Q&A: Parents increasingly cite safety concerns as reason for HPV vaccine hesitancy
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Key takeaways:
- Hesitancy is higher for the HPV vaccine than for other vaccines and many parents remain skeptical about it.
- The proportion of parents who cite safety concerns for their HPV vaccine hesitancy has increased.
Although HPV vaccination rates have improved in recent years, many parents remain skeptical about their children receiving it.
The CDC recommends that routine HPV vaccination begin at ages 11 or 12 years but says the vaccine can be administered as early as age 9 years — which could improve coverage, as could reframing the shot as a cancer vaccine, according to prior research.
Eric Adjei Boakye, PhD, an assistant scientist at Henry Ford Medical Group and assistant professor of research at the Michigan State University College of Human Medicine, co-authored a recent study of trends in HPV vaccine hesitancy, which found that the number of parents citing safety concerns as a reason not to vaccinate their children against HPV has increased.
We spoke with Adjei Boakye about the study and the issue of HPV vaccine hesitancy.
Healio: How does HPV vaccine hesitancy compare with hesitancy for other vaccines?
Adjei Boakye: Vaccine hesitancy for the HPV vaccine is usually much higher than for other vaccines, even though I am not sure how it compares with the COVID-19 vaccine. This is due mainly to the fact that the HPV vaccine is associated with sexuality [by way of] sexually transmitted infections. It has had a bad reputation for that since its approval.
Healio: In your opinion, why were parents increasingly concerned about the vaccine’s safety?
Adjei Boakye: There are several reasons, but here are a few main ones. At the beginning when the vaccine was recommended, there was a lot of attention place on the STI and most people thought it was an STI vaccine rather than cancer prevention vaccine. As a result, some parents think vaccinating their children will give the permission to become sexually active because they will think they are now protected from STIs. There is also lack of awareness that HPV causes several types of cancers, so they are not aware of the cancer prevention benefits. Another big one is lack of trust in the medical system based on history, especially among minorities.
Some parents are hesitant because the vaccine was not recommended to them by a health care provider. Finally, and perhaps the most contributing factor these days is misinformation, especially on social media, which has gotten worse since the COVID-19 pandemic.
Healio: The data are through 2020, the first year of the COVID-19 pandemic. Are there any indications that HPV vaccine hesitancy has grown or shrunk since then?
Adjei Boakye: We don’t know the effect. I stated this in the paper that future studies are needed to examine the effect of the COVID-19 vaccine controversy and hesitancy on HPV vaccination. The data were mostly collected before the COVID-19 vaccine became available, so I don’t believe it affected the HPV vaccine hesitancy in our study.
Healio: Some of the surveyed parents cited “lack of knowledge” as a reason for not intending to vaccinate their child. Recent studies have reported that reframing the shot as a cancer vaccine helps improve uptake, but also, according to a study you co-authored, that awareness of HPV as a cause of cancer has declined. What is a pediatrician to do?
Adjei Boakye: Health care providers, oral health professions and pharmacists should use every visit as an opportunity to educate eligible individuals about the cancer prevention benefit of the HPV vaccine. Physicians should also recommend the vaccine whenever necessary. Providers should present the vaccine as a cancer prevention vaccine and not an STI vaccine. That has been shown to work the best.
Healio: What is the key takeaway here?
Adjei Boakye: Despite consistent evidence of the safety and effectiveness of the HPV vaccine, the number of parents who still cite safety/side effects concerns as a reason for not vaccinating their children has increased from 2010 to 2020. It would have been acceptable around 2006 when the vaccine was new but now, it is shocking that people still think the vaccine may not be safe. Over 100 million doses of the vaccine have been administered and there have been only a few serious adverse effects. Overall, the vaccine is safe and very effective — it is estimated that over 90% of HPV-associated cancers could be prevented with the HPV vaccination.
Honestly, I do not have a solution, but we must address HPV vaccine misinformation especially on social media to help reduce hesitancy. With so much social media tools and basically no regulations, people spread false narratives. And we are all aware how negative information spreads so much quicker. We should also develop tailored interventions to parents’ level of hesitancy and address the main reasons they are hesitant to vaccinate their children. It could be addressing cultural issues, addressing fear that they are being used as “scapegoats,” addressing lack of knowledge and awareness among others.
References:
Adjei Boakye E, et al. Pediatrics. 2023;doi:10.1542/peds.2022-060410.
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