Whilst it is important to note the high levels of support for the HPV vaccine despite limited knowledge of its role in the aetiology of cervical cancer, this balance could shift in the future. Studies of vaccine decision-making for younger children suggest that once a vaccine is perceived to have potential side effects, then gaps in knowledge, myths and misunderstandings about the diseases to be prevented can shift the balance of decision-making [11], since perceptions of the severity and likelihood

of contracting the disease are a key factor considered in whether to accept a vaccine for younger children [12]. In recognition of the poor levels of knowledge about HPV, the public awareness campaigns were launched in the UK to accompany the introduction of the vaccination programme. Their launch coincided with intense media coverage of the diagnosis and death from cervical cancer of reality television star, Jade Goody. Whilst buy Fluorouracil this media coverage might have been assumed to provide useful background

information about cervical cancer and HPV in the lead up to the introduction of the new vaccination programme, an analysis of newsprint coverage of her illness and death found that it tended not to include factual or educational information that would help women to make connections between HPV, cervical cancer and the new programme [13]. Post-implementation studies continue to reveal limited public knowledge about HPV. A recent UK based interview study buy AZD2281 explored girls (aged 17–18 years) knowledge about HPV and attitudes towards HPV vaccination among girls who were part of the ‘catch-up’ vaccination programme. Ten interviews were carried out between March and May 2009. Williams et al.’s study found that most girls

had limited understanding of HPV and HPV vaccination, and were uncertain about the need for the vaccine both in terms of perceived risk [14]. Similarly, a study of HPV knowledge following the implementation of the HPV vaccination programme in Australia found low levels of knowledge [15], and a US study conducted after publicity about the HPV vaccine produced by the manufacturers showed an increase in the perceived need for the vaccine, but no improvement in knowledge and understandings see more about why the vaccine was important [16]. In the UK public awareness about HPV after implementation of the vaccination programme still needs to be ascertained. This study therefore explores adolescent girls’ understandings of HPV and its link with cervical cancer, and their experiences of vaccination in the year following the introduction of the vaccination programme, in order to identify gaps in knowledge which could have important implications for future cervical cancer prevention in the UK. Eighteen focus groups were conducted between December 2009 and May 2010 with schoolgirls aged between 12 and 18 years living in various parts of the UK.