Parent and Adolescent Knowledge, Attitudes and Practice after HPV Vaccine Approval and Implementation

Background:
Little is known about parent and adolescent knowledge and acceptance of HPV vaccine after licensure and recommendation in June 2006.

Objectives:
To assess parents' and adolescents' knowledge and acceptance of HPV vaccine, and measure parent factors that predict HPV vaccine refusal.

Methods:
Parents of adolescents (50% with 11-14yr olds, 50% with 15-17yr olds, n=430) and older adolescents (n=208) were recruited from 9 primary care practices in Rochester, NY March 2007-April 2008. Phone interviews assessed HPV vaccine knowledge and information source, vaccine refusal and receipt. Bivariate and logistic regressions predicted parent factors associated with vaccine refusal.

Results:
Eighty-nine percent of parents and 81% of adolescents had heard of HPV disease. Of those, 90% of parents and 76% of adolescents had heard of HPV vaccine; 67% and 47%, respectively, heard about it from news media, 54% and 59% from a doctor or nurse. Fifty-nine percent of parents of girls reported that their adolescent had already received an HPV vaccine dose. Seventeen percent of parents of girls had refused or would refuse vaccine if offered. There were no differences in refusal based on adolescents' age, urban/suburban location, insurance, parents' perception of vaccine efficacy, or satisfaction with the physician. Hispanic parents were more likely to refuse the vaccine (OR 5.88, p=.05) compared to non-Hispanic parents, as were parents who consider vaccines as unsafe (OR 2.8, p=.04). Primary reasons for vaccine refusal were perception that vaccine hasn't been studied enough, adolescent is not at risk, adolescent did not want shots, or that insufficient information is available about the vaccine.

Conclusions:
More than half of adolescents reported having received at least one HPV vaccine dose. However, vaccine refusal rates were high, particularly among parents who did not feel vaccines are safe. Further information about duration of vaccine efficacy and education about HPV vaccine safety may reduce future refusal rates.