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Arguments in favor of and against the HPV vaccine school-entry requirement in Puerto Rico: a content analysis of newspaper media

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Abstract

Purpose

Vaccine requirements are effective population-based strategies to increase vaccination rates. In 2018, Puerto Rico’s DOH announced that the HPV vaccine would be required for school entrance. This study explored arguments in favor of and against the HPV vaccine school-entry requirement in PR.

Methods

We conducted a content analysis of two Puerto Rican newspapers. Articles (n = 286) published between 1/1/2015 and 7/31/2018 containing the Spanish terms for “HPV” and “human papillomavirus” were included. Data were summarized using descriptive statistics. Articles that mentioned the HPV vaccine school-entry requirement (n = 33) were reviewed qualitatively using applied thematic analysis.

Results

The top five primary focus areas were education about HPV and the HPV vaccine, advertisements promoting the HPV vaccine, general vaccine information, cervical cancer and screening information, and the HPV vaccine school-entry requirement. Of the 33 articles that mentioned the requirement, 61% presented arguments in favor, 15% presented arguments against, 12% presented both arguments, and 12% only mentioned the existence of the requirement or were the DOH announcement. Arguments in favor centered on cancer prevention, high rates of HPV-associated cancers, and population wellness. Arguments against included worries about sexual transmission of HPV, HPV vaccine’s side effects, issues related to the policy (e.g., mandatory), and lack of education.

Conclusion

Understanding reasons people support or oppose an HPV vaccine school-entry requirement is important for the policy processes to be successful. Education efforts must continue to change the HPV vaccine narrative. Messages should be crafted to educate and gain support among parents and stakeholders towards this population-based cancer prevention strategy.

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Funding

Funding for the completion of this project came from the USF COPH Student Honorary Awards for Research and Practice (‘SHARP’) Award and the USF Office of Graduate Studies Scholarships and Fellowships. Coralia Vazquez-Otero is currently supported by the Cancer Prevention Fellowship from the National Cancer Institute and Harvard T.H. Chan School of Public Health—NIH grant number 2T32CA057711-27. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, 450 Brookline Ave., LW 633, Boston, MA, 02215, USA

    Coralia Vázquez-Otero & Jason Beckstead

  2. University of South Florida College of Public Health, 13201 Bruce B. Downs Bld., MDC 56, Tampa, FL, 33612, USA

    Dinorah Martinez Tyson, Cheryl A. Vamos & Ellen M. Daley

  3. Department of Anthropology, University of South Florida College of Arts and Sciences, 4202 E. Fowler Ave., SOC 134, Tampa, FL, 33620, USA

    Nancy Romero-Daza

Authors
  1. Coralia Vázquez-Otero
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  2. Dinorah Martinez Tyson
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  3. Cheryl A. Vamos
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  4. Nancy Romero-Daza
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  5. Jason Beckstead
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  6. Ellen M. Daley
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Correspondence to Coralia Vázquez-Otero.

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Conflict of Interest

One of the authors, Dr. Daley, previously served on the US HPV Vaccine Advisory Board of Merck Pharmaceuticals. The remaining authors declare no conflicts of interest.

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Vázquez-Otero, C., Martinez Tyson, D., Vamos, C.A. et al. Arguments in favor of and against the HPV vaccine school-entry requirement in Puerto Rico: a content analysis of newspaper media. Cancer Causes Control 32, 793–802 (2021). https://doi.org/10.1007/s10552-021-01431-3

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