Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Declining, But Later Accepting, HPV Vaccination
Acad Pediatr; 2018 Mar; Kornides, McRee, et al
A secondary acceptance of HPV vaccination is common among parents, with more than two-thirds in a recent national sample accepting or intending to accept HPV vaccination for their child after declination. In September 2016, researchers conducted an online survey with a national sample of parents of children aged 11 to 17 years. For those who reported having ever declined HPV vaccination for their children (n=494), the survey assessed whether they accepted the vaccine at a subsequent visit. They found:
- Overall, 45% of parents reported secondary acceptance of HPV vaccination, and an additional 24% intended to vaccinate in the next 12 months.
- In multivariable analyses, secondary acceptance was associated with receiving follow-up counseling about HPV vaccination from a health care provider; however, only 53% of parents overall reported receiving such counseling.
- Among the reasons for secondary acceptance, parents most commonly reported the child getting older (45%), learning more about HPV vaccine (34%), and receiving a provider recommendation (33%).
Citation:
Kornides ML, McRee A-L, Gilkey MB. Parents who decline HPV vaccination: Who later accepts and why? Acad Pediatr. 2018;18(2): S37-S43. doi:10.1016/j.acap.2017.06.008.
HPV vaccine acceptance remains lower than for other recommended childhood vaccines. This study looked at acceptance of the HPV vaccine after initial declination and the authors found that repeated and high-quality recommendations by the provider at subsequent visits are associated with secondary acceptance later. This is good news and should encourage providers to continue to engage parents and recommend the vaccine at later visits. Unfortunately, the study found that only about half of those who initially refused the vaccine were counselled later, which is a missed opportunity given that persistence seems to improve vaccination rates. HPV vaccine acceptance remains lower than for other recommended childhood vaccines. This study looked at acceptance of the HPV vaccine after initial declination. The authors found that repeated and high-quality recommendations by the provider at subsequent visits are associated with secondary acceptance later. This is good news and should encourage providers to continue to engage parents and recommend the vaccine at later visits. Unfortunately, the study found that only about half of those who initially refused the vaccine were counselled later, which is a missed opportunity given that persistence seems to improve vaccination rates.—Sarah Rawstron, MB, BS, FAAP, FIDSA
Pediatric Residency Program Director, The Brooklyn Hospital Center, NY
Clinical Associate Professor, Icahn School of Medicine, Mount Sinai, NY