title: Increasing fear of adverse effects drops intention to vaccinate after the introduction of prophylactic HPV vaccine.
abstract: OBJECTIVE
  The purpose of this study was (1) to explore for socio-demographic factors that could potentially affect the intention of women to vaccinate themselves, their 13-year-old daughter and their 13-year-old son against HPV, and (2) to investigate the main reasons for declining vaccination.
  
  
  METHODS
  A structured questionnaire was used in participants of the project (N = 5,249). Logistic regression analysis was applied in order to examine the correlation between vaccine acceptability and a list of potential predictors. In women declining vaccination, the reported reasons for decline were analyzed.
  
  
  RESULTS
  Residence in rural areas and low to medium tiers of family income were the most constant factors in favor of intention to vaccinate. Receiving information from a healthcare professional was found to positively affect vaccine acceptability for the woman herself, but it did not affect her intention to vaccinate her daughter or her son. The acceptance rates decreased significantly after the vaccine became available, both for the women themselves and for their daughters or sons. During the same year, a shift was noted in the reason for declining vaccination; the self-perception of insufficient knowledge significantly decreased and the fear of adverse effects significantly increased in all three cases.
  
  
  CONCLUSIONS
  Apart from demographic factors which may favor or disfavor vaccine acceptability, the intention to vaccinate decreased significantly and the proportion of women rejecting vaccination for safety concerns increased significantly after the introduction of the vaccine, coinciding with isolated cases of negative publicity and highlighting the potential of misinformation by the media.
authors.affiliation: Fourth Department of Obstetrics and Gynecology, Ippokration General Hospital, 49 Constantinoupoleos Street, 546 42 Thessaloniki, Greece. asotir@gmail.com
authors.forename: Alexandros
authors.initials: A
authors.lastname: Sotiriadis
authors.forename: Themistoklis
authors.initials: T
authors.lastname: Dagklis
authors.forename: Vaia
authors.initials: V
authors.lastname: Siamanta
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Chatzigeorgiou
authors.forename: Theodoros
authors.initials: T
authors.lastname: Agorastos
mesh_terms: D000328:Adult; D005239:Fear / Q000523:psychology*; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000009:adverse effects*; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology*; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines