Parental intent: a large barrier to HPV vaccine uptake in the U.S.

  • Hanson KE & al.
  • Clin Infect Dis
  • 14 Sep 2018

  • curated by Liz Scherer
  • Clinical Essentials
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  • Parental HPV vaccination intent remains low, and may be the largest barrier to initiation.

Why this matters

  • Strong provider recommendations are needed to drive HPV vaccine initiation.
  • Pair recommendations with follow-up counseling, reminder/recall strategies.

Key results

  • 76,971 teenagers (parental intent analysis), 28,101 (reasons analysis).
  • From 2010 to 2015, percentage of unvaccinated, undervaccinated teenagers declined (91.7% to 66.9%, 99.6% to 72.7%, among females, males, respectively).
  • Parental intent to vaccinate unvaccinated males did not change significantly, while significant declines were seen in ‘not likely at all to vaccinate’ females (41.5% to 31.2% [difference, 10.3%; P<.001 significant increase in likely to vaccinate difference>
  • Most prevalent reason for vaccine hesitancy: vaccine was unnecessary.
    • Percentage of parents of females citing reason increased 25.8% to 32.7% (P=.02).
  • Parents of males were significantly likelier to cite lack of provider recommendations for hesitancy over time (P<.001 style="list-style-type:circle;">
  • Percentage reporting safety concerns/side effects as main reason increased from 7.3% to 14.8% (difference, 7.5%; 95% CI, 4.5%-10.5%).
  • Findings in parents of undervaccinated teenagers were similar.
  • Study design

    • Analysis of 2010-2015 National Immunization Survey-Teen characterizing parental HPV vaccine intent, vaccine hesitancy rationale.
    • Funding: University of Minnesota Grand Challenge Research Grant, others.


    • Nongeneralizable.
    • Limited analysis.
    • Self-report bias.

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