Abstract B139: Parental reasons for lack of intent to initiate HPV vaccination among adolescents ages 13-17 years: National Immunization Survey – Teen 2019-2021
Authors: Escabí Erika I. , Alvelo-Fernández Paola , Suárez Erick , Colón-López Vivian 
Published: December 2023

Introduction: The purpose of this study was to examine changes in parents’ reasons for not initiating HPV vaccination among their adolescents from 2019 to 2021.   Methods: We used NIS-Teen data from 2019 through 2021. Adolescents aged 13-17 who had adequate provider information and had not received HPV vaccines, as reported by both parents and healthcare providers, were eligible for this analysis. Parents of these adolescents were asked, “How likely is it that your teen will receive an HPV shot in the next 12 months?” Parents who responded, “not too likely,” “not likely at all,” or “not sure/don’t know” were then asked the main reason their teen would not be receiving the HPV vaccine in the next 12 months. We created eight domains for the reasons parents reported: i) safety and effectiveness concerns, ii) systemic barriers, iii) vaccine misinformation and lack of knowledge, iv) sociocultural barriers, v) already up to date (UTD), vi) personal reasons, vii) handicapped/special needs/illness, and viii) other reasons. Each domain was treated as a binary outcome. Binomial regression models were then used to assess changes in the estimated prevalence of each domain for 2020 and 2021, when compared to 2019, by calculating adjusted prevalence ratios (PR) and 95% confidence intervals (95% CI).   Results: From 2019 to 2021, the top 3 reasons for not initiating HPV vaccination reported by parents were vaccine misinformation and lack of knowledge, safety and effectiveness concerns, and systemic barriers (37.9%, 27.1%, and 14.1%, respectively). In 2021, the prevalence of reporting safety and effectiveness concerns was 20% lower (PR adj =0.80, 95% CI=0.73, 0.89) in comparison to 2019, whereas the prevalence of reporting sociocultural barriers was 62% higher (PR adj =1.62, 95% CI=1.33, 1.97) in comparison to 2019. There were no significant changes between the years 2019 and 2020 for any of the domains.  Conclusions: Vaccine misinformation and lack of knowledge was the main reason reported during 2019-2021. To decrease vaccine misinformation and lack of knowledge, future efforts should consider strategies focusing on educational tools that will help inform parents about the HPV vaccine and its benefits. Although the prevalence of Safety and Effectiveness Concerns has decreased since 2019, it remained one of the main reasons parents reported not having initiated the HPV vaccine series in their adolescents. Policies such as school-entry requirements across all states and ensuring schools have the tools necessary to inform parents about the vaccine should be considered.  

Citation Format: Erika I. Escabí, Paola Alvelo-Fernández, Erick Suárez, Vivian Colón-López. Parental reasons for lack of intent to initiate HPV vaccination among adolescents ages 13-17 years: National Immunization Survey – Teen 2019-2021 [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B139.