Trends in Human Papillomavirus Vaccine Safety Concerns and Adverse Event Reporting in the United States

Sonawane, Kalyani; Lin, Yueh-Yun; Damgacioğlu, Haluk; Zhu, Yenan; Fernández, María E.; Montealegre, Jane R.; Cazaban, Cecilia Ganduglia; Li, Ruosha; Lairson, David R.; Lin, Ying; Giuliano, Anna R.; Deshmukh, Ashish A.

doi:10.1001/jamanetworkopen.2021.24502

Cited by 66 publications

(69 citation statements)

References 43 publications

(112 reference statements)

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“…While we did not interview the mothers of participants who reported a lack of maternal support to vaccinate, it is possible that this lack of support was rooted in concerns around the vaccine’s safety. Prior research has cited safety concerns as the primary reason caregivers of adolescents do not initiate the HPV vaccine series [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

Motivators and Barriers to HPV Vaccination: A Qualitative Study of Underserved Women Attending Planned Parenthood

et al. 2022

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Human papilloma virus (HPV) is the most common sexually transmitted infection in the United States. Disease-associated strains of HPV can cause genital warts and six cancer types. HPV-associated cervical cancer disproportionately impacts medically underserved women including Black and Latina women with respect to incidence, prevalence, and mortality rates. Although safe and effective vaccines are available, HPV vaccination rates remain low among low-income individuals and women of color. The current study examined individual and structural motivators and barriers to HPV vaccination among medically underserved women utilizing a Planned Parenthood health center in Southeast Pennsylvania. Guided by narrative engagement theory (NET), qualitative interviews (N = 24) were used to elicit HPV vaccine decision stories from both vaccinated and unvaccinated women. Using a phronetic iterative data analysis approach, we identified three motivators to vaccinate against HPV: (1) receiving an explicit vaccine recommendation from a healthcare provider (a structural determinant), (2) feeling empowered to take control of one’s health (an individual determinant), and (3) knowing someone infected with HPV (an individual determinant). Among unvaccinated participants, barriers to HPV vaccination included: (1) not receiving an explicit vaccine recommendation from a healthcare provider (a structural determinant), (2) low perceived risk for acquiring HPV or that HPV is not severe (an individual determinant), and (3) lack of maternal support to vaccinate (a structural determinant). Healthcare providers are optimally positioned to fill the gap in prior missed vaccine opportunities and empower women by recommending HPV vaccination.

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Section: Discussionmentioning

confidence: 99%

Motivators and Barriers to HPV Vaccination: A Qualitative Study of Underserved Women Attending Planned Parenthood

et al. 2022

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“…For example, in a study by Cunningham-Erves et al, perceived parent vaccine hesitancy by providers was significantly associated with lower provider confidence in vaccine safety, lower outcome expectations for the discussion and lower self-efficacy (Cunningham-Erves et al, 2019 ). Parental concerns about the safety of the HPV vaccine appear to be increasing – an analysis of NIS-Teen data from 2015 to 2018 found that the proportion of parents citing “Safety Concerns” as the primary reason for not vaccinating their child increased significantly from 13.0% in 2015 to 23.4% in 2018 (Sonawane et al, 2021 ). There is evidence that this increase in parental hesitancy is impacting providers as well.…”

Section: A Multilevel Framework For Factors Influencing Provider Reco...mentioning

confidence: 99%

Understanding the Factors Influencing Health Care Provider Recommendations about Adolescent Vaccines: A Proposed Framework

et al. 2022

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Health care provider recommendations are among the most important factors influencing parents’ decisions to vaccinate their adolescents. However, delivery of high-quality health care provider recommendations for vaccination is not universal. There is wide variation in the strength, timeliness and consistency of the delivery of recommendations for all adolescent vaccines. The factors that influence health care providers’ recommendations are multi-level and can be conceptualized in much the same way as vaccine acceptance among parents. Health care providers are influenced by their own attitudes and beliefs about a vaccine and also by the patient they are treating and by the community in which they practice as well as state and national level vaccine policy. We propose a multi-level framework for understanding the factors that influence health care providers’ recommendations at the individual, interpersonal and community level to both develop and adapt interventions to improve providers’ recommendations.

