Original article
Parental Attitudes and Beliefs Regarding the Nine-Valent Human Papillomavirus Vaccine

https://doi.org/10.1016/j.jadohealth.2015.09.003Get rights and content

Abstract

Purpose

The purpose of the study was to explore parents' attitudes and beliefs about the nine-valent human papillomavirus vaccine (HPV9).

Methods

Online focus groups were conducted in January, 2015. The U.S. national sample of parents was recruited to four groups: (1) two groups of parents of HPV unvaccinated daughters aged 9–12 years and (2) two groups of parents of vaccinated daughters aged 11–17 years.

Results

Participants were 43 parents of vaccinated daughters and 38 parents of unvaccinated daughters. Results indicated low and variable levels of knowledge about HPV, related cancers, and vaccination (e.g., parents unaware vaccine is recommended for boys). Parents were encouraged that HPV9 covered more types, and many said they want the “better” vaccine. Parents of unvaccinated girls wondered whether they should delay vaccination until HPV9 was available, whereas parents of vaccinated girls wondered whether their daughters could be revaccinated with HPV9. Concerns were related to adverse reactions and side effects, whether another new vaccine will be released after HPV9, HPV mutation (i.e., will HPV types change over time—thereby necessitating multiple vaccines?), and cost. Physician recommendation was identified as the most important facilitator of vaccination, with participants wanting providers to exhibit high levels of confidence in and knowledge about HPV vaccines. Last, parents also viewed the prospective idea of a 2-dose HPV9 vaccine as positive.

Conclusions

HPV9 recently became available in the United States and has the potential to offer greater cancer prevention if widespread acceptance and uptake occur. Understanding parental perceptions and questions about HPV9 will be important for clinical messaging about this vaccine.

Section snippets

Methods

Online focus groups were conducted in January, 2015, with a U.S. national convenience sample of parents. A total of four focus groups were convened: two groups of parents of HPV unvaccinated daughters aged 9–12 years and two groups of parents of fully vaccinated daughters aged 11–17 years. This study focused on female vaccination as parental beliefs on vaccination may differ based on a child's sex; subsequent work should include parents of males. In addition, HPV9 has greater potential benefit

Demographic characteristics

The final sample consisted of 81 parents of 97 daughters. Forty-three were parents of fully vaccinated (three-dose completion) daughters; 38 were parents of unvaccinated daughters. The parents were diverse, representing 31 states and all nine U.S. Census regions [11]. The majorities of parents were female, had completed some college or obtained a college degree, were employed full time, and were married. See Table 2 for sociodemographic information on parents and daughters.

Qualitative analysis

Four main categories

Discussion

Consistent with other research on HPV vaccination, we found that most parents see HCP recommendation as among the most important factors in deciding about vaccination [12], [13], [14]. Parents clearly valued HCP expertise and expected their daughters' providers to be well informed about HPV9 and to be able to answer any questions that arise. It was notable, however, that there remained substantial gaps in knowledge and misunderstanding about the reasons for the recommendation to vaccinate all

Funding Sources

Support for this study was provided by Indiana University-Purdue University Center for HPV Research, which is funded by the Indiana University-Purdue University Signature Centers Initiative and the support of the IU School of Medicine, Department of Pediatrics and the IU Simon Cancer Center, and Boston College Internal Start-up Funds awarded to Dr. Fontenot.

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