title: Cross-sectional study about primary health care professionals views on the inclusion of the vaccine against human papillomavirus in the vaccine schedules.
abstract: BACKGROUND
  Although the inclusion of the HPV vaccine has been registered in Spain since 2007, vaccination rates are lower than expected. The patients wish to be vaccinated is heavily influenced by information they have received from many source. The Knowledge of primary health care professionals affects the information provided to patients and is fundamental in the decision making. The aim of this study is to assess the opinions of primary health care professionals on the vaccine against HPV and their knowledge about HPV infection and its links to with gynecological and oropharyngeal cancer.
  
  
  METHODS
  Cross-sectional study. A 19-item survey was drawn up. It included questions on basic aspects of HPV infection and marketed vaccines, personal opinion about the inclusion in the immunization schedules and their level of prescription and recommendation to patients in their clinical practice. From October 2013 to December 2013, 607 surveys were distributed among 20 primary health centers affiliated to the University Hospital 12 de Octubre. The results were analyzed using SPSS statistical package.
  
  
  RESULTS
  One hundred sixty four successfully completed surveys were obtained for analysis. 89 % of the professionals knew about the relationship between HPV infection and cervical cancer, 57.3 % did not know any of the serotypes against which vaccines are targeted; 40.4 % believed that there is insufficient data to support the commercialization of the vaccines. Of these, 65.7 % argue that there is no data of its long-term effectiveness, 13.4 % that there is no data as to its side effects, 13.4 % believed that the cost effectiveness is not worthwhile.
  
  
  CONCLUSIONS
  There is a strong controversy among health professionals regarding the marketing and inclusion of HPV vaccine in immunization schedules. However, the knowledge of the primary care health professionals on key aspects of infection and vaccine protection are insufficient. The training of professionals in vaccination, cervical pathology and HPV infection should be improved to provide objective information on the use as this vaccine for patients.
authors.affiliation: Department of Gynecologic Oncology, Hospital Universitario 12 de Octubre, Avda Cordoba s/n, Madrid, Spain.
authors.forename: M Reyes Oliver
authors.initials: MR
authors.lastname: Pérez
authors.affiliation: Department of Gynecologic Oncology, Hospital Universitario 12 de Octubre, Avda Cordoba s/n, Madrid, Spain.
authors.forename: Victoria Bravo
authors.initials: VB
authors.lastname: Violeta
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain.
authors.forename: Ana Vazquez
authors.initials: AV
authors.lastname: Del Campo
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ruiz
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain.
authors.forename: Sonia Yáñez
authors.initials: SY
authors.lastname: Castaño
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Complutense University, Madrid, Spain.
authors.forename: Laura P Pérez
authors.initials: LP
authors.lastname: Conde
authors.affiliation: Department of Gynecologic Oncology, Hospital Universitario 12 de Octubre, Avda Cordoba s/n, Madrid, Spain.
authors.forename: Jesús S Jiménez
authors.initials: JS
authors.lastname: López
keywords: Cervical cancer; HPV vaccines; Human papilloma virus; Primary care