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Clin Infect Dis. 2018 Sep 14;67(7):1018-1026. doi: 10.1093/cid/ciy232.

National Trends in Parental Human Papillomavirus Vaccination Intentions and Reasons for Hesitancy, 2010-2015.

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Division of Epidemiology and Community Health.
Division of Biostatistics, University of Minnesota School of Public Health.
Department of Pediatrics, Division of General Pediatrics and Adolescent Health, University of Minnesota Medical School, Minneapolis.



Human papillomavirus (HPV) vaccination uptake remains lower than other recommended adolescent vaccines in the United States. Parental attitudes are important predictors of vaccine uptake, yet little is known about how they have changed over time.


Participants included US residents aged 13-17 years with documented vaccination status who had received <3 doses of HPV vaccine whose parents responded to the National Immunization Survey-Teen, 2010-2015.


Of the 76971 participants, 63.0% were male, 58.8% were non-Hispanic white, and 14.4 years was the median age. The percentage of unvaccinated teens decreased from 2010 to 2015, yet, annually, parents of unvaccinated teens of both sexes most often reported that they were "not likely at all" to vaccinate their teen. The percentage decreased significantly from 41.5% to 31.2% (P < .001) for parents of unvaccinated females from 2010 to 2015 but did not change among parents of males from 2012 to 2015. Conversely, parents of undervaccinated teens of both sexes reported higher and increasing vaccination intent over time. In 2015, nearly one-third of parents of unvaccinated teens reported that the vaccine was "not needed/necessary." Concerns about vaccine safety and side effects declined among parents of unvaccinated females but increased among parents of males (7.3% to 14.8%; P < .001).


Although parental vaccination intent and knowledge improved over time, intent remains low and many parents still have significant concerns about HPV vaccination, even after series initiation. Multiple strategies are needed to improve series initiation and completion in the United States.

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