EXECUTIVE SUMMARY
New research indicates that concern about sexual activity is declining as a reason parents do not vaccinate their daughters against HPV. Instead, parents don’t see the vaccine as a necessity and are concerned about side effects and safety, data indicate.
- Adolescents’ sexual activity dropped as a reason for parents not vaccinating. In 2010, 18% of parents reported this as a reason; in 2014, that figure fell to 9%.
- Research suggests that an effective recommendation from a healthcare professional is crucial to a parent’s decision to vaccinate their child.
A parent has brought in her young adolescent daughter for care. What must clinicians stress when talking about the human papillomavirus (HPV) vaccine with her?
Just-released research indicates that concern about sexual activity is declining as a reason parents do not allow their daughters to receive the HPV vaccine. Instead, parents view the vaccine as unnecessary and are concerned about side effects and safety, data indicate.1
Data presented at the 2017 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer compared figures from the National Immunization Survey from 2010-2014, which included U.S. parents’ responses to a question about why they did not vaccinate their daughters against HPV and did not intend to in the next 12 months.
According to the analysis, from 2010-2014, the top two reasons were the concerns regarding side effects and the belief that the vaccine is not necessary. Adolescents’ sexual activity, the third most common reason, dropped as a reason for parents skipping the vaccine. In 2010, 18% of parents reported adolescents’ lack of sexual activity as reason; however, in 2014, that figure fell to 9%.1
“With the new nine-valent vaccine, almost 90% of all cervical cancer could be prevented if all adolescents were vaccinated,” says Anna Beavis, MD, MPH, a gynecologic oncologist fellow at Johns Hopkins University and lead author of this research. “Yet, unfortunately, vaccination rates in the United States have lagged considerably behind those of other westernized nations.”
Some parents have been reticent to vaccinate their teens against HPV because they have seen it as promoting possible sexual activity. However, research indicates that children who receive the HPV vaccine do not engage in sexual activity any earlier than those who only received other teen vaccines, indicating that children do not see the HPV vaccine as a license to have sex.2
Providers’ perceptions of parental hesitancy may discourage them from recommending the HPV vaccine routinely.3 However, parents must understand the necessity and safety, as well as the benefits, of the vaccine.
The CDC recommends two HPV vaccine doses for 11- to 12-year-old teens to protect against HPV-caused cancers. The agency says the second dose should be administered six to 12 months after the first dose. (For more information about this change in policy, please read this article from the January 2017 issue of Contraceptive Technology Update: http://bit.ly/2li1dma.)
If parents question the importance of such early vaccination, note that HPV prevalence is highest among younger people, and approximately half of all new infections occur in teens and young adults 15-24 years of age.4
Nearly 90 million doses of HPV vaccines were distributed in the United States from June 2006-March 2016, according to the CDC. Most of the CDC’s HPV vaccine safety monitoring and research focuses on Gardasil, which represents 87% of HPV vaccines distributed in the United States. According to the CDC, 79 million doses of Gardasil were distributed in the United States from 2006-2016; during the same period, there were 33,945 reported adverse events following Gardasil vaccination. The agency says the most frequently reported symptoms include fainting, headache, dizziness, fever, nausea, as well as redness, swelling, and pain where the shot was administered. The CDC notes that of such reports, just 7% were considered “serious.”5
Research suggests a healthcare professional’s recommendation and expertise on the subject is vital in a parent’s decision-making.6 The CDC says clinicians should recommend the HPV vaccine just as they would for other adolescent vaccines.
“Physicians should not be afraid to discuss the HPV vaccine with parents,” Beavis says. “Our focus should be on cancer prevention.”
REFERENCES
- Beavis AL, Krakow M, Levinson K, Rositch AF. Reasons for persistent suboptimal rates of HPV vaccination in the U.S.: Shifting the focus from sexuality to education and awareness. Presented at the 2017 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer. National Harbor, MD; March 2017.
- Bednarczyk RA, Davis R, Ault K, et al. Sexual activity-related outcomes after human papillomavirus vaccination of 11- to 12-year-olds. Pediatrics 2012;130:798-805.
- McRee AL, Gilkey MB, Dempsey AF. HPV vaccine hesitancy: Findings from a statewide survey of health care providers. J Pediatr Health Care 2014;28:541-549.
- Markowitz LE, Dunne EF, Saraiya M, et al; Centers for Disease Control and Prevention (CDC). Human papillomavirus vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2014;63:1-30.
- Centers for Disease Control and Prevention. Frequently Asked Questions about HPV Vaccine Safety. Available at: http://bit.ly/1OqX0Zz. Accessed April 18, 2017.
- Stokley S, Jeyarajah J, Yankey D, et al. Human papillomavirus vaccination coverage among adolescents, 2007–2013, and postlicensure vaccine safety monitoring, 2006–2014 — United States. MMWR Morb Mortal Wkly Rep 2014;63:620-624.
Research indicates that concern about sexual activity is declining as a reason parents do not allow their daughters to receive the HPV vaccine.
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