HPV-Vaccine Hesitancy in Colombia: A Mixed-Methods Study
2. Materials and Methods
2.1. Study Design
2.3. Study Model
2.5. Study Measures
2.8. Data Analysis
3.1. Description of the Sample
3.2. Analysis Based on the COM-B Model
Lack of Information
“I think that there has been a need for an education campaign, that is, promulgation of what papilloma is and what the vaccine does, because normally when a vaccine is talked about repeatedly by many media and people get educated, people have more awareness and then they do it conscientiously, but I have not heard that there has been much of a campaign or education on the subject”.(mother of unvaccinated girl, 51 years old, private school)
“I was diagnosed with HPV 10 or 12 years ago (…) they explained to me that even the nuns get it [HPV], even if they haven’t had sex. I am in this meeting because I have many gaps [in my knowledge] and ignorance on the subject”.(mother of unvaccinated girl, 45 years old, private school)
Relationship between HPV and Cervical Cancer
Trust in Traditional Institutions
“I wanted to say that my ignorance is even bigger because my children were born in Ecuador and there nobody talks about HPV (…). I was one of those mothers who said that I would not give my daughter that vaccine, until recently, when I went to get a booster for my other 10-year-old son and I spoke with a doctor who explained to me that it was absolutely safe, so I began to think differently”.(mother of unvaccinated girl, 45 years old, private school)
The Vaccine as an Act of Care
“It is a matter of avoiding the disease; one does not know when it could happen, God willing it does not happen, but it is a way of caring for and protecting them”.(mother of girl with one dose, 41 years old, private school)
“I have heard many mothers who did not want to vaccinate their daughters; I do not know why. A long time ago there was a problem with some vaccine, after which many mothers believe in these things, and they are scared to vaccinate their daughters”.(mother of unvaccinated girl, 43 years old, private school)
Respect for the Personal Decision to Be Vaccinated
“I never had the power to decide if I wanted to get vaccinated or not; it was not a subject that I could get into”.(Girl, one dose, 15 years old, public rural school)
Association of HPV with Sexuality
“I consider that in the subject of the infection with the human papilloma virus, it is possible to take a look from the biological point of view as the subject of the disease; let’s say that it is detached from the subject of sexuality and that is perfectly well because one can approach the subject with one’s daughter like that”.(Father of girl with one dose, 53 years old, private school)
3.2.4. The Impact of COVID-19 on HPV Hesitancy
“I don’t know exactly how the virus spreads, but I suppose that, like a normal virus, like when you get vaccinated against the coronavirus, you prevent yourself and others, that you don’t spread it, nor are you infected”.(girl with one dose, 15 years old, public school)
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Online Questionnaire
- Do you think your daughter may get cervical cancer at some point in her life? Yes/No
- Do you think your daughter could get HPV? Yes/No
- Have you heard of the HPV vaccine? Yes/No
- Has anyone told you that your daughter needs to be vaccinated against HPV? Yes/No
- Is your daughter going to complete the vaccination schedule? Yes/No
- How concerned are you that your daughter might have a serious side effect from a shot?
- How concerned are you that anyone of the childhood shots might not be safe?
- How concerned are you that a shot might not prevent the disease?
- “If a vaccine against HPV was available for your daughter, how likely is it that she would have it?” 0 (Extremely likely) to 3 (Not at all likely).
- Knowing that other people have put it on
- Doctor’s recommendation
- Someone else’s recommendation
- Knowing that the vaccine is safe
- Thinking that my daughter is at higher risk for HPV
- Listening to positive opinions about the vaccine.
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|Daughter’s school type|
|Girls and Adolescents||%||N|
|Type of school|
|Source of Behaviour||Quantitative Data from the Online Questionnaire||Themes from the Focus Groups|
|Capability||11.7% did not perceive that their daughter would be susceptible to contracting HPV.|
Relationship between likelihood of vaccinating daughter and perceived susceptibility to HPV; Spearman r = 0.309, p < 0.001.
84.7% perceived that their daughter was susceptible to cervical cancer.
96.9% were aware that they should get their daughter vaccinated.
69.4% did not receive any information about HPV vaccination for their daughter.
87.8% trusted the information they received about vaccines.
Relationship between likelihood of getting vaccinated and receiving positive information about the vaccine; Spearman r = 0.338, p < 0.001
|Lack of information|
Relationship between HPV and cervical cancer
|Opportunity||Relationship between likelihood of getting vaccinated and medical recommendation; Spearman r = 0.221, p < 0.01|
Relationship between likelihood of getting vaccinated and seeing others get vaccinated; Spearman r = 0.158, p < 0.05
|Trust in traditional institutions|
|Motivation||30.1% were concerned about vaccine effectiveness |
32.7% were concerned because vaccines may have adverse effects
31.6% were concerned about vaccine safety
Relationship between likelihood of getting vaccinated and vaccine safety; Spearman r = 0.277, p < 0.001.
|Association of HPV with sexuality|
The vaccine as an act of care
Respect for the personal decision to be vaccinated
|Step||Variable Entered||B||Wald||Sig||Exp (B)||C.I for Exp (B)|
|Easy access to vaccine||0.142||0.245||0.620||1.153||0.657||2.025|
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Cordoba-Sanchez, V.; Lemos, M.; Tamayo-Lopera, D.A.; Sheinfeld Gorin, S. HPV-Vaccine Hesitancy in Colombia: A Mixed-Methods Study. Vaccines 2022, 10, 1187. https://doi.org/10.3390/vaccines10081187
Cordoba-Sanchez V, Lemos M, Tamayo-Lopera DA, Sheinfeld Gorin S. HPV-Vaccine Hesitancy in Colombia: A Mixed-Methods Study. Vaccines. 2022; 10(8):1187. https://doi.org/10.3390/vaccines10081187Chicago/Turabian Style
Cordoba-Sanchez, Veronica, Mariantonia Lemos, Diego Alfredo Tamayo-Lopera, and Sherri Sheinfeld Gorin. 2022. "HPV-Vaccine Hesitancy in Colombia: A Mixed-Methods Study" Vaccines 10, no. 8: 1187. https://doi.org/10.3390/vaccines10081187