Addressing Health Inequalities in the Delivery of the Human Papillomavirus Vaccination Programme: Examining the Role of the School Nurse
Open Access
- 13 September 2012
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 7 (9), e43416
- https://doi.org/10.1371/journal.pone.0043416
Abstract
HPV immunisation of adolescent girls is expected to have a significant impact in the reduction of cervical cancer. UK The HPV immunisation programme is primarily delivered by school nurses. We examine the role of school nurses in delivering the HPV immunisation programme and their impact on minimising health inequalities in vaccine uptake. A rapid evidence assessment (REA) and semi-structured interviews with health professionals were conducted and analysed using thematic analysis. 80 health professionals from across the UK are interviewed, primarily school nurses and HPV immunisation programme coordinators. The REA identified 2,795 articles and after analysis and hand searches, 34 relevant articles were identified and analysed. Interviews revealed that health inequalities in HPV vaccination uptake were mainly related to income and other social factors in contrast to published research which emphasises potential inequalities related to ethnicity and/or religion. Most school nurses interviewed understood local health inequalities and made particular efforts to target girls who did not attend or missed doses. Interviews also revealed maintaining accurate and consistent records influenced both school nurses' understanding and efforts to target inequalities in HPV vaccination uptake. Despite high uptake in the UK, some girls remain at risk of not being vaccinated with all three doses. School nurses played a key role in reducing health inequalities in the delivery of the HPV programme. Other studies identified religious beliefs and ethnicity as potentially influencing HPV vaccination uptake but interviews for this research found this appeared not to have occurred. Instead school nurses stated girls who were more likely to be missed were those not in education. Improving understanding of the delivery processes of immunisation programmes and this impact on health inequalities can help to inform solutions to increase uptake and address health inequalities in childhood and adolescent vaccination programmes.Keywords
This publication has 51 references indexed in Scilit:
- School nurses' experiences of delivering the UK HPV vaccination programme in its first yearBMC Infectious Diseases, 2011
- Explaining variation in the uptake of HPV vaccination in EnglandBMC Public Health, 2011
- A Population-Based Evaluation of a Publicly Funded, School-Based HPV Vaccine Program in British Columbia, Canada: Parental Factors Associated with HPV Vaccine ReceiptPLoS Medicine, 2010
- Uptake in cancer screening programmes: a priority in cancer controlBritish Journal of Cancer, 2009
- Parental attitudes and information needs in an adolescent HPV vaccination programmeBritish Journal of Cancer, 2008
- Public knowledge and attitudes towards Human Papilloma Virus (HPV) vaccinationBMC Public Health, 2008
- Variation in incidence of breast, lung and cervical cancer and malignant melanoma of skin by socioeconomic group in EnglandBMC Cancer, 2008
- Uptake of first two doses of human papillomavirus vaccine by adolescent schoolgirls in Manchester: prospective cohort studyBMJ, 2008
- Ethnicity as a correlate of the uptake of the first dose of mumps, measles and rubella vaccineJournal of Epidemiology and Community Health, 2007
- Developing an Evidence Base for Policies and Interventions to Address Health Inequalities: The Analysis of “Public Health Regimes”The Milbank Quarterly, 2006