Does the number of doses matter? A qualitative study of HPV vaccination acceptability nested in a dose reduction trial in Tanzania

Mitchell, K.R. , Erio, T., Whitworth, H.S., Marwerwe, G., Changalucha, J., Baisley, K., Lacey, C.J., Hayes, R., de SanJosé, S. and Watson-Jones, D. (2021) Does the number of doses matter? A qualitative study of HPV vaccination acceptability nested in a dose reduction trial in Tanzania. Tumour Virus Research, 12, 200217. (doi: 10.1016/j.tvr.2021.200217) (PMID:34051389) (PMCID:PMC8233223)

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Abstract

Background: The multi-dose regimen is a known barrier to successful human papillomavirus (HPV) vaccination. Emerging evidence suggests that one vaccine dose could protect against HPV. While there are clear advantages to a single dose schedule, beliefs about vaccine dosage in low and middle income countries (LMICs) are poorly understood. We investigated acceptability of dose-reduction among girls, and parents/guardians of girls, randomised to receive one, two or three doses in an HPV vaccine dose-reduction and immunobridging study (DoRIS trial) in Tanzania. Methods: Semi-structured interviews with girls (n=19), and parents/guardians of girls (n=18), enrolled in the study and completing their vaccine course. Results: Most participants said they entrusted decisions about the number of HPV vaccine doses to ‘experts’. Random allocation to the different dose groups did not feature highly in the decision to participate in the trial. Given a hypothetical choice, girls generally said they would prefer fewer doses in order to avoid the pain of injections. Parental views were mixed, with most wanting whichever dose was most efficacious. Nonetheless, parents sometimes equated a higher number of doses with greater protection. Conclusion: Vaccine trials and programmes will need to employ careful messaging to explain that one dose offers sufficient protection against HPV should emerging evidence from ongoing dose-reduction clinical trials support this.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mitchell, Professor Kirstin
Authors: Mitchell, K.R., Erio, T., Whitworth, H.S., Marwerwe, G., Changalucha, J., Baisley, K., Lacey, C.J., Hayes, R., de SanJosé, S., and Watson-Jones, D.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:Tumour Virus Research
Publisher:Elsevier
ISSN:2666-6790
Published Online:26 May 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Tumour Virus Research 12: 200217
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
Chief Scientist Office (CSO)SPHSU11
727631SPHSU Core Renewal: Relationships & Health Improvement Research ProgrammeLisa McDaidMedical Research Council (MRC)MC_UU_12017/11IHW - MRC/CSO SPHU
Chief Scientist Office (CSO)SPHSU18
Relationships and healthMedical Research Council (MRC)MC_UU_00022/3HW - MRC/CSO Social and Public Health Sciences Unit