Human papillomavirus vaccine receptivity: a systematic review

Objective. To characterize the receptivity to human papillomavirus (HPV) vaccine and to describe factors that hinder or facilitate receptivity. Method. A systematic review was performed based on the 2015 PRISMA protocol. MEDLINE and Web of Science were searched using combinations of the terms papillomavirus, vaccine, adherence, and acceptance to identify articles published from 2006 to 2017. Original articles published in any language were included, and duplicate articles were excluded. Information was collected regarding article identification, methodological design, sample characteristics, and description of contents. Receptivity was characterized in terms of acceptance and adherence. Results. Of 212 articles identified, 10 were selected for analysis. Most showed favorable, but heterogeneous, receptivity, with more acceptance than adherence, especially on the part of female adolescents. The analysis identified 11 facilitators and nine barriers to receptivity, especially knowledge of the theme and individual pattern of behavior regarding the problem. The analysis also detected the absence of a standardized method to evaluate receptivity and the imprecision of the concepts associated with acceptance and adherence. Therefore, a definition was proposed for acceptance (voluntary intention of receiving the vaccine or agreement that the vaccine is a good prevention strategy) and adherence (initiation and completion of the vaccination scheme). Conclusions. Additional studies are required to further investigate predictors of receptivity. For that, the development of an instrument based on the perceptions of target publics and employing precise concepts of acceptance and adherence is recommended, so as to allow a better understanding of the phenomenon and stimulate adherence and the achievement of adequate vaccine coverage.