7 May 2019

Vaccination against cervical cancer: yes or no?

The HPV Vaccination Decision Aid is a new, interactive website that helps mothers and their daughters make informed decisions about the HPV vaccination, which protects against the development of cervical cancer. Mothers who make use of the website, which will be integrated into the national information programme on HPV vaccination next year, are better informed and more willing to have their daughters vaccinated against HPV than mothers who do not. This is the main conclusion of research conducted by Mirjam Pot, who recently defended her PhD at Maastricht University.

pot ruiter

The importance of mothers

Cervical cancer, a common disease among women, is caused by persistent infection with the human papillomavirus (HPV), which is transmitted through sexual contact. New cases are still being discovered, a considerable number of which are fatal: approximately 200 women in the Netherlands die of cervical cancer each year. “Even though there’s a free vaccine that could prevent many of these deaths”, says Pot.

Ruiter: “The main motivation for this PhD was that the vaccination rate has continued to decline since HPV vaccination was included in the national immunisation programme in 2009. There are various reasons for this, although previous research in the Netherlands has shown that mothers play the key role in deciding on their daughters’ HPV vaccination. That’s why this research focused on mothers. They also had an important voice in the development of the website.”

Social change

“It’s crucial to provide proper information that meets the needs of the target group”, Pot says. “Only those who have all the information can make well-considered decisions about HPV vaccination.” “Which is especially important today”, adds Ruiter. “There’s been a social change in recent years: people have become increasingly concerned about vaccine safety. Parents often feel insecure.”

Uncertainty

The belief that vaccines can be dangerous is influenced by dramatic media reports, especially on the internet, Pot found. “This leads to uncertainty and the idea that vaccination is unsafe. And yet the HPV vaccine has been incontrovertibly shown to be safe across the entire population.” Another explanation for the low turnout is the sexual aspect of the infection. “The vaccine is most effective before girls become sexually active. It’s difficult for parents to make a realistic assessment of their daughters’ future sexual behaviour.”

Pot tested the HPV Vaccination Decision Aid in a large-scale experiment. The results were very positive: mothers who used the decision aid were more readily prepared to have their daughters vaccinated than mothers who did not. “The great thing about this decision aid is that it’s accessible and personal”, she says. “Users can contact a virtual assistant that provides immediate feedback on the advantages and disadvantages of vaccination.”

Social impact

Ruiter and Pot expect the website to have significant social impact. As of 2019, every 12-year-old girl in the Netherlands will be called up for the HPV vaccination and provided with a link to the decision aid. “We have high expectations, because we know we can reach large groups at a relatively low cost.”

By: Graziella Runchina (text), Loraine Bodewes (photography)