Promoting HPV vaccination at school: a mixed methods study exploring knowledge, beliefs and attitudes of French school staff

Menée dans 4 régions de France sur la période 2020-2021 par enquête auprès de 301 personnes travaillant en milieu scolaire (infirmières, enseignants et personnel de soutien), cette étude évalue leurs connaissances, croyances et attitudes vis-à-vis du papillomavirus humain (HPV), du vaccin contre le HPV et de la vaccination en général puis analyse le rôle des écoles dans la promotion de la vaccination contre le HPV

BMC Public Health, Volume 23, Numéro 1, Page 486, 2023, article en libre accès

Résumé en anglais

Background: HPV vaccine coverage in France remained lower than in most other high-income countries. Within the diagnostic phase of the national PrevHPV program, we carried out a mixed methods study among school staff to assess their knowledge, beliefs and attitudes regarding HPV, HPV vaccine and vaccination in general, and regarding schools’ role in promoting HPV vaccination.

Methods: Middle school nurses, teachers and support staff from four French regions participated between January 2020 and May 2021. We combined: (i) quantitative data from self-administered online questionnaires (n = 301), analysed using descriptive statistics; and (ii) qualitative data from three focus groups (n = 14), thematically analysed.

Results: Less than half of respondents knew that HPV can cause genital warts or oral cancers and only 18% that no antiviral treatment exists. Almost 90% of the respondents knew the existence of the HPV vaccine but some misunderstood why it is recommended before the first sexual relationships and for boys; 56% doubted about its safety, especially because they think there is not enough information on this topic. Schools nurses had greater knowledge than other professionals and claimed that educating pupils about HPV was fully part of their job roles; however, they rarely address this topic due to a lack of knowledge/tools. Professionals (school nurses, teachers and support staff) who participated in the focus groups were unfavourable to offering vaccination at school because of parents’ negative reactions, lack of resources, and perceived uselessness.

Conclusions: These results highlight the need to improve school staff knowledge on HPV. Parents should be involved in intervention promoting HPV vaccination to prevent their potential negative reactions, as feared by school staff. Several barriers should also be addressed before organizing school vaccination programs in France.