Factors influencing routine verification of Human papillomavirus (HPV) vaccination status by health care professionals at public health posts in São Paulo, Brazil Open Access

Figueroa-Downing, Daniella (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/tq57nr25f?locale=en
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Abstract

In March 2014, Brazil began a national, school-based immunization campaign against human papillomavirus (HPV) for adolescent girls as part of its National Immunization Program. While the primary immunization site is the school, vaccination of all girls not captured on school immunization days should be conducted at public health posts in the Unified Health System (SUS). As part of their role to ensure universal coverage, health care professionals should be routinely inquiring about immunizations status for all eligible adolescent girls and vaccinating those who were previously unvaccinated. However, it is unclear how health care professionals' perception of the vaccine affects their critical role as a safety net for the school-based HPV immunization campaign.

In August 2014, we conducted a pilot study with 200 health care professionals - doctors, nurses, nurse support staff, and community health agents - at five public health posts in the municipality of São Paulo. Respondents self-administered a questionnaire to assess their personal characteristics; their knowledge about HPV infection and the vaccine; their perceptions towards vaccine benefit, safety and efficacy; and their routine verification of adolescents' immunization status.

Overall, verification of immunization status for adolescent girls in the eligible age range is low - 38.5% of providers never ask about HPV immunization status and 25.0% only occasionally ask. Doctors were the least likely to report always asking, while community health agents (CHAs) were more likely to always ask about HPV vaccination. Respondents who self-identified as being responsible for educating about the vaccine were more likely to always verify immunization status. Knowledge about HPV, the HPV vaccine and the national campaign was mixed. Perceptions of the vaccine were generally positive.

Similarly to other studies, here, knowledge and attitude may not play as central a role in HPV vaccination as other factors. In the context of the Family Health Strategy in Brazil, the CHAs are a crucial component of primary health care, including HPV vaccine promotion. Continued education and support of the CHA is essential for sustainable success of HPV immunization efforts in Brazil.

Table of Contents

CHAPTER I: BACKGROUND ........................................ 1
CHAPTER II: MANUSCRIPT ........................................ 10
INTRODUCTION ....................................................... 11
METHODS ............................................................... 13
RESULTS ................................................................. 17
DISCUSSION ........................................................... 20
TABLES ................................................................... 23
CHAPTER III: PUBLIC HEALTH IMPLICATIONS ............... 28
CHAPTER IV: REFERENCES ......................................... 32
APPENDIX ................................................................ 35
SUPPLEMENT: ADDITIONAL TABLES ............................. 36
SUPPLEMENT: SURVEY ............................................... 38

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