Parental vaccine hesitancy and its association with adolescent HPV vaccination.

Despite the Advisory Committee on Immunization Practices’ (ACIP) recommendations for routine vaccination of adolescents, vaccination coverage remains low for many adolescent vaccines, particularly the human papillomavirus (HPV) vaccine [1]. In 2018, 68.1% of adolescents aged 13–17 years had received ≥ 1 dose of HPV vaccine, and only 51.1% were up to date with the HPV vaccine series, well below the Healthy People 2020 target of 80% [2,3]. More efforts are needed to understand barriers to vaccination and improve coverage for all recommended vaccines in this population. Low vaccine uptake can be attributed to various factors, including access issues such as vaccine availability, convenience, cost, and motivation [4]. Motivation refers to overlapping constructs of intention, willingness, acceptability, and hesitancy toward vaccines (e.g., perceived risk of disease, confidence in vaccine effectiveness, safety concerns associated with vaccines and vaccine administration) and the social environment (e.g., strength of provider recommendation, social norms surrounding vaccines, vaccine myths, and misinformation) [4]. Vaccine hesitancy can be defined as a delay in acceptance or the refusal of vaccination despite availability of vaccination services [5,6]. For adolescents, vaccine hesitancy by parents is a significant barrier and has been a factor in outbreaks of vaccine-preventable diseases such as measles and pertussis [7]. Previous studies found that over a third of parents expressed concern about HPV vaccine effectiveness and side effects, and many did not think the HPV vaccine was necessary for their adolescent children [8,9] UTD. This study examines the association of parental vaccine hesitancy with receipt of HPV vaccination (≥1 and up-to-date (UTD) doses) among adolescents. Identifying characteristics of parents of adolescents with vaccine hesitant beliefs is an important step to understanding how such beliefs translate to vaccine uptake and developing strategies to improve communication with parents and adolescents.