title: Exploring human papillomavirus vaccination refusal among ethnic minorities in England: A comparative qualitative study.
abstract: In England, uptake of human papillomavirus (HPV) vaccination to prevent HPV-related cancer is lower among girls from ethnic minority backgrounds. We aimed to explore the factors that prevented ethnic minority parents from vaccinating, compared to White British nonvaccinating parents and vaccinating ethnic minority parents.
  
  
  
  Interviews with 33 parents (n = 14 ethnic minority non-vaccinating, n = 10 White British nonvaccinating, and n = 9 ethnic minority vaccinating) explored parents' reasons for giving or withholding consent for HPV vaccination. Data were analysed using Framework Analysis.
  
  
  
  Concerns about the vaccine were raised by all nonvaccinating ethnic minority parents, and they wanted information to address these concerns. External and internal influences affected parents' decisions, as well as parents' perceptions that HPV could be prevented using means other than vaccination. Reasons were not always exclusive to nonvaccinating ethnic minority parents, although some were, including a preference for abstinence from sex before marriage. Only ethnic minority parents wanted information provided via workshops.
  
  
  
  Ethnic differences in HPV vaccination uptake may be partly explained by concerns that were only reported by parents from some ethnic groups. Interventions to improve uptake may need to tackle difficult topics like abstinence from sex before marriage, and use a targeted format.
authors.affiliation: Behavioural Science and Health, University College London, London, UK.
authors.forename: Alice S
authors.identifier: 0000-0002-9933-7919
authors.initials: AS
authors.lastname: Forster
authors.affiliation: Behavioural Science and Health, University College London, London, UK.
authors.forename: Lauren
authors.initials: L
authors.lastname: Rockliffe
authors.affiliation: Behavioural Science and Health, University College London, London, UK.
authors.forename: Laura A V
authors.initials: LAV
authors.lastname: Marlow
authors.affiliation: Institute of Child Health, University College London, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Bedford
authors.affiliation: Behavioural Science and Health, University College London, London, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: McBride
authors.affiliation: Behavioural Science and Health, University College London, London, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Waller
mesh_terms: D000293:Adolescent; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data*; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D014611:Vaccination / Q000706:statistics & numerical data; D000072758:Vaccination Refusal / Q000706:statistics & numerical data*
chemical_list: D053918:Papillomavirus Vaccines
keywords: England; HPV vaccine; cancer; ethnic minority; oncology; qualitative research