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HPV vaccination refusal, delay continued by some parents
Concerns about HPV vaccine effectiveness, long-term health problems related to vaccination and belief that the vaccine is unnecessary are common reasons for parents to delay or refuse the vaccine for their adolescent daughters, according to recent study findings published in Clinical Pediatrics.
Christina Dorell, MD, MPH, of the office of clinical affairs at the University of Massachusetts Medical School in Worcester, Mass., and colleagues from the CDC evaluated data reported by the parents of 4,103 girls aged 13 to 17 years to determine how common delaying and refusing HPV vaccination is and reasons why parents delay or refuse vaccination. They also report vaccination rates by varying levels of delaying and/or refusing the vaccine. During phone interviews in 2010, parents were asked questions regarding parental delay or refusal of vaccinations.
Sixty-nine percent of parents did not refuse or delay their child’s vaccination before the interview date. By the interview date, 61.8% of girls in the study whose parents did not delay or refuse vaccination received one or more doses of either the bivalent or quadrivalent HPV vaccine, followed by 53.2% whose parents delayed vaccination; 10.4% whose parents delayed and refused vaccination; and 6.6% whose parents refused only. Provider recommendation was reported by most parents regardless of having delayed or refused the vaccine.
The delayed-only group was most likely to be white; have household incomes of 322% to less than 503% of the federal poverty level; ineligible for the Vaccines for Children Program; and had mothers with a college degree. The refused-only group was most likely not eligible for the VFC Program; have mothers with high school or some college education; and receive vaccines at mixed facilities. The delayed and refused group was more likely to be white; have household incomes of at least 503% the poverty level; was not eligible for the VFC Program; have private insurance; or older mothers who were married or had college degrees.
Of parents of unvaccinated children who intended to initiate the HPV vaccine series within the next 12 months, 15% did not previously delay or refuse; 28.4% delayed only; 12.2% previously refused only; and 35% previously delayed and refused vaccination.
The four most common reported reasons for delaying or refusing vaccination were concerns of lasting health problems; believing the vaccine was not needed; concern about the vaccine’s effectiveness; and reporting that their adolescent is not sexually active. However, this differed by delay and/or refusal group, being more frequently reported among those who refused only.
“Only one-third of the parents in our study reported delaying and/or refusing HPV vaccination,” Dorell told Infectious Diseases in Children. “But of those who delayed or refused the vaccine, some still eventually started the vaccine series. In fact, about 80% of those who delayed only, eventually initiated the vaccine series or intended to receive the vaccine. Parents can change their minds. So, it is important for vaccination providers to recommend the vaccine and to find out parental reasons for delaying or refusing vaccination among those who do so. Seeking opportunities to address concerns or barriers through ongoing discussions may help increase acceptance among parents who delay or refuse vaccination.” – by Amber Cox
Christina Dorell, MD, MPH, can be reached at christina.dorell@state.ma.us.
Disclosure: The researchers report no relevant financial disclosures.
