1
|
Klassen AC, Lee G, Chiang S, Murray R, Guan M, Lo WJ, Hill L, Leader AE, Manganello J, Massey PM. Did the COVID-19 experience change U.S. parents' attitudes towards HPV vaccination? Results from a national survey. Vaccine 2024; 42:1704-1713. [PMID: 38355317 DOI: 10.1016/j.vaccine.2024.01.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/17/2024] [Accepted: 01/31/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND In the U.S., uptake of the HPV vaccine remains below coverage goals. There is concern that negative reactions to emergency initiatives during the COVID-19 pandemic, including vaccination, may have increased some parents' hesitancy towards all vaccines, including HPV. Understanding how different parent populations view routine vaccination post-pandemic is key to strategic efforts to maintaining and increasing uptake of HPV vaccine. METHODS In early 2022, we recruited an online panel of English-speaking U.S. parents and caregivers, who used the social media platform Twitter and had HPV vaccine-eligible but unvaccinated children age 9-14 years. Respondents completed a 20-minute survey measuring knowledge, attitudes and intentions regarding HPV vaccination for their child, as well as background socio-demographics and health information-seeking practices. Questions regarding experiences during the COVID-19 pandemic included changes in access to preventive care, and perceptions of whether pandemic experiences had positively or negatively affected their attitudes about routine vaccination, with open text capturing reasons for this change. RESULTS Among 557 respondents, 81 % were definitely or likely to vaccinate their child against HPV, with 12 % being uncertain, and 7 % unlikely to vaccinate. Regarding routine vaccination, most (70 %) felt their attitudes had not changed, while 26 % felt more positively, and only 4 % felt more negatively. Reasons for positive attitude change included increased appreciation for vaccines overall, and motivation to proactively seek preventive care for their child. Negative attitude changes stemmed from distrust of COVID-19 public health efforts including vaccine development, and disillusionment with vaccines' ability to prevent disease. In multivariable models, intention to vaccinate was greater among parents reporting greater education, Democratic affiliation, greater religiosity, and urban residence. Negative attitude change due to the pandemic independently predicted reduced HPV vaccination intention, while positive attitude change predicted positive intention. CONCLUSIONS Post-pandemic, most U.S. parents remain committed to vaccinating their children against HPV. However, addressing residual COVID-19 concerns could improve uptake among vaccine-hesitant parents.
Collapse
Affiliation(s)
- Ann C Klassen
- Drexel University Dornsife School of Public Health, Philadelphia, PA, United States.
| | - Giyoung Lee
- Drexel University Dornsife School of Public Health, Philadelphia, PA, United States
| | - Shawn Chiang
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, United States
| | - Regan Murray
- Department of Counseling, Leadership, and Research Methods, University of Arkansas, Fayetteville, AR, United States
| | - Mengfei Guan
- Department of Communication, University of Oklahoma, Norman, OK, United States
| | - Wen-Juo Lo
- Department of Counseling, Leadership, and Research Methods, University of Arkansas, Fayetteville, AR, United States
| | - Larry Hill
- Department of Counseling, Leadership, and Research Methods, University of Arkansas, Fayetteville, AR, United States
| | - Amy E Leader
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Jennifer Manganello
- Department of Health Policy, Management and Behavior, School of Public Health, University at Albany, State University of New York (SUNY), Albany, NY, United States
| | - Philip M Massey
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, United States
| |
Collapse
|
2
|
Oka E, Ueda Y, Yagi A, Ito Y, Hosokawa Y, Tabuchi T, Kimura T. Parental gender influences their intention to HPV vaccinate their children, and the association between HPV and COVID-19 vaccination intentions. Vaccine X 2024; 17:100441. [PMID: 38352726 PMCID: PMC10861998 DOI: 10.1016/j.jvacx.2024.100441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 02/16/2024] Open
Abstract
Purpose The coronavirus disease of 2019 (COVID-19) pandemic has increased public awareness of infectious diseases and interest in vaccines, including the human papilloma virus (HPV) vaccine. We investigated differences between parental gender and intentions to vaccinate their child for HPV and COVID-19. Methods We analyzed data from Japan's COVID-19 and Society Internet Survey (JACSIS), a web-based cross-sectional survey of 2,444 respondents in 2021. Results Females were more knowledgeable and more afraid of HPV and COVID-19 than males. The proportions of females in favor of, or against, HPV vaccination was higher than among males. The fathers' intention for HPV vaccination was significantly associated with the child's gender, knowledge regarding HPV, and intention to inoculate with the COVID-19 vaccine. The mothers' intention was also associated with her knowledge of HPV and her intention to seek the COVID-19 vaccine, but it included a greater fear of HPV infection. Both male and female parents favored the COVID-19 vaccine over the HPV vaccine. Parents approving of COVID-19 vaccination believed in the overall efficacy of vaccines and were more receptive to opinions from the administration and physicians, even if the parent was currently against HPV vaccination. Conclusions Mothers were more knowledgeable about HPV and more favorable to vaccinate their child for HPV than fathers. The intention to have children COVID-19 vaccinated was also higher than for HPV vaccination. During this period of heightened public interest in vaccines due to the COVID-19 pandemic, this is a good time to educate and inform the public about HPV.
