A new vaccine for girls to prevent cervical cancer was rejected by 20% of parents during a trial, a study says.
Nearly three in 10 parents failed to agree to their children receiving a new cervical cancer vaccine during a trial.
The jab, being rolled out in the UK this year, has proved controversial as it works by making girls immune to a sexually transmitted infection.
The jab, being rolled out in the UK this year, has proved controversial as it works by making girls immune to a sexually transmitted infection.
Most parents did not give reasons for refusing, although a tiny number cited fears about promoting sexual behaviour.
One in five parents did not return consent forms, while 8% sent a refusal letter, although few cited fears about promoting promiscuity.
The Manchester University researchers said increased publicity about the benefits would allay fears.
The British Medical Journal study was carried out by Manchester university.
Some 70% of 12 to 13-year-olds in the trial received the vaccine - with another 10% given approval but missing their appointment, the British Medical Journal reported.
Approximately 70% of 12 to 13-year-olds in the trial received the vaccine, with a small number of others missing the jab for other reasons.
We were very encouraged, and believe that a coverage of 80% is very achievable Loretta BrabinUniversity of Manchester
We were very encouraged, and believe that a coverage of 80% is very achievable Loretta BrabinUniversity of Manchester
The vaccine works by making girls immune to strains of the human papillomavirus (HPV),a sexually-transmitted infection, known to cause approximately 70% of all cervical cancer cases in the UK.
The vaccine works by making girls immune to two key strains of the human papillomavirus (HPV), a sexually-transmitted infection.
Together, the two strains are known to cause approximately 70% of all cervical cancer cases in the UK.
It is suggested that vaccinating most teenage girls could save hundreds of lives a year - although the benefits would not be seen until those receiving the vaccine enter middle age.
It is suggested that vaccinating most teenage girls could save hundreds of lives a year - although the benefits would not be seen until those receiving the vaccine enter middle age.
The government has announced that it will include the vaccine in the school immunisation programme from this September, and the trial was designed to see what kind of coverage could be achieved among schoolgirls.
The government has announced that it will include the vaccine in the school immunisation programme from this September, and the trial was designed to see what kind of coverage could be achieved among schoolgirls.
There had been concerns that parents would not give their consent to the jab because they felt it could encourage early sexual activity, or because it prevented an potential illness many years in the future, rather than addressing a present threat.
There had been concerns that parents would not give their consent to the jab because they felt it could encourage early sexual activity, or because it prevented an potential illness many years in the future, rather than addressing a present threat.
The results, involving almost 3,000 girls in 36 secondary schools in Greater Manchester, were described as "encouraging" by the doctors leading the project.
The results, involving almost 3,000 girls in 36 secondary schools in Greater Manchester, were described as "encouraging" by the doctors leading the project.
While there is no specific target coverage rate - as in MMR - some predictions suggest up to 80% take-up could be expected.
While there is no specific target coverage rate - as in MMR - some predictions suggest up to 80% take-up could be expected.
Although take-up was nowhere near as high as vaccination campaigns against meningitis C or hepatitis B, researchers felt that it could be increased if publicity about the benefits of the vaccine was increased nearer to the launch date.
Although take-up was nowhere near as high as vaccination campaigns against meningitis C or hepatitis B, researchers felt that it could be increased if publicity about the benefits of the vaccine was increased nearer to the launch date.
'Learning curve'
'Learning curve'
Lead researcher Loretta Brabin said: "We were very encouraged, and believe that a coverage of 80% is very achievable.
Lead researcher Loretta Brabin said: "We were very encouraged, and believe that a coverage of 80% is very achievable.
"There is a real learning curve involved with delivering a vaccine of this type."
"There is a real learning curve involved with delivering a vaccine of this type."
The real indication of success will be when vaccination is administered on a national level, beginning this autumn Health Protection Agency spokesman
The real indication of success will be when vaccination is administered on a national level, beginning this autumn Health Protection Agency spokesman
However, two religious schools refused to take part altogether in the pilot scheme.
However, two religious schools refused to take part altogether in the pilot scheme.
In an editorial in the BMJ, Dr Jo Waller and Professor Jane Wardle, researchers from Cancer Research UK said that uptake nationwide could actually end up being lower than in the Manchester study, and more work was needed to understand why parents might be opposed to the vaccine.
In an editorial in the BMJ, Dr Jo Waller and Professor Jane Wardle, researchers from Cancer Research UK said that uptake nationwide could actually end up being lower than in the Manchester study, and more work was needed to understand why parents might be opposed to the vaccine.
They also raised the possibility that, even if parents said no, some of the girls might be old enough to give consent for vaccination themselves, perhaps going to their GP themselves to receive it.
They also raised the possibility that, even if parents said no, some of the girls might be old enough to give consent for vaccination themselves, perhaps going to their GP themselves to receive it.
They wrote: "Decisions need to be made about whether girls should have access to the vaccine through primary care if their parents have refused consent."
They wrote: "Decisions need to be made about whether girls should have access to the vaccine through primary care if their parents have refused consent."
Ms Brabin said this was a "difficult issue" for those providing the vaccine, as giving the jab within schools, and against the wishes of parents, would be problematic for school nurses.
Ms Brabin said this was a "difficult issue" for those providing the vaccine, as giving the jab within schools, and against the wishes of parents, would be problematic for school nurses.
"We should be looking for other ways to increase uptake without doing this if possible," she said.
"We should be looking for other ways to increase uptake without doing this if possible," she said.
A spokesman for the Health Protection Agency, which will be responsible for monitoring the success of the vaccination campaign, said: "This level of coverage is broadly positive for a new vaccine, particularly one that protects against an infection very few people are actually aware of.
A spokesman for the Health Protection Agency, which will be responsible for monitoring the success of the vaccination campaign, said: "This level of coverage is broadly positive for a new vaccine, particularly one that protects against an infection very few people are actually aware of.
"The real indication of success will be when vaccination is administered on a national level, beginning this autumn."
"The real indication of success will be when vaccination is administered on a national level, beginning this autumn."
Simon Blake, chief executive of the sexual health charity Brook, said: "At least 10% of young women have HPV by the age of 16.
"HPV leads to increased risk of cervical cancer in women and the vaccine can save lives.
"It is crucial to give the vaccine to young people before they become sexually active."
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