"Those who love, vaccinate": An Anthropological Perspective on HPV Vaccination in Brazil Open Access

Abstract

Brazil launched an HPV immunization campaign in March of 2014. In less than 6 months, national uptake of the first dose surpassed 80%. Understanding the apparent acceptance of the HPV vaccine in Brazil gives insight into what sorts of factors drive vaccine uptake. Various theoretical frameworks have been developed to help explain, predict, and modify vaccination behavior. Some of these theories propose that biomedical knowledge has a primary influence on decisions to vaccinate. From this perspective, increased knowledge would correlate with increased vaccination. However, a growing body of literature strongly suggests that the provision of scientific knowledge about HPV and its vaccine is not sufficient to motivate parents to vaccinate their daughters. Instead, vaccination is context specific and parent perceptions are shaped by various social, political, and cultural factors that affect how biomedical information is interpreted, the meaning of HPV vaccination, and vaccine access. This study aimed to identify these distal influences and assess the role of HPV knowledge in determining the acceptability of HPV vaccination within a subset of 30 parents from São Paulo, Brazil. The results suggest that the widespread acceptance of the vaccine in São Paulo can be understood by examining the culture of vaccination from which the vaccine gains more than just a biomedical identity. HPV vaccination was portrayed as an act of parental love that provides both health and social insurance against the many unknowns that affect a child's health. This prevailing vaccination culture is mediated by trust in the Ministry of Health and healthcare workers. Thus HPV vaccination isn't just a matter of biomedicine; it intersects the realms of parenting, sexuality, gender roles, power structures, stigma, and social inequality. As hypothesized, these distal factors held more explanatory power for vaccine acceptability than parental knowledge levels. The findings indicate that attempts to understand or modify vaccination rates require the consideration of distal factors.

Table of Contents

I. Introduction 1

II. Methods 31

III. Results 35

IV. Discussion 62

V. Conclusion 72

VI. Appendix 73

VII. References 77

About this Honors Thesis

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School	Emory College
Department	Anthropology
Degree	BS
Submission	Honors Thesis
Language	English
Research Field	Anthropology, Medical and Forensic Health Sciences, General
Keyword	HPV acceptability Brazil HPV vaccine
Committee Chair / Thesis Advisor	Hadley, Craig, Emory University
Committee Members	Brown, Peter J, Emory University Evans, Dabney, Emory University Conis, Elena, Emory University

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