Opportunities for HPV vaccine education in school-based immunization programs in British Columbia, Canada: A qualitative study

ABSTRACT

Despite the availability of school-based immunization programs (SBIPs) in Canada, human papillomavirus (HPV) vaccine uptake remains suboptimal. Vaccine education may improve vaccine uptake among adolescents. The objective of this qualitative study was to identify opportunities for HPV vaccine education in British Columbia, Canada, by exploring the perspectives of students, parents, school staff, and public health nurses on the current SBIP. Individual semi-structured interviews were conducted with adult participants and focus groups were conducted with grade 6 students between November 2019 and May 2020. The interviews and focus groups were transcribed and then analyzed using reflexive thematic analysis. Opportunities for HPV vaccine education were identified in three themes: 1) making SBIPs student-centered; 2) adopting a collaborative and interdisciplinary approach to vaccine education; and 3) actualizing parent education opportunities. Broad support existed for a formal, collaborative HPV grade 6 vaccine curriculum delivered by teachers and public health nurses to provide evidence-based health information. Participants voiced that the curriculum should integrate students’ perspectives on topics of interest and address needle associated pain and anxiety. Parents were identified as the primary vaccine decisionmakers, therefore, participants stated it was crucial to also provide parent-directed vaccine education as part of SBIP. Our findings support the development of a collaborative HPV vaccine curriculum directed to and informed by students and parents to buttress current SBIPs in British Columbia.

KEYWORDS:

• Human papillomavirus
• Canada
• adolescents
• youth
• vaccine acceptance
• vaccine hesitancy

Acknowledgments

The authors wish to thank all participants in this study who provided their time and insights into their decision-making processes and the support of the local school boards.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contribution

JAB, HM and ED were involved with the conception and design of the study; JAB and HM were involved with data collection; JAB, HM, IB and GB were involved with the analysis and interpretation of the data; IB, GB, JAB and HM were involved with the drafting of the paper and all authors were involved with revising it critically for intellectual content and the final version to be published. All authors agree to be accountable for all aspects of the work.

Additional information

Funding

This work was supported by grants from the British Columbia Immunization Committee, the Canadian Institutes of Health Research grant #151944 and the Public Health Agency of Canada grant #151944 (1 June 2017–31 December 2022).