Perceptions of HPV vaccination: a qualitative study with adolescents, parents, school staff, and pharmacists.

Abstract

Despite its proven efficacy in preventing HPV-related cancers, HPV vaccine uptake remains suboptimal in France (i.e., coverage reached 54.6% for girls and 15.8% for boys in 2023). Understanding stakeholder perspectives across key dimensions related to vaccination perceptions, HPV-related representations, barriers, facilitators, and communication dynamics is essential. This study investigates the knowledge, attitudes, barriers, and facilitators related to HPV vaccination among four stakeholder groups: adolescents, parents, school staff, and pharmacists. A total of 63 semi-structured interviews were conducted with middle school students (n = 15), parents (n = 18), school staff (n = 15), and pharmacists (n = 15) in France. Thematic analysis was used to identify common and group-specific representations, emotional responses, and social dynamics influencing HPV vaccine acceptance. Participants generally supported HPV vaccination as a cancer-prevention tool but highlighted barriers such as limited HPV knowledge, gender-based misconceptions, unease discussing sexuality, concerns about side effects, and logistical hurdles. Facilitators included trust in healthcare professionals, pharmacies' accessibility, and the school's potential as an information platform. While adolescents expressed injection anxiety and a need for age-appropriate, anonymous formats, parents emphasized clear, data-driven communication. Overall, teachers felt underprepared, and pharmacists showed willingness to engage but required better informational tools. All groups called for targeted, emotionally resonant, multi-channel communication. Increasing HPV vaccination requires coordinated efforts that support schools, mobilize trusted healthcare professionals, and deliver clear, stigma-free information. Practical tools and targeted training could further strengthen stakeholder engagement.