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Study reveals more efforts needed to communicate safety of HPV vaccine

May 24, 2023

Concern over the safety of human papillomavirus vaccine (HPV) was one of the top reasons parents gave for choosing not to allow their teens to receive the vaccine, and the percentage of parents citing this worry grew from 2010-’20, according to a recent study.

Researchers used data from the 2010 to 2020 National Immunization Survey-Teen (NIS-Teen) from the Centers for Disease Control and Prevention to determine the main reasons why U.S. parents decided not to have their teen vaccinated against HPV. They also looked at whether parents’ reasons changed during the survey period.

They reported their findings in Trends in Reasons for Human Papillomavirus Vaccine Hesitancy: 2010-2020,” (Adjei Boakye E, et al. Pediatrics. May 23, 2023).

Using data from the nationally representative NIS-Teen, researchers identified 180,103 teens ages 13-17 years who had not received an HPV vaccine. They also classified 119,695 of their parents/guardians as “highly hesitant” based on their response to a question asking how likely it was that their child would receive HPV shots in the next 12 months.

Parents/guardians also were asked the main reasons why they wouldn’t allow the vaccination, selecting among 28 choices.

Over the 11-year period, the top five reasons parents gave for not intending to vaccinate were the vaccine was not necessary (20.3%), safety/side effects (15.3%), it was not recommended (14.4%), lack of knowledge (12.4%) and their child was not sexually active (10.3%).

HPV hesitancy decreased by 5.5% annually between 2010 and 2012 and remained stable between 2012 through 2020. However, the proportion of parents citing safety concerns as the reason to reject the vaccine increased significantly by 15.6% every year from 2010 to 2018.

This did not hold true for the other reasons, which decreased or remained stable. The proportion of parents citing not recommended, lack of knowledge or not sexually active went down significantly by 6.8%, 9.9% and 5.9%, respectively, each year between 2013 and 2020. There were no significant changes in parents citing the vaccine was unnecessary.

The researchers noted that the survey revealed important trends, “namely an increase in the percentage of parents/guardians citing safety concerns and a decrease in nearly all other reasons.”

Decreases in vaccine hesitancy suggest interventions have reduced perceived barriers to HPV vaccination, they wrote. Interventions include provider recommendations, which have been shown to be the best predictor of HPV vaccine uptake and vaccine acceptability. Improved outreach on how the vaccine is not associated with increased sexual behavior also could account for some of the results, researchers noted.

Still, a substantial number of parents are unwilling to have their teen receive the HPV vaccine, possibly due to vaccine misinformation.

The authors point out that social media accounts run by antivaccination proponents have increased their following by 7.8 million people since 2019, and fear tactics often dissuade parents from vaccinating their children.

Studies show there are about 14 million new cases of HPV each year, and HPV vaccines could prevent more than 90% of HPV-attributable cancers. As of 2020, 75% of 13- to 17-year-olds had received at least one dose of the vaccine, according to NIS-Teen.

Despite evidence of the HPV vaccine’s safety profile, closing the gap on the remaining unvaccinated U.S. adolescents “will likely require a mix of current and newer approaches to address vaccine hesitancy,” the authors wrote.

“Our findings suggest that strategies to combat safety concerns and improve vaccine confidence are urgently warranted,” they concluded.


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