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HPV Vaccine Decision-making Among Boys and Parents
Vaccine; 2018 May 3; Lacombe-Duncan, Newman, et al
Multilevel factors influence human papillomavirus (HPV) vaccine acceptability and decision-making among parents and their adolescent sons, according to a recent study. Therefore, providing clear and unambiguous messages about HPV vaccines-for whom (boys and girls), for what (genital warts and cancers in men), and when (before sexual debut)-through increased healthcare provider (HCP)-initiated discussion and targeted public health campaigns may support HPV vaccine uptake among boys. A systematic search identified qualitative studies examining HPV vaccines from the perspectives of boys and/or boys' parents. A review of 15 eligible studies (n= 3,362 parents, n=39 boys) revealed multilevel factors that influence HPV vaccine acceptability and decision-making among adolescent boys and their parents:
- Individual, eg, low HPV vaccine knowledge/awareness,
- Interpersonal, eg, key relationships between parents, sons, and HCPs,
- Community/societal, eg, parental duty to protect, and
- Systemic, eg, HPV vaccine messaging.
Acceptability was mitigated by low awareness/knowledge of HPV vaccines and low perceived benefits for boys, lack of HCP-initiated discussion, out-of-pocket costs, multiple doses, stigma, and mixed messages about HPV.
Lacombe-Duncan A, Newman PA, Baiden P. Human papillomavirus vaccine acceptability and decision-making among adolescent boys and parents: A meta-ethnography of qualitative studies. Vaccine. 2018;36(19):2545-2558. doi:10.1016/j.vaccine.2018.02.079.
Although HPV vaccine is one of the newest recommended vaccines, acceptance of the vaccine remains significantly lower than other vaccines. There also continues to be a significant gender difference with this vaccine, which is not surprising since it was recommended only for girls first in 2006, and then recommended for boys in 2009. This study adds to the data looking into some of the reasons why HPV vaccination remains lower in boys, and suggests some clear ideas about how to improve the messaging for why this vaccine is important.—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.