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Managing Uncertainty: Healthcare Professionals' Meanings Regarding the HPV Vaccine

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Abstract

Background

New preventive technologies such as vaccines offer insight into psychological, social, and cultural landscapes. Providers have a key role in parents' decisions for vaccinating their children. Yet, perspectives from providers regarding the human papillomavirus (HPV) vaccine, or vaccination in general, are rarely sought

Purpose

Our objective in this paper is to understand how the HPV vaccine is perceived by health care providers and the multiple contextual meanings it elicits.

Methods

We conducted interviews with 20 health care professionals in Bulgaria about their attitudes and practices related to HPV vaccination and their recommendations for policies. The verbatim-transcribed interviews were analyzed through narrative analysis, with a special focus on language.

Results

We illustrate providers' contradictory and contextualized constructions of the vaccine and the narrative strategies they use to manage any uncertainty it elicits. These include being advocates and missionaries for preventive health, confirming their trust in the medical profession and professional organizations, challenging patients' concerns with rational explanations, normalizing the risk of medical innovations, and avoiding the sexual nature of HPV transmission.

Conclusions

The introduction of a vaccine to prevent HPV infection, and by implication, possibly cervical and other cancers, created hope, and at the same time, intensified confusion and uncertainty. Providers have been frustrated for years with the rising mortality from cervical cancer in Bulgaria, and their perceived powerlessness in affecting this. HPV vaccination, on the other hand, seems relatively simple and “taming uncertainty” positions them as instrumental in limiting (or even eliminating) morbidity and mortality in future generations.

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Notes

  1. Transmission is also possible through skin-to-skin contact and from mother to child during birth.

  2. Though there are hundreds of types of HPV virus, the vaccines target only those types that are responsible for over 75 % of all cancers. In general, the HPV virus is very widespread, with 80 % of the population considered to have it at some point in their lives. In most cases, the infection disappears on its own without any consequences, but in some cases, it is persistent and can lead to cancerous changes many years later.

  3. The rubella vaccine was first introduced for girls and later added for boys.

  4. I = Interviewer; P = Participant

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Acknowledgements

The study was funded by the National Council of Eurasian and East European Research for which we are very grateful. We would also like to thank the participants for sharing their opinions with the research team.

Author information

Authors and Affiliations

  1. Department of Health Sciences, Northeastern University, Robinson Hall 209, Boston, MA, 02115, USA

    Irina Todorova

  2. Health Psychology Research Center, Sofia, Bulgaria

    Anna Alexandrova-Karamanova & Yulia Panayotova

  3. Bulgarian Academy of Sciences, Sofia, Bulgaria

    Elitsa Dimitrova

  4. Burgas Free Universtiy, Burgas, Bulgaria

    Tatyana Kotzeva

Authors
  1. Irina Todorova
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  2. Anna Alexandrova-Karamanova
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  3. Yulia Panayotova
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  4. Elitsa Dimitrova
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  5. Tatyana Kotzeva
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Corresponding author

Correspondence to Irina Todorova.

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Todorova, I., Alexandrova-Karamanova, A., Panayotova, Y. et al. Managing Uncertainty: Healthcare Professionals' Meanings Regarding the HPV Vaccine. Int.J. Behav. Med. 21, 29–36 (2014). https://doi.org/10.1007/s12529-013-9343-9

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  • DOI: https://doi.org/10.1007/s12529-013-9343-9

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