title: Communication challenges of HPV vaccination.
abstract: BACKGROUND
  The UK has introduced a national human papillomavirus (HPV) immunisation programme for girls aged 12-13 from autumn 2008. Previous research has explored public understanding of the causes of cervical cancer and found little awareness of the role of HPV.
  
  
  OBJECTIVE
  To explore GPs' and practice nurses' views of HPV vaccination, prior to implementation of the national immunisation programme, with a focus on their role and anticipated difficulties.
  
  
  METHODS
  Qualitative semi-structured interviews were conducted with 17 GPs and practice nurses from practices in Hampshire and Wiltshire, in March 2008.
  
  
  RESULTS
  The prevailing theme of new communication challenges was identified and these were connected to the activities of (i) explaining, (ii) consenting and (iii) managing conflicts between parents and their children with respect to vaccination decisions. The importance of decisions being fully informed was emphasized and concern was expressed about the adequacy of the information provided to girls and their parents in schools. Whether consent would be granted by the parent or by the child and how potential disagreements should be managed remained ambiguous. Participants considered it appropriate to offer the vaccine without parental consent if other criteria, such as an assessment of competency, were met.
  
  
  CONCLUSIONS
  Success of the national immunization programme will depend on overcoming the challenges of providing explanations to ensure that individuals understand the potential benefits of HPV vaccination. Primary care can play an important role, but this study suggests there are fundamental issues that need further clarification.
authors.affiliation: Primary Medical Care, Community Clinical Sciences Division, University of Southampton School of Medicine, Aldermoor Health Centre, Southampton SO16 5ST, UK. elizabeth.brown5@nhs.net
authors.forename: Elizabeth C F
authors.initials: EC
authors.lastname: Brown
authors.forename: Paul
authors.initials: P
authors.lastname: Little
authors.forename: Geraldine M
authors.initials: GM
authors.lastname: Leydon
mesh_terms: D000293:Adolescent; D000295:Adolescent Medicine; D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002983:Clinical Competence; D003142:Communication; D003657:Decision Making; D004739:England; D005260:Female; D006801:Humans; D017589:Immunization Programs; D007407:Interviews as Topic; D008875:Middle Aged; D009726:Nurses / Q000523:psychology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D010287:Parent-Child Relations; D010821:Physicians, Family / Q000523:psychology; D011315:Preventive Medicine; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000517:prevention & control
chemical_list: D053918:Papillomavirus Vaccines