary
The bivalent and quadrivalent vaccine has two and four anti carcinogenic viral antigens respectively which deactivates the causative agents have been ratified for use (Ezenwa, Balogun, and Okafor, 2013). The principal targets are girls and sexually active women between the age of eleven and twenty-six years of age. In the meantime, the young males are not left out of immunization merely because they might be the leading carriers of the dreaded virus. Recurrent infection of the two precarious types of cancers are prevalence to sexually active women and all, therefore, all female is at risk as long as they are exposed to oncogenic viruses. The most preferred and readily available protections such as condom bars the HPV infection risk by 70 % meaning there is no guarantee that the use of a condom will keep the active women away from the carcinogenic agent. However, the Gardasil vaccination has proved to reduce the risk of some cancer diseases. Continued vaccination of human papillomavirus has recorded the excellent outcome. Nevertheless, the use of the bivalent and quadrivalent vaccine has been associated with some limitation in contrast to what it was previously expected. Lack of education and community awareness resulted into many parents shying away from their children receiving the vaccination. The main agenda of this study is to evaluate the acceptability of HPC among parents towards their children. Moreover, it focuses its attention on the attitude towards human papillomavirus vaccination among parents of teenage girls (Ezenwa, Balogun, and Okafor, 2013).
Knowledge, attitude, and behaviors toward the human papillomavirus would also be featured in the study as well factors that affect parental goals to vaccinate their children against human papillomavirus (Mortensen, Adam, and Idtaleb, 2015). The elements might be the knowledge of cervical cancer and sexually transmitted infections, risks of cervical cancer, genital warts and attitude toward the vaccines. Additionally, this paper will identify a range of attitude levels and knowledge together with the type of practices on the adolescent vaccines. Hence, this will allow us to identify how attitudes, knowledge, and practices would affect vaccine uptake as well as how it would affect the coverage of vaccines. The primary intention of the study was to answer an undoubtedly important question of; parental understanding toward the Gardasil vaccine and the reason behind immunization to children. The research question is: What is the knowledge and attitudes towards Gardasil vaccination among parents for their children?
Additionally, another question to be answered was whether the parents are aware of the idea behind the age bracket of people considered to receive the drug (MehmoodKhan, Saleem, and UrRehman, 2016). The study was conducted to prove that the vaccination can be successful and a technique of ailment suppression. Many countries in the world have recommended the HPV vaccines as a solution to prevent Human Papillomavirus. In Africa, several states had introduced HPV vaccine to stop the spread of cancer among school and the adolescent girls. The vaccines were introduced as school-based programs. The World Health Organization comes in to define the adolescents that individuals ranging from the age of 10 to 19 years of age. However, there is a significant challenge that parents as well and teachers lack information concerning the vaccines. Parents have been preaching the whole vaccination idea negatively. Some have been suggesting that the introduction of the vaccines would promote immorality in the society. Therefore, the involvement of the parents concerning the HPV vaccines including the attitude and knowledge can affect the willingness of young girls to be vaccinated (Mortensen, Adam, and Idtaleb, 2015).
References
Chawla, P., Chawla, A., & Chaudhary, S. (2016). Knowledge, attitude & practice on human papillomavirus vaccination: A cross-sectional study among healthcare providers. Indian Journal of Medical Research, 44(5), 741-749. doi:10.4103/ijmr.IJMR_1106_14
Ezenwa, B., Balogun, M., & Okafor, I. (2013). Mothers’ human papilloma virus knowledge and willingness to vaccinate their adolescent daughters in Lagos, Nigeria. International Journal of Women's Health, 5(1), 371-377. doi: 10.2147/IJWH.S44483
Hussain, A., Alkhenizan, A., McWalter, P., Qazi, N., Alshmassi, A., Farooqi, S., & Abdulkarim, A. (2016). Attitudes and perceptions towards HPV vaccination among young women in Saudi Arabia. Journal of Family and Community Medicine, 144-150. doi:10.4103/2230-8229.189107
Mehmood Khan, T., Buksh, M., Rehman, I., & Saleem, A. (2016). Knowledge, Attitudes, and Perception towards Human Papillomavirus among university students in Pakistan. Papillomavirus Research, 2(1), 122-127. doi:10.1016/j.pvr.2016.06.001
Mortensen, G., Adam, M., & Idtaleb, L. (2015). Parental attitudes towards male human papillomavirus vaccination: a pan-European cross-sectional survey. BMC Public Health, 15(624), 1-10. doi:10.1186/s12889-015-1863-6
Osazuwa-Peters, N. (2013). Human papillomavirus (HPV), HPV-associated oropharyngeal cancer, and HPV vaccine in the United States--do we need a broader vaccine policy? Vaccine, 31(47), 5500-5505. doi:10.1016/j.vaccine.2013.09.031
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