THE INFLUENCE OF THE MAIN SOURCES OF INFORMATION ON THE DECISION OF VACCINATING/NON VACCINATING CHILDREN BETWEEN THE AGES OF AGAINST HPV INFECTION FIRST AUTHOR: ADELINA SOFIA GRIGORE CO-AUTHORS: ANDRIES ADRIANA, RALUCA ADELA CRACIUN COORDINATOR: LECTURER SEPTIMIU VOIDĂZAN

Romania holds the first place in Europe in terms of mortality due to cervical cancer. Every year more than 4000 new cases are reported in Romania, placing the cervical cancer on the third place in occurrence, after breast cancer and colorectal cancer. With a total of diagnosed patients, our country holds the first place in Europe in terms of mortality owed to cervical cancer, that is 6.3 times more than in the other European countries. The HPV infection is correlated in 99,7% of the cases with cervical cancer, and it is considered as an etiological factor in the cervical cancer development

The HPV infection is the most common STD in the world. There are more than 100 different types of HPV from which 15 of them determine cancerous lesions, type 16 and 18 being responsible for 70% of all cervical cancers and some in men (anal and oropharyngeal cancer) Usually the HPV infection is transitory, disappearing in a couple of months, without any signs or symptoms. Although, if the infection persists long enough, the high risk types of HPV will determine precancerous lesions and finally cervical cancer In the year 2006/2007 two vaccines were licensed (Gardasil and Cervarix) against HPV oncogenic type 16 and 18 and type 11 and 6 Anti HPV vaccination offers the best protection for boys and girls who are vaccinated properly and have the necessary time to develop their immune response before becoming sexual active. This is why the guidelines suggestions are that the vaccination should be provided around the age of 11 years In 2008 in Romania there was a National Vaccination campaign against HPV type 16 and 18 and it was addressed to school girls between the ages of The campaign was unsuccessful, many parents refusing the vaccination.

Objective The purpose of the study was to find a correlation between the HPV infection/vaccine information source and the decision whether to vaccinate or not.

- We applied a cross-sectional study using questionnaires which were given to parents of children from 3 random schools from Târgu Mureș - At the beginning of the questionnaire we mentioned the purpose of the study, the guarantee of anonymity and confidentiality of the provided data. For the Hungarian speaking parents we administrated questionnaires translated in Hungarian. Our study was approved by the Ethics Committee of the University of Medicine and Pharmacy Tg Mures. Materials and Methods

The questionnaire was composed of 34 questions divided into 9 categories, such as: demographics data/ educational level of the parent/ knowledge about HPV infection/ the quality of information received from the family physician about cervical cancer/ level of knowledge regarding the vaccine/ reasons for non- vaccinating/ awareness that their daughter could get infected with HPV/ the intention to vaccinate their daughter in the future and the parent’s point of view regarding the best ways to get informed in the next vaccination campaigns

3 schools from Targu Mures were chosen randomly. The teachers gave the children a sealed envelope. The questionnaires were answered in a time frame of 2 weeks by the parents and brought back to school to be collected. The data collection took part between. From 1100 administered questionnaires,918 parents agreed to participate in the study, that means a response rate of 83.4%

The average age of the parents was that of 40 years old, with a minimum of 28 years and a maximum of 57 years old.

Based on their current level of awareness, 1 out of 3 parents would vaccinate their child against HPV. The main reasons for non-vaccination were: fear of the side effects, the vaccine is a new one and it’s not sufficiently studied, or that they are not informed about this vaccine.

Results 42% of the parents who were informed by the family physician want to vaccinate their child. From the parents who asked their family doctor for information, 44,2% would want to vaccinate. Other information sources (friends, family, specialty books, mass media and the internet) do not impact the vaccination decision. The quality of the information given by the media was doubtful, it does not increase the level or quality of knowledge and it can influence the decision of vaccination

Results The family doctor’s role, through his correct information, is considered to have an important part in determining the parent to vaccinate his child. The decision is strongly influenced if the parent received information about prevention methods of HPV, vaccine recommendations, vaccine benefits. Even more, beside these information provided by the family doctor, the knowledge about complete protection, precaution from other persons or family history of cancer, improve considerably (68.8%) the parent attitude towards vaccination.

Conclusions The parents who received information from the family doctor were the ones who, on a scale from 1(very low) to 5(excellent) graded their knowledge of HPV infection/vaccination 4 or 5, proving that the information given by the doctors are the most relevant. Educational campaigns would have a higher success if they were to be performed by the family/school doctor. The physician would have to give explanations regarding the prevention methods, vaccinations, screening, risk and benefits.