Abstract D030: Arguments in favor and against the new HPV school entry implementation in Puerto Rico: Content analysis of online media coverage

Background: In August 2018, Puerto Rico (PR) adopted the Human papillomavirus (HPV) vaccine as a school-entry requirement for all students (male and female) 11 to 12 years old. Information about HPV shared in online media outlets may influence vaccine hesitancy, uptake, and parental decision. Before and after the requirement took effect, news coverage of this policy promoted discussions by groups in favor of the vaccine as well as the uproar of anti-vaccine groups, which may have influenced parental perceptions of the school-entry policy. Objective: This qualitative study explored arguments in favor of and against HPV vaccination and the new school-entry vaccination policy among parents, stakeholders, and coalitions in Puerto Rico. Methods: A systematic review was conducted to identify digital media reports related to the HPV vaccination policy and its implementation in PR from January 2017 to December 2018. This analysis focuses only on the codes extracted from the arguments provided by different organizations, coalitions and parents interviewed in the media. A grounded theory approach was used to identify emergent arguments discussed during this period in the news reports. ATLAS.ti 8 was used to facilitate data manipulation and retrieval. Results: Of all the quotes analyzed, 78% were coded as negative (against), 19% were positive (in favor) and only 3% were neutral towards the new HPV school-entry policy. The analysis identified emergent themes related arguments in favor of and against the HPV vaccine policy implementation. Positive arguments frequently discussed, included the following themes: 1) importance of the HPV vaccine for cancer prevention; 2) acknowledgment of sexual practices/activities in youth and 3) healthcare provider recommendation. Primary themes that emerged in arguments against the HPV school-entry policy included: 1) patient autonomy; 2) the right of parents to be informed about the vaccine; 3) lack of education regarding the efficacy of the vaccine; 4) potential risk of vaccines; and 5) pharmaceutical and economic interests. Conclusion: This study explored the most emerging arguments discussed in the media before and during the implementation of the HPV school entry policy in Puerto Rico. Most information disseminated was against this new policy. Media shared online was not balanced, which can lead to the promotion of vaccine hesitancy. Future online media coverage could expand the scope of information and provide a balanced, unbiase