Assessing drivers of HPV vaccine hesitancy
In the United States, human papillomavirus (HPV) vaccination rates are well below national and local targets. Wider vaccination against HPV could make a significant impact in preventing thousands of cases of cancer each year.
The University of Washington Population Health Initiative led a mixed methods study to understand what factors drive HPV vaccination and vaccine hesitancy among parents in order to inform interventions that could help increase coverage among adolescents. This project was a collaboration with researchers from the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine.
The project, which ended in June 2024, had three areas of focus:
- Use of national-representative survey data to identify the trends in HPV coverage between U.S. states.
- Identification of the most relevant sociodemographic factors associated with HPV vaccination.
- Completing primary data collection in eight local communities across two U.S. states to provide greater insight into the barriers and successes associated with timely HPV vaccination.
Some of the major findings from the study included:
- There were large geographical variations in HPV vaccine confidence, which was also the finding of a similar European Union study led by the Vaccine Confidence Project.
- The HPV vaccine was found not to be prioritized compared to other vaccines by U.S. providers or parents/caregivers, and carries less concern compared to other vaccine-preventable diseases.
- Providers play a significant role in demonstrating the prioritization and importance of the HPV vaccine through communicating accurate safety information and effectively addressing parental concerns.
- Nearly 50% of survey participants said they had difficulty accessing the HPV vaccines due to a lack of accessibility to care, lack of knowledge about the vaccine among both providers and parents and parental resistance.
- Various socio-demographic factors and behavioral and social drivers among parents/caregivers were associated with their children’s HPV vaccination status, including gender, age, religion, and perceived safety/importance.
- A need exists for multi-level tailored interventions to tackle parental hesitancy and barriers to enhance HPV vaccination rates, such as improving provider communication and education strategies, community education and partnerships, parental educational strategies and catch-up interventions such as teen empowerment and education.
We believe the findings of this project will help support policymakers in crafting policies, interventions and strategies to address the diverse and geographically variable barriers to HPV vaccination and drivers of HPV vaccine hesitancy. Tailored interventions and targeted education and healthcare provider involvement can help to increase vaccine confidence and uptake, particularly in geographic regions with lower vaccination rates.
Funding Acknowledgement
This study was funded by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp (MISP Reference Number 100933).