Parents of 1 in 2 unvaccinated US adolescents have no intention to initiate HPV vaccine

July 21, 2020

Study results documenting parental hesitancy to begin and complete their child's HPV vaccine series were published in The Lancet Public Health by researchers at The University of Texas Health Science Center at Houston (UTHealth).

Based on survey data from the 2017-2018 National Immunization Study, the research team discovered that of the estimated 4.3 million children who were not vaccinated against the human papillomavirus (HPV), nearly 60% of their parents had no intention to initiate the vaccine series. In certain states (Idaho, Kansas, Michigan, Montana, Nebraska, North Dakota, Oklahoma, and Utah), vaccine hesitancy was even higher at more than 65%.

"The hesitancy of parents to protect their child against HPV is troubling because improving HPV vaccination coverage is our only option to curb the rising burden of cancers caused by this virus," said Kalyani Sonawane, PhD, the study's first and corresponding author and an assistant professor at UTHealth School of Public Health. "The silver lining here is that these reasons are addressable. Health care providers can play a vital role in combatting misinformation by educating parents about HPV vaccine safety and benefits, and they can also emphasize the importance of series completion."

The U.S. Centers for Disease Control and Prevention (CDC) recommends a two-dose vaccination regimen for children if the first dose is received before age 15, or a three-dose regimen if the series is started between ages 16 and 26.

The research team completed a cross-sectional study using responses from parents and caregivers of 82,297 U.S. children ages 13 to 17. The study also reported that parents of 1 in 4 adolescents who received their first HPV vaccine dose did not intend to complete the series. In Arkansas, Florida, Georgia, Hawaii, Idaho, Utah, and West Virginia, more than 30% of parents reported their teen would not receive subsequent vaccine doses to complete the series. For parents of children who received one dose but failed to complete the full series, the most common cause cited was lack of a recommendation from a health care provider.

Data from the CDC has suggested that HPV is responsible for 34,800 new cancer diagnoses yearly. More than 90% of all cervical and anal cancers, more than 60% of all penile cancers, and approximately 70% of all oral cancers are caused by HPV, a common and highly contagious sexually transmitted infection. However, current vaccination rates reveal that just over half of U.S. teens (51.1%) are fully vaccinated. The current vaccine provides protection against nearly 90% of cancer-causing HPV infections.

"Our findings suggest that parental reluctance to complete HPV vaccine series for their teen might be a major impediment to achieving the Healthy People 2020 goal of 80% coverage," said Ashish A. Deshmukh, PhD, MPH, senior author and an assistant professor at UTHealth School of Public Health.
Other UTHealth School of Public Health authors include Yenan Zhu, MS; David R. Lairson, PhD; and Cici Bauer, PhD. Jane R. Montealegre, PhD, and Lindy U. McGee, MD, both of Baylor College of Medicine, and Anna R. Giuliano, PhD, of the Center for Immunization and Infection Research in Cancer at the Moffitt Cancer Center in Tampa, Florida, were also co-authors.

Funding was provided by a grant from the U.S. National Cancer Institute, part of the National Institutes of Health (R01CA232888).

University of Texas Health Science Center at Houston

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