Abstract PR-10: Tracking a decade of trends in human papillomavirus (HPV) vaccine hesitancy in the United States
Authors: Abouelella Dina , Osazuwa-Peters Nosayaba , Boakye Eric Adjei 
Published: January 2022

Abstract
Background: The human papillomavirus was first approved for use in adolescents in the United States in 2006, and teen vaccine uptake is primarily a decision of parents. Parental skepticism regarding HPV vaccine has been a known driver of suboptimal vaccine uptake in the United States, and may have been exacerbated by societal anti-vaccine sentiments, medical mistrust and social media disinformation. However, no study has tracked whether HPV vaccine hesitancy trends in the last decade has changed based on drivers of vaccine hesitancy. Thus, we assessed trends in the characteristics of parents without an intent to initiate HPV vaccination for their unvaccinated adolescents in the last decade. Methods: We analyzed the 2010–2019 National Immunization Survey (NIS)–Teen data, a national survey representative of the United States' adolescent population. Adolescents who had received zero dose of the HPV vaccine (unvaccinated adolescents) were included in this study. Vaccine hesitancy of parents was assessed with the question “How likely is it that your teen will receive HPV shots in the next 12 months?” Parents who responded with “not too likely”, “not likely at all” or “not sure/don't know” were deemed vaccine hesitant. Joinpoint regression estimated yearly increases/decreases in vaccine hesitancy by mother's age, marital status, and education as well as the adolescent's gender and race through annual percent changes (APC). Results: A total of 16,383 adolescents were included in the study. HPV vaccine hesitancy decreased from approximately 69% in 2010 to 63% in 2019. Average vaccine hesitancy for mothers with male adolescents decreased 6.17% annually from 2010 to 2012 but remained stable from 2012 to 2019. Mothers with children of Hispanic race had an average hesitancy decrease of 6.24% per year from 2010 to 2013 but an average increase of 1.19% per year from 2013 to 2019. No significant changes were observed for children of other races. For mothers aged 35-44, average vaccine hesitancy decreased 5.88% from 2010 to 2012 and remained stable from 2012 to 2019; and for mothers aged &gt;=45, average vaccine hesitancy decreased 3.92% from 2010 to 2013 and remained stable afterwards. Mothers who had college degree/higher or high school diploma had 6.03% and 6.24% average decrease in vaccine hesitancy from 2010 to 2012, respectively and the trend remained stable. Average vaccine hesitancy among married mothers decreased at 5.07% annually from 2010 to 2012 and then remained stable the remaining 8 years. Conclusions: While parental vaccine hesitancy declined from 2010 to 2012, it has remained stable until 2019. Overall, vaccine hesitancy remains very high in the United States, with almost two-thirds of the parents in our study remaining hesitant about the vaccine as of 2019. Hispanic mothers may have higher rates of vaccine hesitancy than other races, which is important given the burden of HPV-associated cancer among Hispanics.
Citation Format: Dina Abouelella, Nosayaba Osazuwa-Peters, Eric Adjei Boakye. Tracking a decade of trends in human papillomavirus (HPV) vaccine hesitancy in the United States [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PR-10.