Perceptions of and barriers to vaccinating daughters against Human Papillomavirus (HPV) among mothers in Hong Kong

Background: Significant others are noted to be remarkable influences in modelling children's and young people's health perceptions and their adoption of health behaviour. The vaccinations which a child receives are shown to be significantly influenced by his or her parents. However, there is a paucity of Chinese-based studies. When discussing the Human Papillomavirus (HPV) vaccine, very few studies examine the perceptions of Chinese parents regarding the vaccine as a preventive health measure, and even fewer examine how these perceptions of the vaccine and sexual values influence their motivations in encouraging their children to be vaccinated. In view of the literature gap, this article investigates the perceptions of Hong Kong mothers in regard to vaccinating their daughters against HPV in Hong Kong. Methods: A qualitative research approach with individual semi-structured interviews was conducted with 35 mothers aged 30 to 60 years old with daughter(s) between 9 and 17 years old. Results: Six connected themes emerged. The participants commonly perceived the HPV vaccination as being unnecessary for their daughters in view of their young age. They worried that it would encourage their daughters to engage in premarital sex, and perceived the vaccination to be potentially harmful to health. Also, their low perceived risk of HPV in addition to the lack of reassurance from their health care providers failed to convince the participants that the vaccination was important for their daughters' health. Finally, the participants found the vaccine to be expensive and perceived it to have little protection value in comparison to other optional vaccines. Conclusion: The sampled mothers did not have a positive perception of the HPV vaccine. The cultural association between receiving the vaccination and premarital sex was prevalent. Bounded by their cultural values, the participants also had many misconceptions regarding the vaccine and the transmission of HPV, which discouraged them from having their daughters vaccinated. Furthermore, a lack of support from health care providers and the government health authorities concerning HPV vaccination failed to provide confidence and reassurance to mothers, and conveyed a meaning to these mothers that HPV vaccine is relatively unimportant.