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“…In Japan, the repeated broadcast of adverse events, which are regarded as functional disorders, has discouraged many individuals from getting their daughters vaccinated [ 2 , 5 , 11 ]. In the United States, the HPV vaccination rate has risen to around 50% among vaccine-eligible adolescents, with vaccine hesitancy as a main source of the ongoing problem [ 12 ]. It has been demonstrated that the most frequent reason for hesitancy stems from people’s concerns regarding safety and adverse effects [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the United States, the HPV vaccination rate has risen to around 50% among vaccine-eligible adolescents, with vaccine hesitancy as a main source of the ongoing problem [ 12 ]. It has been demonstrated that the most frequent reason for hesitancy stems from people’s concerns regarding safety and adverse effects [ 12 ]. As social media continues to become a major source for public health information, it has become increasingly difficult to filter out wrong and inaccurate information.…”

Section: Introductionmentioning

confidence: 99%

The Effect of a Web-Based Cervical Cancer Survivor’s Story on Parents' Behavior and Willingness to Consider Human Papillomavirus Vaccination for Daughters: Randomized Controlled Trial

Suzuki

Sukegawa

Ueda

et al. 2022

JMIR Public Health Surveill

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Background Providing adequate information to parents who have children eligible for human papillomavirus (HPV) vaccination is essential to overcoming vaccine hesitancy in Japan, where the government recommendation has been suspended. However, prior trials assessing the effect of brief educational tools have shown only limited effects on increasing the willingness of parents to vaccinate their daughters. Objective The aim of this trial is to assess the effect of a cervical cancer survivor’s story on the willingness of parents to get HPV vaccination for their daughters. Methods In this double-blinded, randomized controlled trial (RCT) implemented online, we enrolled 2175 participants aged 30-59 years in March 2020 via a webpage and provided them with a questionnaire related to the following aspects: awareness regarding HPV infection and HPV vaccination, and willingness for HPV vaccination. Participants were randomly assigned (1:1) to see a short film on a cervical cancer survivor or nothing, stratified by sex (male vs female) and willingness for HPV vaccination prior to randomization (yes vs no). The primary endpoint was the rate of parents who agreed for HPV vaccination for their daughters. The secondary endpoint was the rate of parents who agreed for HPV vaccination for their daughters and the HPV vaccination rate at 3 months. The risk ratio (RR) was used to assess the interventional effect. Results Of 2175 participants, 1266 (58.2%) were men and 909 (41.8%) were women. A total of 191 (8.8%) participants were willing to consider HPV vaccination prior to randomization. Only 339 (15.6%) participants were aware of the benefits of HPV vaccination. In contrast, 562 (25.8%) participants were aware of the adverse events of HPV vaccination. Although only 476 (21.9%) of the respondents displayed a willingness to vaccinate their daughters for HPV, there were 7.5% more respondents in the intervention group with this willingness immediately after watching the short film (RR 1.41, 95% CI 1.20-1.66). In a subanalysis, the willingness in males to vaccinate daughters was significantly higher in the intervention group (RR 1.50, 95% CI 1.25-1.81); however, such a difference was not observed among females (RR 1.21, 95% CI 0.88-1.66). In the follow-up survey at 3 months, 1807 (83.1%) participants responded. Of these, 149 (8.2%) responded that they had had their daughters receive vaccination during the 3 months, even though we could not see the effect of the intervention: 77 (7.9%) in the intervention group and 72 (8.7%) in the control group. Conclusions A cervical cancer survivor’s story increases immediate willingness to consider HPV vaccination, but the effect does not last for 3 months. Furthermore, this narrative approach to parents does not increase vaccination rates in children eligible for HPV vaccination. Trial Registration UMIN Clinical Trials Registry UMIN000039273; https://tinyurl.com/bdzjp4yf

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Trends in Human Papillomavirus Vaccine Safety Concerns and Adverse Event Reporting in the United States

Cited by 66 publications

References 43 publications

Motivators and Barriers to HPV Vaccination: A Qualitative Study of Underserved Women Attending Planned Parenthood

Motivators and Barriers to HPV Vaccination: A Qualitative Study of Underserved Women Attending Planned Parenthood

Understanding the Factors Influencing Health Care Provider Recommendations about Adolescent Vaccines: A Proposed Framework

The Effect of a Web-Based Cervical Cancer Survivor’s Story on Parents' Behavior and Willingness to Consider Human Papillomavirus Vaccination for Daughters: Randomized Controlled Trial

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