ArticleBMC public health2009
A qualitative study to assess school nurses' views on vaccinating 12-13 year old school girls against human papillomavirus without parental consent.
Article in BMC public health, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Barriers and enablers to adolescent self-consent for vaccination: A mixed-methods evidence synthesis.Vaccine · 2019Pooled it
- HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe.Human vaccines & immunotherapeutics · 2019Pooled it
- Barriers and facilitators to HPV vaccination of young women in high-income countries: a qualitative systematic review and evidence synthesis.BMC public health · 2014Pooled it
- Barriers in the School-Based Pan-Gender HPV Vaccination Program in Sweden: Healthcare Providers' Perspective.Vaccines · 2023Article
- Parental intention to vaccinate adolescents with HPV vaccine in selected communities in Ibadan, Southwest Nigeria: an application of Integrated Behavioral Model.Human vaccines & immunotherapeutics · 2022Article
- Encountering Parents Who Are Hesitant or Reluctant to Vaccinate Their Children: A Meta-Ethnography.International journal of environmental research and public health · 2021Review
- Concept analysis of impressionability among adolescents and young adults.Nursing open · 2018Article
- An appraisal of theoretical approaches to examining behaviours in relation to Human Papillomavirus (HPV) vaccination of young women.Preventive medicine · 2015Review
- Informed consent for HPV vaccination: a relational approach.Health care analysis : HCA : journal of health philosophy and policy · 2015Article
- Awareness of human papillomavirus and factors associated with intention to obtain HPV vaccination among Korean youth: quasi experimental study.BMC international health and human rights · 2015Article
- School nurses' experiences of delivering the UK HPV vaccination programme in its first year.BMC infectious diseases · 2011Article
- Ontario's school-based HPV immunization program: school board assent and parental consent.Canadian journal of public health = Revue canadienne de sante publiqueArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the UK, parental consent for the routine vaccination of 12-13 year olds schoolgirls against human papillomavirus (HPV) is recommended, although legally girls may be able to consent themselves. As part of a vaccine study conducted ahead of the National HPV Vaccine Programme we sought the views of school nurses on vaccinating girls who did not have parental consent.
methodsHPV vaccination was offered to all 12 year old girls attending schools in two Primary Care Trusts in Greater Manchester. At the end of the study semi-structured, tape-recorded interviews were conducted with school nurses who had delivered the vaccine (Cervarix). The interview template was based on concepts derived from the Theory of Planned Behaviour. Transcripts were analysed thematically in order to understand school nurses' intentions to implement vaccination based on an assessment of Gillick competency.
resultsSchool nurses knew how to assess the competency of under-16s but were still unwilling to vaccinate if parents had refused permission. If parents had not returned the consent form, school nurses were willing to contact parents, and also to negotiate with parents who had refused consent. They seemed unaware that parental involvement required the child's consent to avoid breaking confidentiality. Nurses' attitudes were influenced by the young appearance and age of the school year group rather than an individual's level of maturity. They were also confused about the legal guidelines governing consent. School nurses acknowledged the child's right to vaccination and strongly supported prevention of HPV infection but ultimately believed that it was the parents' right to give consent. Most were themselves parents and shared other parents' concerns about the vaccine's novelty and unknown long-term side effects. Rather than vaccinate without parental consent, school nurses would defer vaccination.
conclusionHealth providers have a duty of care to girls for whom no parental consent for HPV vaccination has been given, and in the UK, this includes conducting, and acting upon, an assessment of the maturity and competence of an adolescent minor. To facilitate this, policies, training and support structures for health providers should be implemented.
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