Human papillomavirus (HPV) vaccine coverage among girls is low. We used data reported by parents of 4103 girls, 13 to 17 years old, to assess associations with, and reasons for, delaying or refusing HPV vaccination. Sixty-nine percent of parents neither delayed nor refused vaccination, 11% delayed only, 17% refused only, and 3% both delayed and refused. Eighty-three percent of girls who delayed only, 19% who refused only, and 46% who both delayed and refused went on to initiate the vaccine series or intended to initiate it within the next 12 months. A significantly higher proportion of parents of girls who were non-Hispanic white, lived in households with higher incomes, and had mothers with higher education levels, delayed and/or refused vaccination. The most common reasons for nonvaccination were concerns about lasting health problems from the vaccine, wondering about the vaccine’s effectiveness, and believing the vaccine is not needed.
HaririSUngerERSternbergM. Prevalence of genital human papillomavirus among females in the United States, the National Health and Nutrition Examination Survey, 2003-2006. J Infect Dis. 2011;204:566-573.
5.
MarkowitzLEDunneEFSaraiyaMLawsonHWChessonHUngerER. Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2007;56(RR-2):1-24.
6.
Centers for Disease Control and Prevention. FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2010;59(20):626-629.
7.
Centers for Disease Control and Prevention. National and state vaccination coverage among adolescents aged 13 through 17 years—United states, 2010. MMWR Morb Mortal Wkly Rep. 2011;60(33):1117-1123.
8.
Centers for Disease Control and Prevention. National and state vaccination coverage among adolescents aged 13-17 years—United States, 2012. MMWR Morb Mortal Wkly Rep. 2013;62(34):685-693.
9.
DorellCYankeyDStrasserS. Parent-reported reasons for nonreceipt of recommended adolescent vaccinations, National Immunization Survey—Teen, 2009. Clin Pediatr (Phila). 2011;50:1116-1124.
10.
DorellCGYankeyDSantibanezTAMarkowitzLE. Human papillomavirus vaccination series initiation and completion, 2008-2009. Pediatrics. 2011;128:830-839.
11.
DorellCGYankeyDSantibanezTAMarkowitzLE. Human papillomavirus vaccination series initiation and completion, 2008-2009. Pediatrics. 2011;128:830-839. Erratum: Pediatrics. 2012;130:166-168.
12.
DempseyAFAbrahamLMDaltonVRuffinM. Understanding the reasons why mothers do or do not have their adolescent daughters vaccinated against human papillomavirus. Ann Epidemiol. 2009;19:531-538.
13.
DempseyAFZimetGDDavisRLKoutskyL. Factors that are associated with parental acceptance of human papillomavirus vaccines: a randomized intervention study of written information about HPV. Pediatrics. 2006;117:1486-1493.
14.
ReiterPBrewerNGottliebSMcReeASmithJ. Parents’ health beliefs and HPV vaccination of their adolescent daughters. Soc Sci Med. 2009;69:475-480.
15.
SmithPHumistonSMarcuseE. Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the health belief model. Public Health Rep. 2011;126(suppl 2):135-146.
FrankelL. The report of the CASRO Task Force on Response Rates. In: WisemanE, ed. Improving Data Quality in Sample Surveys. Cambridge, MA: Marketing Science Institute; 1983:1-11.
SmithPJChuSYBarkerLE. Children who have received no vaccines: who are they and where do they live?Pediatrics. 2004;114:187-195.
20.
SmithPKennedyAWootenKGustDPickeringL. Association between health care providers’ influence on parents who have concerns about vaccine safety and vaccination coverage. Pediatrics. 2006;118:e1287-e1292.
21.
GerendMShepherdJ. Predicting human papillomavirus vaccine uptake in young adult women: comparing the health belief model and theory of planned behavior. Ann Behav Med. 2012;44:171-180.
22.
WebbTLSheeranP. Does changing behavioral intentions engender behavior change? A meta-analysis of experimental evidence. Psychol Bull. 2006;132:249-268.
23.
HughesCCJonesALFeemsterKAFiksAG. HPV vaccine decision making in pediatric primary care: a semi-structured interview study. BMC Pediatr. 2011;11:74.
National Center for Immunization and Respiratory Diseases. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2011;60(RR-02):1-60.
DorellC. Human papillomavirus (HPV) vaccination coverage in the United States: National Immunization Survey–Teen, 2006-2011. Talk presented at: The Advisory Committee on Immunization Practices Meeting; October 25, 2012. http://www.cdc.gov/vaccines/acip/meetings/downloads/min-archive/min-oct12.pdf. Accessed January 13, 2014.
TomljenovicLShawCA. Death after quadrivalent human papillomavirus (HPV) vaccination: causal or coincidental?Pharmaceut Reg Affairs. 2012;S12:001. doi:10.4172/2167-7689.S12-001.
GriffioenAMGlynnSMullinsTK. Perspectives on decision making about human papillomavirus vaccination among 11- to 12-year-old girls and their mothers. Clin Pediatr (Phila). 2012;51:560-568.
35.
DiekemaDS. Responding to parental refusals of immunization of children. Pediatrics. 2005;115:1428-1431.
36.
AskelsonNCampoSLoweJSmithSDennisLAndsagerJ. Using the theory of planned behavior to predict mothers’ intentions to vaccinate their daughters against HPV. J Sch Nurs. 2010;26:194-202.
37.
RosenstockIDerryberryMCarrigerB. Why people fail to see poliomyelitis vaccination. Public Health Rep. 1959;74:98-104.
