Variations in reason for intention not to vaccinate across time, region, and by race/ethnicity, NIS-Teen (2008–2016). Issue 4 (21st January 2019)

• Record Type: Journal Article
• Authors: Hirth, Jacqueline M.; Fuchs, Erika L.; Chang, Mihyun; Fernandez, Maria E.; Berenson, Abbey B.
• Is Part Of: Vaccine. Volume 37:Issue 4(2019)
• Page Start: 595
• Page End: 601
• Publication Date: 2019-01-21
• Subjects: Vaccine hesitancy -- HPV vaccination -- Reasons for vaccine hesitancy -- Vaccine disparities; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2018.12.017
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Lack of knowledge as a reason for HPV vaccine hesitancy declined in frequency over time. Concerns about safety increased as a reason for HPV vaccine hesitancy over time. Reasons for vaccine hesitancy that are not easily addressed were not commonly cited. Results showed a response to increased provider recommendation for HPV vaccine. Abstract: Background: Human papillomavirus (HPV) vaccination is expected to reduce HPV-related disease and cancer in the US. However, many parents are hesitant to obtain the vaccine for their children. The purpose of this study is to examine how the reasons for refusing the HPV vaccine vary across regions of the US, across time, and by race/ethnicity. Methods: This study used data on 13–17 year old adolescents collected by the National Immunization Survey – Teen (NIS-Teen) annually between 2008 and 2016. We evaluated the frequencies of parents who did not intend to vaccinate their children in the next year among unvaccinated children. Among these non-intenders, we evaluated how reasons for HPV vaccine hesitancy changed across time, by region of the US, and race/ethnicity. Results: The proportion of non-intenders among unvaccinated decreased from 72% in 2010 to 58% in 2016. The most frequent reason for vaccine hesitancy was that parents felt HPV vaccination was not necessary (22.4%), followed by lack of provider recommendation (16.2%), and lack of knowledge (15.6%). Lack of provider recommendation increased in frequency as a reason for HPV vaccine hesitancy until 2012, then decreased in frequency through 2016. Cost was one reason that was elevated in all regions compared to the Northeast. Black non-intenders were less likely to report safety, costs, or their children's fear as reasons for not intending to vaccinate their children compared to white non-intenders. Hispanic non-intenders were more likely to report lack of knowledge and that the vaccine is not a school requirement as reasons not to vaccinate their children compared to white non-intenders. Conclusions: National advocacy for improving provider recommendation for HPV vaccination likely contributed to a sharp decline in HPV vaccine hesitancy due to lack of provider recommendation. Results indicate the need for multifaceted interventions to increase HPV vaccination.