HPV vaccination programmes across the world are suffering from waving of public confidence and trust. In some countries - such as Japan, Denmark, or France - this has led to a sometimes dramatic decrease in the demand for the vaccine. Concerns have been shown to vary by region and country, but also by population group, with parents, teenagers, but also healthcare workers raising diverse concerns and doubts about the vaccine. Interventions developed with the aim of increasing HPV vaccination uptake and confidence should be based on a thorough understanding of the issues influencing public distrust.
The Vaccine Confidence Project has led various studies to broaden the understanding of factors and determinants associated to low public confidence in HPV vaccination. The results presented here primarily include those from a systematic literature review conducted in Europe, as well as an analysis of the media.
RESULTS/CONCLUSIONS: European populations were found to be particularly concerned about the safety of the HPV vaccine. In some cases, most commonly observed in online discussions, these concerns were related to rumours of specific side effects (POTS and CRPS). However, most safety concerns were reported to be broad and non-specific, and to rather reflect fears related to uncertainties and distrust. Beliefs that the vaccine is not effective, and that there is insufficient information available about the vaccine are among the uncertainties. Morality was another common issue, including perceptions that the vaccine could encourage promiscuity and unsafe sexual behaviours. Some countries are facing more challenges than others, calling for the development of context-specific interventions.
Communicating scientific facts is not sufficient, especially in a context of post-truth societies. Interventions to address HPV vaccination confidence should be informed by an understanding of key issues that influence public trust and distrust. Other possible interventions that encourage dialogue include the organisation of peer-to-peer information and discussion sessions, or through healthcare worker-moderated online discussion groups.