title: Understanding Public Perceptions of the HPV Vaccination Based on Online Comments to Canadian News Articles.
abstract: BACKGROUND
  Given the variation in human papillomavirus (HPV) vaccine coverage across Canada, and debate regarding delivery of HPV vaccines in Catholic schools, we studied online comments on Canadian news websites to understand public perceptions of HPV and HPV vaccine.
  
  
  METHODS
  We searched English- and French-language Canadian news websites for 2012 articles that contained the terms "HPV" or "human papillomavirus." Articles about HPV vaccinations that contained at least one comment were included. Two researchers independently coded comments, analyzing them for emerging themes.
  
  
  RESULTS
  We identified 3073 comments from 1198 individuals in response to 71 news articles; 630 (52.6%) individuals expressed positive sentiments about HPV vaccination (2.5 comments/individual), 404 (33.7%) were negative (3.0 comments/individual), 34 (2.8%) were mixed (1.5 comments/individual) and 130 (10.8%) were neutral (1.6 comments/individual). Vaccine-supportive commenters believed the vaccine is safe and effective. Common themes in negative comments included concerns regarding HPV vaccine safety and efficacy, distrust of pharmaceutical companies and government, and belief that school-age children are too young for HPV vaccine. Many comments focused on whether the Catholic Church has the right to inform health policy for students, and discussion often evolved into debates regarding HPV and sexual behaviour. We noted that many individuals doubted the credibility of vaccine safety information.
  
  
  CONCLUSIONS
  The majority of commenters do not appear to be against HPV vaccination, but public health messaging that focuses on both the vaccine's safety profile, and its use as a means to prevent cancer rather than sexually transmitted HPV infection may facilitate its acceptance.
authors.affiliation: Public Health Ontario, Toronto, Canada.
authors.forename: Yael
authors.initials: Y
authors.lastname: Feinberg
authors.affiliation: Public Health Ontario, Toronto, Canada.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Pereira
authors.affiliation: Public Health Ontario, Toronto, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Quach
authors.affiliation: Public Health Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Canada; University Health Network, Toronto, Canada.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Kwong
authors.affiliation: Public Health Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada.
authors.forename: Natasha S
authors.initials: NS
authors.lastname: Crowcroft
authors.affiliation: Public Health Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Wilson
authors.affiliation: Département des sciences de la santé communautaire, Université de Sherbrooke, Longueuil, Canada; Institut national de santé publique du Québec, Longueuil, Canada; Centre de recherche de l'Hôpital Charles LeMoyne, Longueuil, Canada.
authors.forename: Maryse
authors.initials: M
authors.lastname: Guay
authors.affiliation: Public Health Ontario, Toronto, Canada.
authors.forename: Yang
authors.initials: Y
authors.lastname: Lei
authors.affiliation: Public Health Ontario, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Shelley L
authors.initials: SL
authors.lastname: Deeks
mesh_terms: D002170:Canada; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D053918:Papillomavirus Vaccines; D011639:Public Opinion; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D014611:Vaccination
chemical_list: D053918:Papillomavirus Vaccines