Parental Decision Making about the HPV Vaccine

Abstract

Background: Prophylactic human papillomavirus (HPV) vaccines are available, but uptake is suboptimal. Information on factors influencing parental decisions regarding vaccination will facilitate the development of successful interventions.Methods: Parents of girls ages 9 to 17 years (n = 476; cooperation rate = 67%) from a panel of U.S. households completed online surveys between September 2007 and January 2008, documenting vaccine knowledge, attitudes, and intentions.Results: Among those aware of the vaccine, 19% had already vaccinated their daughter(s), 34% intended to, 24% were undecided, and 24% had decided against vaccination. Awareness of HPV was high but knowledge levels were suboptimal (mean 72%, SEM 0.8%). Black and Hispanic parents were significantly less likely to be aware of the vaccine compared with White parents. In multivariate analyses, compared with parents who opposed vaccination, those who had already vaccinated their daughter(s) or who intended to do so had more positive attitudes, reported fewer barriers, and were more likely to perceive that family and friends would endorse vaccination. They also reported higher levels of trust in pharmaceutical companies that produce the vaccine.Conclusions: Despite limited knowledge, most parents had decided to vaccinate their daughter(s). Given evidence of diminished access to information among Black and Hispanic parents, programs should focus on reaching these groups. Interventions should address parental concerns about behavioral consequences, reduce structural barriers, and promote the perception that vaccination is endorsed by significant others. Moreover, interventions may need to address mistrust of pharmaceutical companies.Impact Statement: This study documents factors associated with parental decisions about HPV vaccination for their daughter(s) and provides direction for intervention development. Cancer Epidemiol Biomarkers Prev; 19

To Consent or Decline HPV Vaccination: A Pilot Study at the Start of the National School‐Based Vaccination Program in Sweden

“…The parents declined the vaccine as they believed the risks outweighed the benefits and this backs up the results of our recent qualitative study, where parents expressed fear of side effects, especially narcolepsy, was one reason why they declined the HPV vaccination 9. General attitudes toward vaccines have an impact on the attitude to HPV vaccination in particular 37. Therefore, it is not surprising that the declining parents in this study reported lower acceptance of previous vaccinations.…”

Effect of the decision-making process in the family on HPV vaccination rates among adolescents 9–17 years of age

“…[10][11][12][13] Due to the high involvement of mothers in making vaccination decisions, it is critical that they have adequate knowledge about the risks and benefits of the HPV vaccine. 10,11,[15][16][17] However, several studies have shown that a large proportion of women have never heard of HPV. [18][19][20] This is consistent with our finding, which found that 28% of mothers were not aware of HPV.…”

Protecting Women Against Human Papillomavirus: Benefits, Barriers, and Evidence-Based Strategies to Increase Vaccine Uptake

“…For many parents, concerns about vaccination encouraging adolescents' earlier sexual debut and greater promiscuity are a barrier [20,21]. Despite these fears, research shows that adolescents who received the vaccine have not had greater numbers of sexual partners than those who did not receive the vaccine [11].…”

“…This is a missed opportunity, and HPV vaccination should be offered to all eligible adolescents and young adults at all visits. Cost can also impact vaccination access [20]. However, under the Patient Protection and Affordable Care Act of 2010 and the Vaccines for Children Program, all age-eligible females and males-including those who are uninsured-should have coverage for this vaccine.…”

“…Barriers Lack of physician recommendation or lack of strong recommendation [22,25] Physician hesitancy [25] Parental perception that recommended vaccination age (11-12 years) is too young [19] Parents belief that vaccination would encourage early sexual debut [20,21,24] Parental low perceived risk of HPV infection [22] Parental lack of knowledge about HPV and/or HPV vaccine [22,23] Concerns about vaccine safety [21,23,24] Concerns about vaccine effectiveness [24] Cost of vaccine [20] Mistrust of health care provider recommendation [20] Note. HPV, human papillomavirus.…”