title: Human papillomavirus vaccine acceptability among parents of adolescent girls: obstacles and challenges in Mysore, India.
abstract: OBJECTIVE
  Worldwide, 530,000 women are diagnosed with cervical cancer and 275,000 die annually. India bears the greatest burden of the disease with 132,000 cases and 74,000 deaths yearly. Widespread uptake of human papillomavirus (HPV) vaccine could reduce incidence and mortality by two-thirds. This study explored obstacles and facilitators of parental acceptability of HPV vaccine.
  
  
  METHODS
  In 2010, questionnaires were sent home with a random sample of 800 girls attending 12 schools in Mysore city to be completed by a parent. Data were analyzed using multivariable logistic regression with generalized estimating equation to account for potential clustering by school.
  
  
  RESULTS
  Of the 797 completed surveys; 71% reported willingness to accept HPV vaccine for their daughters. The adjusted odds of acceptance was higher among participants who received recommendation from their parents, perceived cervical cancer as a serious disease, believed that HPV vaccine was safe, or felt that vaccination was a good way to protect against cervical cancer. Parents who had concerns about vaccine side-effects or thought that it would cause pain had lower odds of acceptance.
  
  
  CONCLUSIONS
  Future promotion of vaccine should emphasize safety of immunization and involve promotion to the extended family, so that they actively recommend immunization of young adolescent girls.
authors.affiliation: Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA; Public Health Research Institute of India, Mysore, India. Electronic address: pmadhiva@fiu.edu.
authors.forename: Purnima
authors.initials: P
authors.lastname: Madhivanan
authors.affiliation: Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA.
authors.forename: Tan
authors.initials: T
authors.lastname: Li
authors.affiliation: Public Health Research Institute of India, Mysore, India.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Srinivas
authors.affiliation: Health Behavior Research Centre, Department of Epidemiology and Public Health, UCL, London, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Marlow
authors.affiliation: Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA.
authors.forename: Soumyadeep
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA; Public Health Research Institute of India, Mysore, India.
authors.forename: Karl
authors.initials: K
authors.lastname: Krupp
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004522:Educational Status; D004651:Employment; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D033282:Parental Consent / Q000523:psychology / Q000706:statistics & numerical data*; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012067:Religion; D012572:School Health Services; D014505:Urban Population; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines
keywords: Acceptability; Adolescent; Barrier; Correlate; Human papillomavirus; India; School; Vaccine