Association of caregiver attitudes with adolescent HPV vaccination in 13 southern US states
Lavanya Vasudevan,
Jan Ostermann,
Yunfei Wang,
Sayward E. Harrison,
Valerie Yelverton,
Laura J. Fish,
Charnetta Williams,
Emmanuel B. Walter
Affiliations
Lavanya Vasudevan
Department of Family Medicine and Community Health, Duke University School of Medicine, 2200 W. Main Street, Suite 600, Durham, NC 27705, USA; Duke Global Health Institute, 310 Trent Drive, Durham, NC 27710, USA; Duke Human Vaccine Institute, 27 Alexandria Way, Durham, NC 27703, USA; Corresponding author at: 2200 W. Main Street, Suite 600, Durham, NC 27710, USA.
Jan Ostermann
Duke Global Health Institute, 310 Trent Drive, Durham, NC 27710, USA; Department of Health Services Policy & Management, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; South Carolina Smart State Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
Yunfei Wang
Duke Human Vaccine Institute, 27 Alexandria Way, Durham, NC 27703, USA
Sayward E. Harrison
South Carolina Smart State Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA; Department of Psychology, University of South Carolina, 1512 Pendleton Street, Barnwell College, Suite #220, Columbia, SC 29208, USA
Valerie Yelverton
Department of Health Services Policy & Management, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA
Laura J. Fish
Department of Family Medicine and Community Health, Duke University School of Medicine, 2200 W. Main Street, Suite 600, Durham, NC 27705, USA; Duke Cancer Institute, 2424 Erwin Rd, Suite 602, Durham, NC 27710, USA
Charnetta Williams
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, Atlanta, GA 30329, USA
Emmanuel B. Walter
Duke Global Health Institute, 310 Trent Drive, Durham, NC 27710, USA; Duke Human Vaccine Institute, 27 Alexandria Way, Durham, NC 27703, USA; Department of Pediatrics, Duke University School of Medicine, Box 3675, DUMC, Durham, NC 27710, USA
Background and objectives: HPV vaccination coverage is lower than that of other adolescent vaccines in the southern US. This study sought to characterize caregiver attitudes associated with adolescent HPV vaccination in the southern US and to inform interventions to promote HPV vaccination. Methods: From December 2019 – January 2020, caregivers of adolescents (ages 9–17 years) living in thirteen southern US states were recruited from a nationally-representative online survey panel. Caregivers (N = 1,105) completed a cross-sectional survey that assessed general adolescent vaccine attitudes as well as those associated with the HPV vaccine and HPV vaccination decision-making. The primary study outcome was adolescents’ receipt of at least one dose of the HPV vaccine. Results: Caregivers with vaccinated adolescents had greater positive attitudes towards adolescent vaccines compared to caregivers of unvaccinated adolescents. Top three areas of concern among caregivers were related to vaccine ingredients, perceptions that adolescents receive too many vaccines, and worry about vaccine side effects. In multivariable regression models, positive attitudes towards the HPV vaccine and HPV vaccination decision-making strongly associated with HPV vaccination in addition to general adolescent vaccination attitudes. Caregivers’ reported discomfort with discussing the topic of sex was predictive of lower vaccination uptake for older adolescents. Conclusions: Public health messaging in the southern US should be tailored to reduce concerns about vaccine safety and to communicate the importance of timely HPV vaccination. Campaigns that deliver information specific to the HPV vaccine and to support vaccination decision-making may be more effective than those delivering only general adolescent vaccination information at promoting on-time HPV vaccination.
