Survey of Acceptance of Human Papillomavirus Vaccine Among Parents of Children Followed in Hematology/Oncology Clinic at a Single Institution in Louisiana

Abstract

Human Papillomavirus infection (HPV) is the most common sexually transmitted disease, with about 14 million cases diagnosed annually, and causing cancers of the anogenital tract. Vaccination against HPV was first introduced in the United States in 2006 and the vaccine is now recommended as a preventive therapy for children, adolescents, and young adults from 9 years to 26 years. Despite this recommendation, a small number of parents still refuse to immunize their children with this vaccine. We performed a survey of 41 parents whose children had been followed at Children's Hospital of New Orleans for oncologic and hematologic disorders, and queried them on their knowledge af HPV and acceptance of the vaccine. We assumed that individuals whose children had been diagnosed with cancer diagnoses would be more knowledgeable about and receptive to the vaccine. IRB approval had been obtained and parents properly consented. Children were ages 10-21 years (mean 14.8+/-.43 years). Sixteen were African-American, 17 white, 5 of mixed ethnicity, and 3 self-identified as Asian or Native American. Fifty-four percent said that they had knowledge (even if superficial) of the vaccine, while 20% said they had not. Seventy-three percent said that they were aware of how to obtain it. Only 7 (17%) were not aware of what problems could be caused by the virus. Fifty-eight percent felt that the vaccine was important while 56% indicated that it should be incorporated into the vaccine schedule. Fifty-nine percent indicated an intent to have their son or daughter vaccinated. The vast majority (71%) knew how to obtain the vaccine through their PCP with just over half of the parents having already discussed the issue with the PCP. We examined the effect of ethnic or racial grouping and found that the only significant difference between racial or ethnic groups was in awareness of how to obtain the vaccine, with more African-American parents noting that they did not know where to get the vaccine for their children. As noted, we had thought that individuals whose children may have been diagnosed with cancer would have a greater sense of urgency about vaccinating their children. Parents of children with cancer diagnoses were more knowledgeable about HPV in general, had more likely heard or read about the vaccine, were more aware of how to obtain it (p<0.05 for all survey questions) but paradoxically they did not think of the vaccine as any more important than did those parents of children with non-oncologic disorders (p=0.5). However they were more likely to want the vaccine incorporated into the vaccine schedule and would want their children to be vaccinated (p<0.001). We acknowledge that the number of individuals surveyed is relatively small. However, the number of parents willing to have their child vaccinated is still far short of the goal of an 80% annual rate that has been set for the United States to reach by 2026. As noted, seventy-one of our parents indicated knowledge of how to obtain the vaccine, the main sources of information being their physician, TV or newspaper but those still having reservations felt they did not have sufficient information or that there possibly could be side-effects, while a minority did not agree with compulsory vaccines or felt that the vaccine would encourage inappropriate behavior in their children. All of this means that there is still considerable work to do in persuading individuals of the worthwhileness of vaccinating children in the appropriate age groups.