HPV vaccination knowledge, intentions, and practices among caregivers of childhood cancer survivors

Abstract

The HPV vaccine is an important vaccine for childhood cancer survivors because of their risks of second cancers, yet few survivors receive it. We examined HPV vaccine knowledge among caregivers of childhood cancer survivors, whether their child had received the vaccine, and their intentions to vaccinate. Eligible participants were caregivers (mostly parents) whose child finished cancer treatment at Primary Children's Hospital in Salt Lake City, Utah 3 to 36 months prior to the start of the study (N = 145). Additional analyses were done among caregivers whose child was age-eligible for the HPV vaccine (ages 11 and up; N = 61). We ran descriptive statistics and fit multivariable generalized linear models to identify factors associated with intention to vaccinate and HPV vaccination uptake. Among caregivers whose child had not yet gotten the HPV vaccine, approximately 30% stated they were not likely to get the vaccine for their child and the most commonly cited reason was not enough information (25.2%). Provider discussion about vaccines and side effects (relative risk (RR) = 1.85, 95% CI 1.16-2.94), along with recommendations regarding vaccines after cancer treatment (RR = 1.35, 95% CI 1.06-1.72), led to greater caregiver intention to get the HPV vaccine for their child with cancer. Approximately 40% of ageeligible survivors had gotten at least one dose of the HPV vaccine. Our findings demonstrate a need for oncology-focused interventions to educate families of childhood cancer survivors about the importance of the HPV vaccine after cancer therapy.

Missed opportunities for concomitant HPV vaccination among childhood cancer survivors

“…Survivors treated with chemotherapy had more missed opportunities for concomitant HPV vaccination than survivors who did not receive chemotherapy, indicating that providers may need guidance regarding vaccine safety following cancer treatments. At the same time, caregivers of survivors have cited lack of information on the vaccine and concerns over potential side effects as their primary reason for not vaccinating their child 32 27,33 …”

Influence of provider recommendations to restart vaccines after childhood cancer on caregiver intention to vaccinate

“…Caregiver vaccine intentions after childhood cancer treatment likely differs by vaccine type. For example, while we did not account for differences in caregiver’s intentions by vaccine type, an earlier report of HPV vaccine intentions showed that one-third of caregivers of childhood cancer who were age-eligible for the HPV vaccine were unlikely-very unlikely to get the HPV vaccine for their child [ 32 ]. Finally, there was a significantly lower proportion of rural patients with caregivers in the study (18.7%) compared to non-participants (18.7%, p=0.02).…”

“…Before completing the survey, caregivers were provided terms that included a list of all recommended vaccines, including the yearly influenza vaccine, and the recommended age for each vaccine, and definitions of other terms (i.e., cancer treatment, catch-up vaccines, booster vaccine, titer testing, and primary care provider). Results from questions on HPV vaccination are reported elsewhere [ 17 ].…”

There’s Much Yet to be Done: Diverse Perspectives on HPV Vaccination

“…46,47 Two additional papers examine issues of risk compensation post-vaccination in the U.S. and in China, respectively. 48,49 Still other articles involve a latent-class analysis of parental worries, 50 adolescents' perspectives on vaccination, 51 college students' lack of awareness of HPV diseases and vaccination, 52 knowledge and attitudes of caregivers of childhood cancer survivors, 53 HCPs' recommendation profiles and perceptions of barriers to vaccination, 54,55 and perspectives on vaccination among boys in Sweden. 56 Finally, articles in this section apply the Precaution Adoption Process Model to a study of parental vaccine hesitancy, 57 examine preferences for a vaccine-related mobile health tool among young men who have sex with men, 58 and report on the association between vaccination history in women and the HPV vaccine status of their 11-14-y-old children.…”