Why so young? Age and HPV vaccination acceptability for 11-12 year old girls

Background: Routine HPV vaccination is recommended for 11-12 year old girls. Despite the vaccine's availability for more than two years and evidence pointing to its safety and efficacy, vaccine uptake remains low. We compare attitudes, beliefs, and knowledge among key stakeholders as a foundation to intervention design.

Methods: Data were collected from 4 NC counties with relatively high rates of cervical cancer. We conducted 14 key informant interviews with health, school, and community leaders and 4 focus groups (n=40) with mothers of girls ages 11-12 who had not received the vaccination. Researchers identified key themes using content analysis techniques.

Findings: Mothers expressed (1) awareness of the vaccine but a limited basis for informed decision-making; (2) a desire to protect daughters from cervical cancer but acknowledgment that other health issues were more immediate; (3) some misunderstanding about the vaccine's recommendation at that age, often making a link between the vaccine and sexual activity; (4) a fear of unknown side effects, which took mothers in two directions – a willingness to ‘take a chance,' or conversely, a reluctance to assume responsibility for making the decision for their daughter; (5) a sense of feeling ‘pushed' to get the vaccine. Key informant responses generally reflected mothers' opinions, however one concern voiced only by informants was the vaccine's perceived irrelevance among parents with conservative values.

Conclusion: Multiple perspectives will inform our intervention to encourage wider adoption of the vaccine. Particular attention will be paid to addressing misconceptions and presenting clear rationale for vaccinating at this age.