Parents who refuse or delay HPV vaccine: Differences in vaccination behavior, beliefs, and clinical communication preferences

Abstract

Background: We sought to estimate the national prevalence of HPV vaccine refusal and delay in a nationally-representative sample of parents of adolescents. We also compared parents who refused versus delayed HPV vaccine in terms of their vaccination beliefs and clinical communication preferences. Methods: In 2014 to 2015, we conducted an online survey of 1,484 US parents who reported on an 11-to 17-year-old child in their household. We used weighted multinomial logistic regression to assess correlates of HPV vaccine refusal and delay. Results: Overall, 28% of parents reported that they had ever "refused or decided not to get" HPV vaccine for their child, and an additional 8% of parents reported that they had "delayed or put off getting" HPV vaccine. Compared to no refusal/delay, refusal was associated with lower confidence in adolescent vaccination (relative risk ratio [RRR] D 0.66, 95% confidence interval [CI], 0.48-0.91), lower perceived HPV vaccine effectiveness (RRR D 0.68, 95% CI, 0.50-0.91), and higher perceived harms (RRR D 3.49, 95% CI, 2.65-4.60). In contrast, delay was associated with needing more information (RRR D 1.76, 95% CI, 1.08-2.85). Most parents rated physicians and information sheets as helpful for making decisions about HPV vaccination, although parents who reported refusal endorsed these resources less often. Conclusions: Our findings suggest that HPV vaccine refusal is common among parents of adolescents and may have increased relative to previous estimates. Because the vaccination beliefs and communication preferences of parents who refuse appear to differ from those who delay, targeted communication strategies may be needed to effectively address HPV vaccine hesitancy.

HPV vaccine hesitancy among parents in Italy: a cross-sectional study

“…These rates are worrying because the coverage among adolescents remains well below the Italian immunization goals. 2 The coverage was similar to that found in the United States with 54.4% of African American parents of children aged 10-12 years consented this vaccination 23 and 8% of parents of 11-to 17-year-old child reported they had "delayed or put off getting" HPV vaccine 24 and in the UK 11% of parents of girls aged 13-17 years delayed. 25 Whereas higher values have been reported in Brazil, where parental acceptance of HPV vaccine was 92% for daughters and 86% for sons 26 and lower values were reported in Serbian population (2%).…”

“…This observation is in agreement with data reported from previous studies. 16,24,28,29 The results demonstrate that health-care professionals, and specifically primary health-care providers, responsible for delivery of childhood vaccination and for providing adequate information to parents, are encouraged to inform parents more effectively about the importance and the safety of the vaccination to reduce the burden of HPV infection-related cancers. Moreover, these findings may be useful for policy makers and health-care managers to better target the vaccination programs, since it is well established that the success of these programs depends on the provision of health-care services.…”

Investigating Italian parents' vaccine hesitancy: A cross-sectional survey

“…Similar results were also seen in previously studies. 17,31,34,40,[44][45][46] Despite this finding, it is interesting to observe that, as already reported, the main reason provided by participants for having refused the vaccinations was that the pediatricians, contrary to the expectations, did not recommend the vaccines during the childhood. This observation is alarming, since the primary responsibility of the pediatricians is to protect individual children and by a public health point of view the immunization can not be optional.…”

No pain no gain? Adjuvant effects of alum and monophosphoryl lipid A in pertussis and HPV vaccines

“…The most recent CDC report shows that fewer than half of adolescent girls in the U.S. were adequately immunized in 2015 [2,3]. Although multiple overlapping factors affect uptake of a new vaccine, concern about side effects is frequently cited by parents who decline HPV immunizations for their teen-aged children [4–7,8 • ,9] (Table 1). In these surveys, 16–55% of parents cited vaccine side effects and concern about short-term health problems as one of the reasons for their refusal (Table 1).…”