197001 Acceptability of school requirements for human papillomavirus vaccine

Monday, November 9, 2009: 11:30 AM

Jennifer S. Smith, PhD , Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
Noel T. Brewer, PhD , Health Behavior and Health Education, UNC-Chapel Hill, School of Public Health, Chapel Hill, NC
Yuli Chang, BA , School of Public Health: Health Behavior and Health Education, UNC-Chapel Hill, Chapel Hill, NC
Sarah Guerry, MD , Sexually Transmitted Disease Program, LA County Dept of Health Services, Los Angeles, CA
Erica M. Pettigrew , Schools of Medicine and Law, University of North Carolina, Chapel Hill, NC
Nicole Liddon, PhD , Division of STD Prevention, Behavioral Interventions and Research Branch, Centers for Disease Control and Prevention, Atlanta, GA
Lauri E. Markowitz, MD , Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Sami L. Gottlieb, MD, MSPH , Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
  
BACKGROUND: Although school requirements are in place for childhood vaccines and have fostered high vaccination coverage, few states have school requirements for adolescent vaccines. We sought to characterize parental attitudes regarding HPV vaccination requirements for adolescent girls.

METHODS: We interviewed 889 of 1,220 eligible parents of 10-18 year-old girls in areas of North Carolina with high cervical cancer incidence. Odds ratios (ORs) and 95% confidence intervals (CIs)were calculated by logistic regression.

RESULTS: Less than half (47%) of parents agreed that laws requiring HPV immunization for school attendance “are a good idea” when opt-out provisions were not mentioned. Far more agreed that “these laws are okay only if parents can opt out if they want to” (84%). Parents were more likely to disagree with vaccine requirements being a good idea if they expressed concerns about HPV vaccine safety (OR=3.9, 95%CI:2.1-7.5), its recent introduction (OR=3.2, 95%CI:1.9-5.5), or potential to increase their daughters' sexual activity (OR=2.6, 95%CI:1.6-4.3). Correlates of supporting requirements included believing HPV vaccine has higher effectiveness against cervical cancer or is more beneficial if provided at an earlier age. Parents who had initiated or intended HPV vaccination for their daughters were more likely to agree that laws requiring vaccination were a good idea.

DISCUSSION: More than 80% of parents agreed with HPV vaccination requirements if parents could opt out. Parental acceptability of school requirements appears to depend on perceived HPV vaccine safety, efficacy, optimal timing of administration, and potential sexual disinhibition attributable to HPV vaccination.

Supported by the CDC and ACS.

Learning Objectives:
1. Describe opposition to school requirements for HPV vaccination; and 2. Describe parental attitudes associated with acceptability of school HPV vaccination requirements.

Keywords: Immunizations, Cervical Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have received a Phd and MPH from Johns Hopkins School of Public Health and Hygiene, and published over 80 public health research articles.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Merck Pharmaceuticals HPV prevalence Independent Contractor (contracted research and clinical trials)
GlaxoSmithKline HPV vaccines and prevalence Advisory Committee/Board and Independent Contractor (contracted research and clinical trials)

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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