Background

Human Papillomavirus (HPV) vaccination programmes have the potential to reduce the incidence of cervical cancer. The preferred age for HPV vaccination is 12–13 years for optimal benefit. The legal framework in England allows adolescents to be vaccinated without parental consent if they are assessed as competent. A ‘South West Template Pathway on Self Consent for School Aged Immunisations’ was developed to improve uptake of immunisations in south-west England.

Study aim

To examine how acceptable the new procedures are to the young women, parents and carers, school staff and immunisation nurses involved.

Methods

The research was undertaken in two local authorities in south-west England during the 2017/18 and 2018/19 programme years. Semi-structured digitally recorded interviews were undertaken with 53 participants: one health service manager, three immunisation nurses, five staff at alternative education providers, three staff at mainstream schools, 19 young women and 22 parents. All recordings were transcribed verbatim and thematic analysis was undertaken, assisted by NVivo software.

Results

Most participants were not fully aware of the legal framework that enables a young person to self-consent to vaccination. There was a strong presumption that parents should make decisions affecting the health of their children. The preferred age at which the HPV vaccination is administered (12–13 years) contributed to reluctance in endorsing self-consent which was thought to have the potential to break down trust between parents and school staff, and within families. In practice, formal self-consent was rare.

Conclusion

Unresolved issues in relation to adolescent self-consent include public and professional perceptions of young people’s rights and abilities to take responsibility for decisions affecting their health, and concerns about the impact of self-consent on relationships both within families and between professionals and the families they serve.

中文翻译：

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青少年自我同意接种 HPV 疫苗的可接受程度如何：英格兰西南部的一项定性研究结果

 背景

人乳头瘤病毒 (HPV) 疫苗接种计划有可能降低宫颈癌的发病率。 HPV 疫苗接种的首选年龄是 12-13 岁，以获得最佳效果。英国的法律框架允许青少年在被评估为有能力的情况下无需父母同意即可接种疫苗。开发了“西南学龄免疫接种自我同意模板途径”，以提高英格兰西南部的免疫接种率。

 学习目的

研究年轻女性、家长和护理人员、学校工作人员和免疫接种护士对新程序的接受程度。

 方法

这项研究是在 2017/18 和 2018/19 计划年度在英格兰西南部的两个地方当局进行的。对 53 名参与者进行了半结构化数字记录访谈：一名卫生服务经理、三名免疫护士、五名替代教育机构工作人员、三名主流学校工作人员、19 名年轻女性和 22 名家长。所有录音均逐字转录，并在 NVivo 软件的协助下进行主题分析。

 结果

大多数参与者并不完全了解使年轻人能够自行同意接种疫苗的法律框架。人们强烈认为父母应该做出影响孩子健康的决定。接种 HPV 疫苗的首选年龄（12-13 岁）导致不愿意认可自我同意，这被认为有可能破坏家长和学校工作人员之间以及家庭内部的信任。在实践中，正式的自我同意很少见。

 结论

与青少年自我同意相关的未解决问题包括公众和专业人士对年轻人对影响其健康的决定负责的权利和能力的看法，以及对自我同意对家庭内部以及专业人士与家庭之间关系的影响的担忧。服务。