Abstract D045: Content analysis of online media coverage of the human papillomavirus vaccine as a school-entry policy in Puerto Rico
Authors: Rivera-Figueroa Vilnery , Arroyo-Morales Glizette O , Soto-Abreu Roxana , Rivera-Encarnación Manuel E , Díaz-Miranda Olga L , Medina-Laabes Diana T , Ortíz-Martínez Ana P , Suárez-Pérez Erick L , Fernández Maria E , Hull Pamela C , Colón-López Vivian 
Published: September 2020

Abstract
Introduction: In August 2018, Puerto Rico (PR) adopted a Human Papillomavirus (HPV) vaccine school-entry policy, required for students, 11-12 years old. Previous research suggests that influence from media coverage and content might impact parents’ perception of vaccine efficacy, safety and willingness to vaccinate their children. We analyzed the coverage related to the implementation of the HPV vaccine in PR as a requirement for school-entry policy. Methods: A systematic review was conducted from January 2017 through December 2018. Search terms (in Spanish) included: Virus de Papiloma Humano, VPH, vacuna, vacunación contra VPH, implementación, among others. The search included 17 online websites; 34 articles were gathered, which were included if coverage of the new school entry-policy was mentioned in the content. The following steps were developed to review the content of the articles: 1) a matrix to evaluate the content of the article in relation to the school-entry policy and 2) qualitative analysis using grounded theory approach. Since headlines might promote readers’ perception, three different raters read the article title to document the sentiment (positive, negative or neutral). Fleiss’ Kappa analysis was used to assess intra-rater agreement. Results: Data from the matrix showed that 79% focused on this new school-entry mandate as a policy for cancer prevention and 61% of the news articles did not discuss the HPV doses required. Media reports highlighted the link between HPV and HPV-related cancers, mostly cervical cancer (59%). Limited information regarding other HPV-related cancers such as vaginal (18%), vulvar (20%), anal (12%), penile (21%) and oropharynx (24%) was included. In 2017, prior to policy implementation, news coverage focused mostly on the description of the school-entry policy, while 2018 coverage focused on the controversy of the school policy being mandatory. Most of the emergent themes related to the implementation of the HPV vaccine as a school-entry policy were negative, involving: 1) risk of the vaccine (safety and efficacy); 2) representative hesitancy; 3) parental autonomy; 4) right to be informed; and 5) lack of education about HPV and the vaccine. Positive content included: 1) knowledge and acceptance of the HPV vaccine for cancer prevention; 2) the importance of education and protective sexual behaviors; 3) support from coalitions, health providers and government representatives for implementation. The agreement of the headline sentiment between the three raters was fair (k= 32%; p &lt;0.01). Conclusion: Most of the media coverage about HPV in PR had limited information related to the vaccine, HPV, and HPV-related cancers. Weak concordance of the headline’s sentiments shows how different headlines influence the total impression created by a news story. In the case of HPV and this new policy, this situation could influence negatively public concerns regarding the new school-entry policy, as well as HPV vaccination rates in PR.
Citation Format: Vilnery Rivera-Figueroa, Glizette O Arroyo-Morales, Roxana Soto-Abreu, Manuel E Rivera-Encarnación, Olga L Díaz-Miranda, Diana T Medina-Laabes, Ana P Ortíz-Martínez, Erick L Suárez-Pérez, Maria E Fernández, Pamela C Hull, Vivian Colón-López. Content analysis of online media coverage of the human papillomavirus vaccine as a school-entry policy in Puerto Rico [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D045.