School Nurses' Experiences of the School-Based HPV Vaccination Program - A Decade Later.

This study investigated Swedish school nurses' experiences, self-perceived knowledge, and attitudes towards HPV vaccination. A cross-sectional repeated questionnaire study was conducted. The results were compared to a previous study conducted in 2016. Additionally, open-ended responses were thematically analysed. A total of 344 nurses participated. Overall, more participants reported good self-perceived knowledge and favourable attitudes towards HPV vaccination compared to 2016. Still, nearly half expressed a need for further education. The thematic analysis revealed barriers including lack of training, inconsistent guidelines for addressing vaccine hesitancy and ensuring children's participation in decision-making, limited access to diverse information materials, and time constraints related to vaccination tasks. Since school nurses in Sweden are responsible for all aspects of school-aged vaccinations within the national immunization program, it is essential that they receive support to feel motivated and confident in addressing vaccine hesitancy. Continued education and the implementation of uniform guidelines are therefore necessary.