Barriers to human papillomavirus vaccination for adolescent girls

The exact etiology of cervical cancer is not clearly known, but human papillomavirus (HPV) infection has been identified as a risk factor. It is estimated that 75 percent of reproductive age women and men have been infected with genital HPV at some point in their lives. In December 2005, Merck & Company filed an application for approval of its vaccine, Gardasil, with the Food and Drug Administration; an expedited decision – which is reserved for medications that treat unmet medical needs – was made in June 2006. Before the vaccine was approved, Merck began an educational campaign encompassing television and print ads with the message that cervical cancer is caused by HPV, “a cancer is caused by a virus”. However, the vaccine has already met with controversy and distrust by parents, conservative groups, and school boards. As the vaccine is targeted at young adolescent girls, parental acceptance of vaccination against HPV is an important consideration. Parents will have to decide to have their non-sexual, adolescent daughters be vaccinated against a sexually transmitted infection (STI). Furthermore, conservative groups are arguing that vaccinated girls might be more likely to initiate sexual exploration earlier or partake in risky sexual behaviors because they now consider themselves protected against this ubiquitous STI. These conservative groups also state that it sends the wrong message – going against the abstinence-only-unless married agenda. In order to develop efficacious, comprehensive promotion strategies for parents, it is first vital to identify and understand the barriers and beliefs of parental acceptance of HPV vaccination.