Study results documenting parental hesitancy to begin and complete their child's human papillomavirus (HPV) vaccine series were published by Sonawane et al in The Lancet Public Health.

The Centers for Disease Control and Prevention recommends a two-dose HPV vaccination regimen for children if the first dose is received before age 15, or a three-dose regimen if the series is started between ages 16 and 26.

“The hesitancy of parents to protect their child against HPV is troubling because improving HPV vaccination coverage is our only option to curb the rising burden of cancers caused by this virus,” said Kalyani Sonawane, PhD, the study's first and corresponding author and Assistant Professor at The University of Texas Health Science Center at Houston School of Public Health, in a statement. “The silver lining here is that these reasons are addressable. Health-care providers can play a vital role in combating misinformation by educating parents about HPV vaccine safety and benefits, and they can also emphasize the importance of series completion.”

Methods

The cross-sectional study used data from the adolescent component of the 2017–2018 National Immunization Survey (NIS-Teen). Study participants were parents or caregivers of adolescents aged 13 to 17 years in the United States; 82,297 respondents completed the survey. About 37% of the children of the respondents were unvaccinated, and about 11% had received only one dose of the vaccination.

Results

The research team discovered that nearly 60% of the respondents had no intention to initiate the vaccine series for their children. In certain states (Idaho, Kansas, Michigan, Montana, Nebraska, North Dakota, Oklahoma, and Utah), vaccine hesitancy was even higher—at more than 65%.

The study also reported that among respondents whose children had received their first HPV vaccine dose, 23.5% of parents did not intend to complete the series for their children. In Arkansas, Florida, Georgia, Hawaii, Idaho, Utah, and West Virginia, more than 30% of parents reported their teen would not receive subsequent vaccine doses to complete the series.

For parents of unvaccinated children, the most common cause cited for lack of initiation was concern over safety. For parents of children who received one dose but failed to complete the full series, the most common cause cited was lack of a recommendation from a health-care provider.

Recommendation of vaccination from a health-care provider was associated with greater odds of parental intent to initiate the series, but 45.5% of parents of unvaccinated adolescents had reportedly received an HPV vaccine recommendation from a health-care provider. Parents of 60.6% of unvaccinated adolescents with both a recommendation from a health-care provider and data available on parental intent still had no intention to initiate the vaccination series.

Current vaccination rates reveal that just over half of U.S. teens (51.1%) have received the full HPV vaccine series. The current vaccine provides protection against nearly 90% of cancer-causing HPV infections.

The study authors concluded, “Lack of parental intent to initiate and complete the HPV vaccine series for adolescents is a major public health concern in the United States. Combating vaccine safety concerns and strong recommendations from health-care providers could improve the currently suboptimal HPV vaccination coverage.”

Disclosure: The study was funded by the National Cancer Institute. For full disclosures of the study authors, visit thelancet.com.