Controversy Undermines Support For State Mandates On The Human Papillomavirus Vaccine

Gollust, Sarah E.; Dempsey, Amanda F.; Lantz, Paula M.; Ubel, Peter A.; Fowler, Erika Franklin

doi:10.1377/hlthaff.2010.0174

Cited by 51 publications

(35 citation statements)

References 21 publications

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“…Providers felt that school-entry requirements would improve coverage rates, but were concerned about provoking an intense public backlash that could hinder vaccination efforts. These opinions are consistent with other US-based surveys, 15,17,39,40 and reflect the national debate on the issue of mandatory HPV vaccination. School-entry requirements are generally considered very effective policies for achieving widespread childhood vaccination.…”

supporting

confidence: 89%

Parents' and providers' attitudes toward school-located provision and school-entry requirements for HPV vaccines

Vercruysse

Chigurupati

Fung

et al. 2016

Human Vaccines & Immunotherapeutics

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Objective: To determine parents' and providers' attitudes toward school-located provision and schoolentry requirements for HPV vaccination. Methods: Parents/guardians of 11-17 y old girls and pediatric healthcare providers at one inner-city public clinic and three private practices completed semi-structured interviews in 2012-2013. Participants were asked open-ended questions regarding their attitudes toward school-located provision and school-entry requirements for HPV vaccination. Parents' answers were analyzed with relationship to whether their daughters had not initiated, initiated but not completed, or completed the HPV vaccine series. Qualitative analysis was used to identify themes related to shared views. Results: 129 parents/guardians and 34 providers participated. 61% of parents supported providing HPV vaccinations in schools, citing reasons of convenience, improved access, and positive peer pressure. Those who opposed school-located provision raised concerns related to privacy and the capacity of school nurses to manage vaccine-related reactions. Parents whose daughters had not completed the series were more likely to intend to vaccinate their daughters in schools (70%) and support requirements (64%) than parents who had not initiated vaccination (42% would vaccinate at school, 46% support requirements) or completed the series (42% would vaccinate at school, 32% support requirements; p < 0 .05 for all comparisons). 81% of providers supported offering vaccination in schools, wanting to take advantage of the captive audience, improve vaccine completion rates, and decrease the administrative burden on medical office staff, but were concerned about adequate information transfer between schools and medical offices. Only 32% of providers supported school-entry requirements, largely because they felt that a requirement might provoke a public backlash that could further hinder vaccination efforts. Conclusions: School-located provision of HPV vaccination was widely accepted by healthcare providers and parents whose children have not completed the series, indicating that this venue might be a valuable addition to improve completion rates. Support for school-entry requirements was limited among both parents and healthcare providers.

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supporting

confidence: 89%

Parents' and providers' attitudes toward school-located provision and school-entry requirements for HPV vaccines

Vercruysse

Chigurupati

Fung

et al. 2016

Human Vaccines & Immunotherapeutics

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“…12 Parents indicated only modest support for school entry mandates for HPV vaccination, 13,14 and the introduction of this legislation met with substantial public backlash. 15,16 . By 2008, only Virginia and the District of Columbia had enacted schoolentry mandates, and these included liberal opt-out provisions for HPV vaccine that did not apply to other vaccinations.…”

Section: Introductionmentioning

confidence: 99%

Impact of school-entry and education mandates by states on HPV vaccination coverage: Analysis of the 2009–2013 National Immunization Survey-Teen

Perkins

Lin

Wallington³

et al. 2016

Human Vaccines & Immunotherapeutics

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Objective: To determine the effectiveness of existing school entry and education mandates on HPV vaccination coverage, we compared coverage among girls residing in states and jurisdictions with and without education and school-entry mandates. Virginia and the District of Columbia enacted school entry mandates, though both laws included liberal opt-out provisions. Ten additional states had mandates requiring distribution of education to parents or provision of education within school curricula. Methods: Using data from the National Immunization Survey-Teen from 2009-2013, we estimated multilevel logistic regression models to compare coverage with HPV vaccines for girls ages 13-17 residing in states and jurisdictions with and without school entry and education mandates, adjusting for demographic factors, healthcare access, and provider recommendation. Results: Girls residing in states and jurisdictions with HPV vaccine school entry mandates (DC and VA) and education mandates (LA, MI, CO, IN, IA, IL, NJ, NC, TX, and WA) did not have higher HPV vaccine series initiation or completion than those living in states without mandates for any year (2009)(2010)(2011)(2012)(2013). Similar results were seen when comparing girls ages 13-14 to those ages 15-17, and after adjustment for known covariates of vaccination. Conclusions: States and jurisdictions with school-entry and education mandates do not currently have higher HPV vaccination coverage than states without such legislation. Liberal opt-out language in existing school entry mandates may weaken their impact. Policy-makers contemplating legislation to improve vaccination coverage should be aware of the limitations of existing mandates.

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“…Studies have also explored the ethical, legal, and political aspects of the HPV vaccine and the nature of the public debate around the vaccine [10e12, 16,17,19,21]. Generally, discussion of the policy response to the new vaccine has focused on legislative proposals to mandate vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…The term "mandates" or "mandatory" vaccination is used in most discussions of vaccination requirements [10,12,16,17,21,22,26]. Bills requiring HPV vaccinations for school entry were coded as mandatory vaccination if the law mentioned "required" or "mandated" vaccination.…”

Section: Methodsmentioning

confidence: 99%

Early Policy Responses to the Human Papillomavirus Vaccine in the United States, 2006–2010

Laugesen

Mistry

Carameli

et al. 2014

Journal of Adolescent Health

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Controversy Undermines Support For State Mandates On The Human Papillomavirus Vaccine

Cited by 51 publications

References 21 publications

Parents' and providers' attitudes toward school-located provision and school-entry requirements for HPV vaccines

Parents' and providers' attitudes toward school-located provision and school-entry requirements for HPV vaccines

Impact of school-entry and education mandates by states on HPV vaccination coverage: Analysis of the 2009–2013 National Immunization Survey-Teen

Early Policy Responses to the Human Papillomavirus Vaccine in the United States, 2006–2010

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