title: To Consent or Decline HPV Vaccination: A Pilot Study at the Start of the National School-Based Vaccination Program in Sweden.
abstract: Parents' beliefs about human papillomavirus (HPV) vaccination influence whether they allow their daughters to be vaccinated. We examined the association between parents' refusal and sociodemographic background, knowledge and beliefs about HPV, and the HPV vaccination in relation to the Health Belief Model.
  
  
  
  The sample consisted of 200 (55%) parents of children aged 11-12 years in the Swedish national vaccination program. Data were collected using a self-reported questionnaire. Most parents (N = 186) agreed to the vaccination. Pearson's chi-square, Fisher's exact test, and the Mann-Whitney U test were used to analyze data.
  
  
  
  Declining parents saw more risks and fewer benefits of HPV vaccination but no differences in beliefs regarding the severity or young girls' susceptibility to HPV were found. There was an association between refusing the HPV vaccine and lower acceptance of previous childhood vaccinations, and their main source of information was the Internet. Parents who declined the vaccine believed it could adversely affect condom use, the age of their daughter's sexual debut, and the number of sexual partners.
  
  
  
  Parents should have the possibility to discuss HPV and HPV vaccine with a school nurse or other health care professionals, and should have access to evidence-based information on the Internet.
authors.affiliation: Department of Public Health and Caring Sciences and Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Grandahl
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Tanja
authors.initials: T
authors.lastname: Tydén
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Ragnar
authors.initials: R
authors.lastname: Westerling
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Tryggve
authors.initials: T
authors.lastname: Nevéus
authors.affiliation: Centre for Clinical Research Västerås, Uppsala University, Västerås, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rosenblad
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Hedin
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.|Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Oscarsson
mesh_terms: D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005220:Fathers / Q000193:education / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D008297:Male; D009035:Mothers / Q000193:education / Q000523:psychology* / Q000706:statistics & numerical data; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control* / Q000635:transmission; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D033282:Parental Consent / Q000523:psychology* / Q000706:statistics & numerical data; D010865:Pilot Projects; D012572:School Health Services / Q000458:organization & administration / Q000592:standards*; D057566:Self Report; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013548:Sweden
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccination; Health Belief Model; health beliefs; school nurses; school-based vaccination programs