“It All Depends”: A Qualitative Study of Parents’ Views of Human Papillomavirus Vaccine for their Adolescents at Ages 11–12 years

Abstract

Routine vaccination with three doses of human papillomavirus (HPV) vaccine is recommended for adolescent girls and boys at 11 or 12 years of age; however, vaccine uptake remains suboptimal. To understand the reasons why parents may accept or refuse HPV vaccine for their children at age 11 or 12 years, we conducted a qualitative study. Semi-structured interviews were conducted with parents or guardians (n=45) whose adolescents receive care at an urban, hospital-based primary care practice. Data were analyzed using an iterative thematic approach. We found that many parents expressed high levels of support for HPV vaccine, including a majority who agreed with vaccination at age 11-12 years. Parents recognized that for prevention of consequences of HPV infection, vaccination of their child early in adolescence was desirable conceptually. However, many parents also expressed that in practice, HPV vaccine should be given to adolescents at the onset of sexual activity, a perception that led to preferences to delay administration of HPV vaccine among certain parents. These apparently contradictory views indicate the need for interventions focused on the benefits of vaccination at the recommended ages. Our findings may be useful in providers' discussions with parents about the vaccine, as pediatric and adolescent health care providers have the unique opportunity to educate parents and clarify misconceptions about vaccination.

“I think they're all basically the same”: parents' perceptions of human papilloma virus (HPV) vaccine compared with other adolescent vaccines

“…Regardless of whether they believed that the vaccine was similar to or different from other adolescent vaccines, many parents stated that it was better than other comparable vaccines because it prevented a very serious disease (cancer). The findings of this study are consistent with prior research that demonstrated high HPV vaccine acceptability in parents and guardians (Olshen et al 2005;Hansen et al 2016;Krawczyk et al 2015). We found that regardless of whether parents perceived HPV vaccine to be similar to or different from other adolescent vaccines, a majority recognized the importance of the vaccine.…”

“…Previous analysis of data from this sample revealed general support for vaccination (Hansen et al . ). Illustrative quotes are presented in the succeeding texts for each identified theme related to similarities to and differences with other vaccines.…”

“…The methods for this research project have been previously described (Hansen et al 2016). This study was carried out in the state of Connecticut, located in the northeastern region of the USA.…”

Cancer-salient messaging for Human Papillomavirus vaccine uptake: A randomized controlled trial

“…However, messages currently being used - including messages from the CDC - are not focused on perceived susceptibility of cervical cancer, or perceived severity of cervical cancer; even though these factors have been identified as predictive to vaccination status among adolescents [16]. For example, the CDC’s Vaccine Information Statement (VIS) has direct reference to HPV as a sexually transmitted disease, despite literature suggesting sexual reference is a factor contributing to vaccine refusal and delay [7,11,12]. Additionally, current CDC and other messages are not disease salient in regard to cervical cancer.…”

Human Papillomavirus Vaccination in Hmong-American Adolescents: A Participatory Focus Group Study

“…This decision resulted in our not exploring other research findings that parents' views of the sexual nature of HPV transmission is a potential barrier to HPV vaccination. [40,[64][65][66]…”