Sherri Sheinfeld Gorin, professor in the Department of Family Medicine, is one of three recipients of the University of Michigan Medical School’s Global REACH's Partnership Development Grant. She will use the funding for her ongoing project, "Multi-level Approaches to Reducing HPV Vaccine Hesitancy in Colombia."
She has worked on the project for several years, partnering with Mariantonia Lemos Hoyos, PhD, Profesora Titular of Universidad EAFIT, in Medellín, Colombia, who is helping to lead the project. Also contributing is Veronica Cordova Sanchez, a former student of Sheinfeld Gorin’s and a psychology doctoral student at Universidad de San Buenaventura, also in Medellín.
The long-term goal of the study is to increase HPV vaccine uptake—and to reduce hesitancy—to prevent cervical and other HPV-related cancers among Colombian adolescents. Using a multi-level approach, the project aims to describe the barriers to and facilitators of vaccine uptake through interviews and focus groups with key stakeholder groups. This funding will enable the partnership to build on existing studies of HPV vaccine hesitancy and to expand the partnership for future collaborations.
Sheinfeld Gorin plans to travel to Colombia multiple times to conduct research. Work has already begun on focus groups and the formulation of an intervention. The next phase is to organize a randomized controlled trial, and recruitment has commenced. The intervention will be implemented in Colombian schools, where vaccination typically occurs.
Cervical cancer is one of the most frequently diagnosed cancers on a global scale and is the fourth leading cause of death among Colombian women, according to a report produced by the International Association for Research on Cancer. Almost all cervical cancers are caused by persistent infections with high-risk types of human papillomavirus (HPV). The routine administration of the HPV vaccination could effectively reduce the burden of cervical and other HPV-associated cancers over the coming decades, according to Sheinfeld Gorin. However, HPV vaccine hesitancy has thwarted administration of the HPV vaccine in Colombia.
Sheinfeld Gorin said that at the initiation of a free and compulsory school-based vaccination program in 2012-2013, Colombia experienced high rates of vaccine administration. However, due to widely-reported incidents of some young women experiencing side effects after receiving the HPV vaccine, specifically in the municipality of El Carmen de Bolivar in 2014, uptake rates dropped precipitously.
The National Institute of Health (i.e. Instituto Nacional de Salud or INS, as it is known in Colombia) conducted studies that instead described the 2014 events as ‘psychogenic’ and unrelated to the effects of the HPV vaccine itself.
“Vaccines are still available, but the uptake rates are the lowest in the region at 37 percent,” Sheinfeld Gorin said. “Colombia continues to promote the vaccine through multiple approaches, relying on the recommendations from an influential National Institute of Health policy brief in which our own research was cited. Since 2014, their rates have begun to go up again, though not as high as before. Importantly, however, they are now starting to vaccinate boys as well.”
Sheinfeld Gorin noted that she and her team found that although there is still some suspicion about vaccines, the Colombian population overall have trust in their health care providers. The National Institute of Health in Colombia is recommending that all health care providers be further educated about and encouraged to recommend the vaccine.
“That’s a plus for vaccination administration,” she said.
Sheinfeld Gorin and her team have already published work on their research in Colombia and plan to publish additional papers by the end of the year.
For additional reading about this subject, click on the following links:
HPV-Vaccine Hesitancy in Colombia: A Mixed-Methods Study authored by Veronica Cordoba-Sanchez, Mariantonia Lemos, Diego Alfredo Tamayo-Lopera, and Sherri Sheinfeld Gorin
A Feasibility Study of a Behavioral Intervention to Increase Uptake of Human Papillomavirus (HPV) Vaccination in Envigado, Colombia authored by Veronica Cordoba Sanchez, MS, Mariantonia Lemos, PhD, and Sherri Sheinfeld Gorin, PhD
