Abstract
Study Objective
Human papillomavirus (HPV) vaccination is proven to reduce the risk of HPV-associated
cancers and lesions. Factors associated with HPV vaccine receipt or rejection have
been studied, but specific maternal characteristics driving uptake among teens requires
further investigation. The aim of this study was to examine maternal characteristics
influencing teen vaccine uptake and intent to vaccinate.
Study Design
Cross-sectional analysis
Methods
We analyzed data on 27,320 teens aged 13-17 using the 2020 National Immunization Survey-Teen.
We constructed regression models to determine the associations, via relative risk,
between child vaccination status and maternal characteristics.
Results
Compared with mothers with less education, those with a college degree were significantly
more likely to have their children receive HPV vaccination (RR = 1.18; 95% CI, 1.11-1.26).
Compared to mothers under 35 years, those aged 35-44 (RR 1.07; 95% CI 1.01-1.14) and
over 45 (RR = 1.13; 95% CI, 1.07-1.21) were more likely to provide HPV vaccination
to their child. Among children not previously vaccinated (n = 12,098; N = 5,752,355),
educated mothers were significantly less likely to report intent to vaccinate their
child in the next year. There was no significant difference in vaccination rates in
mothers who were married compared with never married (RR = 0.99; 95% CI, 0.97-1.02).
Conclusion
Maternal education was the strongest predictor of teens receiving the HPV vaccine.
Among mothers with teens not previously vaccinated, intent to obtain the HPV vaccine
for their child was higher among mothers with less education compared with college-level
educated mothers. Understanding maternal characteristics driving HPV vaccine hesitancy
can inform targeted approaches to improve vaccine uptake in children. Additionally,
adequate and consistent health messaging on the safety, efficacy, and benefits of
HPV vaccination from health providers and public health agencies could increase uptake
among adolescents and teens of vaccine-hesitant mothers.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric and Adolescent GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- HPV and HPV-associated diseases.Infect Dis Clin North Am. 2013; 27: 765-778
- Pathogenesis of human papillomavirus-associated mucosal disease.J Pathol. 2015; 235: 527-538
- Human papillomavirus and cervical cancer.Lancet. 2013; 382: 889-899
- Public knowledge and attitudes towards Human Papilloma Virus (HPV) vaccination.BMC Public Health. 2008; 8
- Human papillomavirus vaccination: Ongoing challenges and future directions.Gynecol Oncol. 2020; 156: 498-502
Centers for Disease Control and Prevention: HPV-associated cancer diagnosis by age. Available: https://www.cdc.gov/cancer/hpv/statistics/age.htm. Accessed July 17, 2022
- HPV infection in urology practice.Int Urol Nephrol. 2020; 52: 1-8
- Human papillomavirus vaccine against cervical cancer: Opportunity and challenge.Cancer Lett. 2020; 471: 88-102
- Estimates of the annual direct medical costs of the prevention and treatment of disease associated with human papillomavirus in the United States.Vaccine. 2012; 30: 6016-6019
- Updated medical care cost estimates for HPV-associated cancers: implications for cost-effectiveness analyses of HPV vaccination in the United States.Hum Vaccines Immunother. 2019; 15: 1942-1948
- The psychosocial burden of HPV: a mixed-method study of knowledge, attitudes and behaviors among HPV+ women.J Health Psychol. 2010; 15: 279-290
- Primary prevention of HPV through vaccination: update on the current global status.Curr Obstet Gynecol Rep. 2016; 5: 210-224
Centers for Disease Control and Prevention: HPV Vaccination Recommendations. Available: https://www.cdc.gov/vaccines/vpd/hpv/hcp/recommendations.html. Accessed October 22, 2022
- Efficacy and safety of prophylactic HPV vaccines. A Cochrane review of randomized trials.Expert Rev Vaccines. 2018; 17: 1085-1091
- Addressing HPV vaccine myths: practical information for healthcare providers.Hum Vaccines Immunother. 2019; 15: 1628-1638
- Vaccine hesitancy.Hum Vaccines Immunother. 2013; 9: 1763-1773
- Effect of the decision-making process in the family on HPV vaccination rates among adolescents 9–17 years of age.Hum Vaccines Immunother. 2014; 10: 1807-1811
- Mothers’ decision-making processes regarding health care for their children.Public Health Nurs. 2001; 18: 157-168
Centers for Disease Control and Prevention: About the National Immunization Surveys. Available: https://www.cdc.gov/vaccines/imz-managers/nis/about.html. Accessed May 16, 2022
- Computing adjusted risk ratios and risk differences in Stata.Stata J. 2013; 13: 492-509
- What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes.JAMA. 1998; 280: 1690-1691
- HPV vaccination and the risk of invasive cervical cancer.N Engl J Med. 2020; 383: 1340-1348
- Factors associated with parents’ intent to vaccinate adolescents for human papillomavirus: findings from the 2014 National Immunization Survey–Teen.Prev Chronic Dis. 2017; 14
- Children who have received no vaccines: who are they and where do they live?.Pediatrics. 2004; 114: 187-195
- Factors associated with not receiving HPV vaccine among adolescents by metropolitan statistical area status, United States, National Immunization Survey–Teen, 2016–2017.Hum Vaccines Immunother. 2020; 16: 562-572
- Do parental education and income matter? A nationwide register-based study on HPV vaccine uptake in the school-based immunisation programme in Norway.BMJ Open. 2015; 5e006422
- Parental refusal of human papillomavirus vaccine: multisite study.J Pediatr Health Care. 2018; 32: 150-156
- Breast and cervical cancer screening: sociodemographic predictors among White, Black, and Hispanic women.Am J Public Health. 2003; 93: 618-623
World Health Organization: One-dose Human Papillomavirus (HPV) vaccine offers solid protection against cervical cancer. Available: https://www.who.int/news/item/11-04-2022-one-dose-human-papillomavirus-(hpv)-vaccine-offers-solid-protection-against-cervical-cancer. Accessed November 5, 2022
- Generational differences in beliefs about COVID-19 vaccines.Prev Med. 2022; 157107005
- (Edited by)The theory of planned behavior.in: Van Lange PAM Kruglanski AW Higgins ET Handbook of Theories of Social Psychology: Volume 1. Sage, 2012: 438-459 (Edited by)
- HPV vaccine and adolescent males.Vaccine. 2011; 29: 5595-5602
- Human papillomavirus (HPV) and HPV vaccine knowledge, the intention to vaccinate, and HPV vaccination uptake among male college students.J Am Coll Health. 2022; 70: 1079-1093
- The feminization of HPV: how science, politics, economics and gender norms shaped U.S. HPV vaccine implementation.Papillomavirus Res. 2017; 3: 142-148
- HPV vaccination in boys and men.Hum Vaccines Immunother. 2014; 10: 2109-2111
- Single-dose human papillomavirus vaccination in low- and middle-income countries-time for implementation?.J Pediatr Adolesc Gynecol. 2021; 34: 586-590
Article info
Publication history
Published online: February 07, 2023
Accepted:
January 27,
2023
Received in revised form:
January 11,
2023
Received:
September 7,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Ethics approval: No ethical approval was sought or required for this work.
Conflicts of Interest: Dr Hartwell received funding from the National Institute of Justice and the Health Resources Services Administration for research outside of the current work. Other authors declare no competing interests.
Identification
Copyright
© 2023 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
