ArticleBMC public health2021
Understanding parents' views toward the newly enacted HPV vaccine school entry policy in Puerto Rico: a qualitative study.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Factors that influence caregivers' and adolescents' views and practices regarding human papillomavirus (HPV) vaccination for adolescents: a qualitative evidence synthesis.The Cochrane database of systematic reviews · 2025Pooled it
- Co-creating HPV Vaccination Messages for Rural Washington: Application of a Boot Camp Translation Approach.Health education & behavior : the official publication of the Society for Public Health Education · 2026Article
- Barriers associated with the parental acceptance of human papillomavirus (HPV) vaccination of minors in Asir, Saudi Arabia: A cross-sectional study.Human vaccines & immunotherapeutics · 2025Article
- Is It Safe for Me to Get It? Factors Influencing COVID-19 Vaccination Decision-Making among Postpartum Women Who Are Black and Hispanic in Deep South.Journal of racial and ethnic health disparities · 2025Article
- Article
- Implementing a School-Entry Mandate for the Human Papillomavirus Vaccine: Benefits and Challenges.Cureus · 2024Review
- Perceptions of a State-Level HPV Vaccine Mandate and Exemption Option in Rural Virginia: A Qualitative Study.Vaccines · 2024Article
- Epidemiology of Cervical Cancer in the Caribbean.Cureus · 2023Review
- HPV vaccination and cervical cancer screening promotion among Black individuals: social ecological perspectives from key informants interviews.Ethnicity & health · 2023Article
- Patient-centeredness-a cultural targeted survey among junior medical managers.International journal for equity in health · 2023Article
- Indiana Parental Perceptions of the Acceptability of General and HPV-Specific State Vaccine Requirements.Journal of community health · 2023Article
- The predictive role of parental attitudes toward COVID-19 vaccines and child vulnerability: A multi-country study on the relationship between parental vaccine hesitancy and financial well-being.Frontiers in public health · 2023Article
- The adoption of the HPV vaccine school-entry requirement in Puerto Rico: How practical lessons can inform future vaccine policies.Preventive medicine reports · 2022Article
- Sex and educational attainment differences in HPV knowledge and vaccination awareness among unvaccinated-sexually active adults in Puerto Rico.Human vaccines & immunotherapeutics · 2022Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThe Human papillomavirus vaccine (HPV) is an essential tool for the prevention of HPV-related cancers. In Puerto Rico, the Secretary of Health established a school entry requirement of at least one dose of HPV vaccination in girls and boys aged 11 and 12 years, taking effect in August 2018. Our study aimed to examine parents' and guardians' views of unvaccinated children about the process of implementation of the new HPV vaccination school entry policy in Puerto Rico and identify potential barriers and facilitators related to the implementation of this requirement.
methodsDuring April through November 2019, we conducted three focus groups (n = 12) and eight in-depth semi-structured interviews with parents of children aged 11 and 12 who had not yet initiated the HPV vaccine series. The interview topics addressed were: perception of vaccination, HPV vaccine and it is inclusion as new school entry requirement practice, procedure of the sources of information, influencers, and willingness to change. The interviews were recorded and transcribed by our staff members. We identified emergent themes through thematic analysis.
resultsThe participants' perspective on the HPV vaccine school requirement was mixed. Lack of information of the HPV vaccines and lack of communication about the school-entry requirement were the themes most mentioned in the interviews. Moreover, previous negative experiences from friends or family members and adverse effects deterred some participants from vaccinating their kids. We discussed barriers in the process of soliciting an exemption.
conclusionMost barriers mentioned by study participants are modifiable. Information about the HPV vaccine mandate's implementation and educational materials regarding HPV vaccine safety need to be provided to address parents' concerns related to the vaccine's side effects. Schools (teachers, principal directors, and administrative staff), the government, and parent organizations need to be part of these efforts. This multilevel approach will help to improve disseminating information about HPV vaccination to clarify doubts and misinformation among parents.
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