Peter G Szilagyi1, Christina S Albertin2, Dennis Gurfinkel3, Alison W Saville4, Sitaram Vangala5, John D Rice6, Laura Helmkamp7, Gregory D Zimet8, Rebecca Valderrama9, Abigail Breck10, Cynthia M Rand11, Sharon G Humiston12, Allison Kempe13. 1. Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, CA, USA. Electronic address: PSzilagyi@mednet.ucla.edu. 2. Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, CA, USA. Electronic address: Christina_Albertin@URMC.Rochester.edu. 3. Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA. Electronic address: Dennis.Gurfinkel@cuanschutz.edu. 4. Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA. Electronic address: Alison.saville@cuanschutz.edu. 5. Department of Medicine, Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. Electronic address: Svangala@mednet.ucla.edu. 6. Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA; Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO, USA. Electronic address: John.Rice@cuanschutz.edu. 7. Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA. Electronic address: Laura.Helmkamp@cuanschutz.edu. 8. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address: gzimet@iu.edu. 9. Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, CA, USA. 10. Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, CA, USA. Electronic address: Abreck@mednet.ucla.edu. 11. Department of Pediatrics, University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA. Electronic address: Cynthia_Rand@urmc.rochester.edu. 12. Department of Pediatrics, Children's Mercy, Kansas City, MO, USA. Electronic address: sghumiston@cmh.edu. 13. Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: Allison.kempe@childrenscolorado.org.
Abstract
BACKGROUND: While many clinicians encounter parents or adolescents who refuse HPV vaccine, little is known about the prevalence of hesitancy for HPV vaccine nationally or its association with vaccination. METHODS: In April 2019, we surveyed families with adolescents 11-17 years using a national online panel (Knowledge Panel®) as the sampling frame. We assessed the prevalence of HPV vaccine hesitancy with the validated 9-item Vaccine Hesitancy Scale (VHS). We used multivariate analyses to assess demographic factors associated with HPV vaccine hesitancy. We also assessed practical barriers to receipt of HPV vaccine and the relationship between barriers and hesitancy. Finally, we evaluated the association between both HPV vaccine hesitancy and practical barriers on HPV vaccine receipt or refusal. RESULTS: 2,177 parents out of 4,185 sampled (52%) completed the survey, 2,020 qualified (lived with adolescent). Using a VHS cut-off score > 3 out of 5 points, 23% of US parents were hesitant about HPV vaccine. Hesitancy was lower among those with Hispanic ethnicity. At least one out of five parents disagreed that the HPV vaccine is beneficial for their adolescent, that the vaccine is effective, protects against HPV-related cancers, or that they followed their adolescent's health-care provider's recommendation about the vaccine. Many were concerned about vaccine side effects and the novelty of the vaccine. Adolescents living with vaccine-hesitant parents were less than one-third as likely to have received the vaccine (RR = 0.29, 95% CI 0.24, 0.35) or completed the vaccine series (RR = 0.29, 95% CI 0.23, 0.36), and were 6-fold more likely to have refused the vaccine because of parental vaccine-related concerns (RR = 6.09, 95% CI = 5.26, 7.04). Most practical barriers were independently associated with vaccine receipt but not with vaccine refusal. CONCLUSIONS: HPV vaccine hesitancy is common nationally and strongly related to both under-vaccination and vaccine refusal.