Collapse
Affiliation(s)
- Emiko Oka
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, 2-7, Daigakumachi, Takatsuki, Osaka 569-0801, Japan
| | - Yutaka Ueda
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Asami Yagi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, 2-7, Daigakumachi, Takatsuki, Osaka 569-0801, Japan
| | - Yoshihiko Hosokawa
- Department of Obstetrics and Gynecology, Institute of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Takahiro Tabuchi
- Department of Cncer Epidemiology, Cancer Control Center, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan
| |
Collapse
|
3
|
Kohler RE, Wagner RB, Careaga K, Btoush R, Greene K, Kantor L. Mothers' perceptions and attitudes about HPV vaccination initiation among 9- and 10-year-olds. Hum Vaccin Immunother 2023; 19:2270842. [PMID: 37955127 PMCID: PMC10653617 DOI: 10.1080/21645515.2023.2270842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
HPV vaccination has potential to prevent 90% of HPV-associated cancers. The Advisory Committee on Immunization Practices recommends HPV vaccination for 11- and 12-year-olds, but vaccine initiation can start at age 9. The purpose of this study was to explore perceptions about starting HPV vaccination at a younger age to inform future interventions that promote initiation at ages 9 and 10 years. This was part of a larger study about vaccine hesitancy among racially/ethnically diverse parents of adolescents in the Greater Newark Area of New Jersey. We thematically analyzed transcripts from 16 interviews with English- and Spanish-speaking mothers who had at least one child ≤ 10 years. Analyses focused on perceptions of HPV-related disease risk, attitudes toward HPV vaccination need, and vaccine confidence specifically for 9- and 10-year-olds. Few parents with young adolescents reported receiving vaccination recommendations, and only one reported series initiation before age 11. Mothers' hesitation about younger HPV vaccination initiation revolved around: 1) low perceived necessity among English-speaking mothers due to young adolescents not being sexually active, 2) concerns about potential side effects associated with vaccinating prepubescent adolescents, and 3) a desire for adolescents to be old enough to provide assent. Participants were not opposed to younger initiation but wanted and relied on pediatricians to inform them about vaccination for younger adolescents. These findings suggest mothers are willing to vaccinate at younger ages after clear provider recommendations. Equipping providers with evidence about vaccine safety and cancer prevention communication strategies may promote initiation and timely completion at younger ages.
Collapse
Affiliation(s)
- Racquel E. Kohler
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- School of Public Health, Rutgers University, New Brunswick, NJ, USA
| | - Rachel B. Wagner
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- School of Public Health, Rutgers University, New Brunswick, NJ, USA
| | - Katherine Careaga
- Center for Cancer Health Equity, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Rula Btoush
- School of Nursing, Rutgers University, New Brunswick, NJ, USA
| | - Kathryn Greene
- School of Communication & Information, Rutgers University, New Brunswick, NJ, USA
| | - Leslie Kantor
- School of Public Health, Rutgers University, New Brunswick, NJ, USA
| |
Collapse
|
4
|
Ford CA. The Journal of Adolescent Health's Editor-In-Chief Annual Reflection: A Year to Embrace Science and Compassion. J Adolesc Health 2023; 73:213-216. [PMID: 37455041 DOI: 10.1016/j.jadohealth.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/11/2023] [Indexed: 07/18/2023]
|
5
|
Gray A, Fisher CB. Factors associated with HPV vaccine acceptability and hesitancy among Black mothers with young daughters in the United States. Front Public Health 2023; 11:1124206. [PMID: 37139381 PMCID: PMC10150885 DOI: 10.3389/fpubh.2023.1124206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/28/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Compared to other-race peers, Black women are disproportionately impacted by human papillomavirus [HPV] infection, related health outcomes, and cervical cancer mortality as a result of suboptimal HPV vaccine uptake during adolescence. Few studies in the United States have examined psychosocial determinants of HPV vaccine acceptability and hesitancy among Black parents. The current study integrated the health belief model and the theory of planned behavior to evaluate the extent to which psychosocial factors are associated with pediatric HPV vaccination intentions among this population. Methods Black mothers (N = 402; age range = 25 to 69 years, M = 37.45, SD = 7.88) of daughters ages 9 to 15 years completed an online survey assessing HPV infection and vaccine beliefs and attitudes across four domains: Mother's HPV Perceptions, Mother's Vaccine Attitudes, Cues to Action, and Perceived Barriers to HPV Vaccination. Participants indicated their willingness to vaccinate their daughter on a 5-level ordinal scale ("I will definitely not have my daughter get the vaccine" to "I will definitely have my daughter get the vaccine") which was dichotomously recoded for binomial logistic regressions. Results Half of the sample (48%) intended to vaccinate their daughter. Number of daughters, mother's HPV vaccine status, perceived HPV vaccine benefits, HPV vaccine safety concerns, pediatric HPV vaccine peer norms, and doctor recommendations emerged as independent factors of Black mothers' intentions to vaccinate their daughters against HPV when controlling for all other factors. Discussion In addition to medical training to increase doctor recommendation of the HPV vaccine for Black girls, population-tailored public health messaging aimed at promoting HPV vaccine acceptance among Black mothers is urgently needed. This messaging should engage community support and emphasize the benefits of vaccination for adolescent Black girls while also addressing parental concerns regarding the safety of pediatric HPV vaccination.
Collapse
Affiliation(s)
- Aaliyah Gray
- Department of Psychology, Fordham University, Bronx, NY, United States
- Department of Epidemiology, Florida International University, Miami, FL, United States
- *Correspondence: Aaliyah Gray,
| | - Celia B. Fisher
- Department of Psychology, Fordham University, Bronx, NY, United States
- Center for Ethics Education, Fordham University, Bronx, NY, United States
| |
Collapse
|