Human papillomavirus (HPV) vaccination recently became available in Brazil for school-aged girls through the Brazil National Immunization Program. We evaluated acceptability of HPV vaccination for daughters among women at high risk for cervical cancer.
Between January and November of 2016, we conducted a cross-sectional survey 500 women with abnormal cervical cytology to examine predictors of HPV vaccination acceptability for daughters.. Participants had no history of HPV vaccination, and were referred for first colposcopy at Barretos Cancer Hospital, a large tertiary care hospital in the state of São Paulo, Brazil.
Most women had heard of prophylactic HPV vaccination (71%) and cervical cancer (95%). However, only around one third (39%) were aware of a vaccine to prevent cervical cancer. Most respondents (86%) indicated they would definitely get HPV vaccination for their adolescent daughters. Respondents were more likely to intend to vaccinate if a doctor recommended it (85% vs. 58% for nurse; p<0.001). Most (82%) indicated they would have their daughter vaccinated if it were available at school, and a notable proportion of respondents preferred to have their daughters vaccinated at a public health clinic (35%) or gynecologist’s office (41%). Correlates of intent to vaccinate included being married or in a domestic partnership (OR 2.41; 95% CI, 1.36-4.19), having the belief that HPV vaccination did not increase sexual activity (OR 2.36; 95% CI, 1.31-4.18), and that obtaining vaccination was not difficult (OR 1.86; 95% CI, 1.05-3.27).
HPV vaccination of adolescent daughters was highly acceptable to a group of at-risk Brazilian women, including through school-located programs. National vaccination strategies in Brazil should emphasize HPV vaccination as a free, accessible, and effective tool to prevent cervical cancer and encourage physicians to discuss HPV vaccination with their patients.