A population based survey of school nurses' attitudes to the implemented HPV vaccination programme in Sweden

Objective: To investigate school nurses’ attitudes to, and experiences of the school-based HPV vaccination programme,one year after its implementation in Sweden.Methods: Data were collected using a web-based questionnaire in spring 2013, and 83.1% (851/1024) of the nursesanswered the questionnaire.Results: The majority (88.9%, n=756) agreed that HPV vaccinations should be the school nurses’ responsibility, and mostalso agreed (81.5%, n=693) that boys also should be offered the vaccine. Two thirds, 66.9% (n=570), stated that they hadexperienced difficulties with the vaccination and of these 59.1% (n=337) considered the task time-consuming. Three outof four nurses, 76.1% (n=648), had been contacted by parents who raised questions regarding the vaccine. The most commonquestions were related to side effects. There were strong associations between the nurses’ received education aboutthe HPV vaccine and perceived knowledge about the HPV vaccine and a favourable attitude towards vaccination (both p<0.001). A school nurse with a high level of received education was 9.8 times more likely to have a positive attitude to HPVvaccination compared to a nurse with a low level of received education (p<0.001). Nurses with high perceived knowledgewere 2.5 times more likely to have a positive attitude compared to those with a low level of perceived knowledge(p=0.006).Conclusions: HPV vaccination is a complex and time-consuming task and the school nurses need adequate knowledge,education, skills and time in order to address questions and concerns from parents, as well as informing about HPV.