Understanding the Reasons Why Mothers Do or Do Not Have Their Adolescent Daughters Vaccinated Against Human Papillomavirus

Abstract

PURPOSE The objective of this study was to compare the reasons why mothers do or do not have their adolescent daughters vaccinated against HPV. METHODS Mothers of vaccinated and unvaccinated 11- to 17-year-old girls seen during preventive care visits in outpatient family medicine or pediatric clinics underwent an audiotaped structured telephone interview that used open-ended questions to assess the reasons underlying maternal decisions about HPV vaccination. Qualitative methods categorized maternal responses into themes. RESULTS Interviews of 52 mothers (19 declining vaccination, 33 accepting) identified several distinct factors underlying their decisions about HPV vaccination. Lack of knowledge about HPV, age-related concerns, and low perceived risk of infection were commonly cited reasons for declining vaccination. Desire to prevent illness, physician recommendation, and a high perceived risk of infection were commonly identified motivating factors. Both groups of mothers had significant concerns about vaccine safety. Locus of control (e.g., mother or daughter) of health-related decisions arose as a novel factor influencing this decision that had not been previously described in the context of HPV vaccination. CONCLUSIONS Addressing safety concerns, educating parents about the age-specific risk of HPV infection, and promoting strong physician recommendation for vaccination may be the most useful targets for future interventions to increase HPV vaccine utilization.

Provider communication about HPV vaccination: A systematic review

“…4,19,74,78,79 Indeed, some parents indicated a preference for vaccinating in the preteen years specifically because they viewed adolescents as having little say during this 11 Cross-sectional, online survey rout rout F, M 776 National sample of pediatricians and family physicians Gilkey, 2016 60 Cross-sectional, online survey rout rout F, M 1495 National sample of parents of adolescents (ages 11-17) Gilkey, under review 16 Cross-sectional, online survey rout rout F, M 1484 National sample of parents of adolescents (ages [11][12][13][14][15][16][17] (Continued on next page) time. 18,80 In contrast, other studies found that adolescents did play a role in communication and decision-making in clinical settings, one which increased with age, maturity, and social privilege. 18,27,71,73,76,80 For some parents, the desire to maximize adolescents' role was even a reason for delaying HPV vaccination.…”

“…18,80 In contrast, other studies found that adolescents did play a role in communication and decision-making in clinical settings, one which increased with age, maturity, and social privilege. 18,27,71,73,76,80 For some parents, the desire to maximize adolescents' role was even a reason for delaying HPV vaccination. 80 Studies suggested that parent-adolescent decisions were largely concordant and that most dyads ultimately reached agreement about the vaccination decision, but they sometimes looked to providers for guidance in the case of initial disagreement.…”

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

“…Other factors associated with their acceptance were a doctor's recommendation and the fact that they had agreed to previous childhood vaccinations 13. Parents who declined cited reasons such as concerns about side effects13, 20 and long‐term safety 19, 21. They also believed that their daughters were too young13, 21 or they did not perceive that there was a risk of HPV infection 21.…”

“…Parents who declined cited reasons such as concerns about side effects13, 20 and long‐term safety 19, 21. They also believed that their daughters were too young13, 21 or they did not perceive that there was a risk of HPV infection 21. Another common barrier to accepting the vaccination was insufficient knowledge or information about the virus and the vaccine 13, 19.…”

The HPV Vaccine Controversy

“…Studies show that the influence of accurate information about vaccines is maximized when conveyed from physician to parent or patient [75]. In prioritizing this approach over general health advertisement campaigns, physicians retain their position as patient advocates rather than agents of the government who must enforce policy.…”