BACKGROUND: While many clinicians encounter parents or adolescents who refuse HPV vaccine, little is known about the prevalence of hesitancy for HPV vaccine nationally or its association with vaccination. METHODS: In April 2019, we surveyed families with adolescents 11-17 years using a national online panel (Knowledge Panel®) as the sampling frame. We assessed the prevalence of HPV vaccine hesitancy with the validated 9-item Vaccine Hesitancy Scale (VHS). We used multivariate analyses to assess demographic factors associated with HPV vaccine hesitancy. We also assessed practical barriers to receipt of HPV vaccine and the relationship between barriers and hesitancy. Finally, we evaluated the association between both HPV vaccine hesitancy and practical barriers on HPV vaccine receipt or refusal. RESULTS: 2,177 parents out of 4,185 sampled (52%) completed the survey, 2,020 qualified (lived with adolescent). Using a VHS cut-off score > 3 out of 5 points, 23% of US parents were hesitant about HPV vaccine. Hesitancy was lower among those with Hispanic ethnicity. At least one out of five parents disagreed that the HPV vaccine is beneficial for their adolescent, that the vaccine is effective, protects against HPV-related cancers, or that they followed their adolescent's health-care provider's recommendation about the vaccine. Many were concerned about vaccine side effects and the novelty of the vaccine. Adolescents living with vaccine-hesitant parents were less than one-third as likely to have received the vaccine (RR = 0.29, 95% CI 0.24, 0.35) or completed the vaccine series (RR = 0.29, 95% CI 0.23, 0.36), and were 6-fold more likely to have refused the vaccine because of parental vaccine-related concerns (RR = 6.09, 95% CI = 5.26, 7.04). Most practical barriers were independently associated with vaccine receipt but not with vaccine refusal. CONCLUSIONS: HPV vaccine hesitancy is common nationally and strongly related to both under-vaccination and vaccine refusal.
Authors: Philip J Smith; Sharon G Humiston; Edgar K Marcuse; Zhen Zhao; Christina G Dorell; Cynthia Howes; Beth Hibbs Journal: Public Health Rep Date: 2011 Jul-Aug Impact factor: 2.792
Authors: Gretchen J Domek; Sean T O'Leary; Sheana Bull; Michael Bronsert; Ingrid L Contreras-Roldan; Guillermo Antonio Bolaños Ventura; Allison Kempe; Edwin J Asturias Journal: Vaccine Date: 2018-07-27 Impact factor: 3.641
Authors: Marc D Samsky; Li Lin; Stephen J Greene; Steven J Lippmann; Pamela N Peterson; Paul A Heidenreich; Warren K Laskey; Clyde W Yancy; Melissa A Greiner; N Chantelle Hardy; Abhishek Kavati; Siyeon Park; Robert J Mentz; Gregg C Fonarow; Emily C O'Brien Journal: JAMA Cardiol Date: 2020-03-01 Impact factor: 14.676
Authors: Tanja Y Walker; Laurie D Elam-Evans; David Yankey; Lauri E Markowitz; Charnetta L Williams; Benjamin Fredua; James A Singleton; Shannon Stokley Journal: MMWR Morb Mortal Wkly Rep Date: 2019-08-23 Impact factor: 17.586
Authors: Lavanya Vasudevan; Jan Ostermann; Yunfei Wang; Sayward E Harrison; Valerie Yelverton; Laura J Fish; Charnetta Williams; Emmanuel B Walter Journal: Vaccine X Date: 2022-06-15
Authors: Laura M Kiener; Corina L Schwendener; Kristen Jafflin; Audrey Meier; Noah Reber; Susanna Schärli Maurer; Franco Muggli; Nejla Gültekin; Benedikt M Huber; Sonja Merten; Michael J Deml; Philip E Tarr Journal: BMJ Open Date: 2022-04-21 Impact factor: 3.006
Authors: Adeyemi A Okunowo; Aloy O Ugwu; Jubril O Kuku; Adaiah P Soibi-Harry; Bolanle O Okunowo; Nneoma K Ani-Ugwu; Benedetto O Osunwusi; Muisi A Adenekan Journal: Prev Med Rep Date: 2021-11-15
Authors: Emily A Groene; Keith J Horvath; Nicholas Yared; Inari Mohammed; Miriam Muscoplat; Sydney Kuramoto; Tyler Richter; Shalini Kulasingam Journal: Public Health Rep Date: 2021-07-12 Impact factor: 3.117