Acceptance of Human Papillomavirus Vaccination Among Californian Parents of Daughters: A Representative Statewide Analysis

Abstract

Genital infection by human papillomavirus (HPV) is, at present, considered to be the most common sexually transmitted infection in the US, and it is the primary cause of cervical cancer. An estimated three-fourths of new infections in the year 2000 were in females 15 to 24 years of age. A vaccine based on HPV types 6, 11, 16, and 18 now is available; these types account for more than two-thirds of cervical cancers and for 90% of genital warts. Because the vaccine has been recommended for girls 11 and 12 years of age, parental acceptance is a critical factor. The authors conducted a random-digit-dial telephone survey of parents in California households, totaling 522 parents having an eligible daughter aged 18 or younger. Nearly three-fourths of participants were females ranging in age from 30 to 49 years. Hispanics and non-Hispanic Whites predominated. Both educational attainment and household income varied widely. Three of four parents said that they would be likely to vaccinate a daughter before age 13 years, and another 6% would do so at age 16 but not before age 13. Hispanic women were the most likely to accept vaccination before age 13. The most common reasons given for unwillingness to permit vaccination at either age level were moral concerns about sexual activity, vaccine side effects, use of holistic medicine, and assurance that there would be no need for vaccination. Parents who would allow vaccination but not before age 13 tended to have specific concerns about the vaccine or had pragmatic concerns about their daughter's sexual behavior because she would be much likelier to have sexual relations at age 16. A majority of parents clearly are supportive of HPV vaccination for their daughters-at least hypothetically. Information about the reasons why some parents do not accept vaccination for their daughters can aid policy decisions and educational planning.