Abstract

“I’ve just been hearing horror stories”: A Qualitative Exploration of HPV Vaccine Decision- Making and Hesitancy in Caregivers of Adolescents in the NE and SE United States

Ingrid Williams, MPH¹, Spring Cooper, PhD¹, Andrew Porter, PhD², Aisha King³, Carmen Presti, DNP⁴ and Avi Mikhaylov⁵
(1)CUNY School of Public Health and Health Policy, New York, NY, (2)Coral Gables, FL, (3)CUNY SPH, Brooklyn, NY, (4)The University of Miami, Coral Gables, FL, (5)City University of New York (CUNY) Hunter College, New York, NY

APHA 2025 Annual Meeting and Expo

Background: The HPV vaccine plays a significant role in lowering the incidence of cervical and other cancers. Vaccine hesitancy has increased in the United States since 2020. This study explores HPV vaccine hesitancy among caregivers of adolescents in the NE and SE United States in this new era of vaccine hesitancy. Methods: We conducted a qualitative study using in-depth, semi-structured interviews to explore the perceptions, beliefs, and experiences of parents/caregivers who demonstrated high levels of vaccine hesitancy toward HPV vaccine. Participants were recruited from a larger sample that completed a quantitative survey that included a subscale measuring their attitudes toward vaccines. Those that we identified as HPV vaccine-hesitant were invited to participate in an interview. We conducted thematic analysis using Dedoose software. Results: The findings resulted in the following four themes: 1) There are complex pathways leading to HPV vaccine hesitancy; 2) Decisions about the HPV vaccine are shaped by overarching concerns and mistrust in the healthcare system/government; 3) Parental decision-making is characterized by low health literacy and media literacy; and 4) Caregivers struggle with their child’s developing autonomy in relation to HPV vaccination decision-making. Conclusion: HPV vaccine hesitancy is rooted in a multi-faceted complex of attitudes and misunderstandings of the efficacy, safety and intended contribution to public health. Caregivers are conflicted in whom they should trust when researching the vaccine due to the perceived financial influence pharmaceutical industries and healthcare providers face when making recommendations. We will discuss potential avenues for intervention and increasing HPV vaccine confidence.

Planning of health education strategies, interventions, and programs Protection of the public in relation to communicable diseases including prevention or control Social and behavioral sciences