March 27, 2013
Growing Percentage of Parents Expressing Concern
About HPV Vaccine

Rochester, MN—In an effort to increase protection against the human papilloma virus by increasing availability, most states now authorize pharmacists to administer the HPV vaccine with some age restrictions.

That might not be enough for continued increase in vaccine rates, however.

According to a new study published in the journal Pediatrics, an increasing percentage of parents say they won't have their teen daughters vaccinated against HPV. In a survey by Mayo Clinic researchers and colleagues from the universities of Oklahoma and South Carolina, more than two in five parents said they believe the HPV vaccine is unnecessary, while many also expressed concern about potential side effects.

The study looked at three vaccines routinely recommended for adolescents in the United States: HPV; Tdap (for tetanus, diphtheria, and acellular pertussis), and the meningococcal conjugate vaccine, or MCV4 vaccine.

Up-to-date immunization rates rose for all three vaccines, but the proportion of teenage girls fully immunized against HPV—receiving three doses over 6 months—was substantially lower than for the other two vaccines.

Researchers note that 40% of parents surveyed said they wouldn't vaccinate their girls against HPV 5 years ago and that the percentage rose to 41% by 2009. By 2010, the percentage had increased to 44%.

“That's the opposite direction that rate should be going,” said co-author Robert Jacobson, MD, a pediatrician with the Mayo Clinic Children's Center.

The study also found that parental concern about HPV vaccine safety more than tripled from 5% in 2008 to 16% in 2010, while less than 1% expressed worry about the safety of the Tdap and MCV4 vaccines.

Jacobson noted that the concern rose even as more studies demonstrated the safety and effectiveness of the HPV vaccine, which protects against cervical and other genital cancers by preventing the infections than can lead to them.

For the study, researchers analyzed vaccination data in the 2008-10 National Immunization Survey of Teens. They found that, as of 2010, 80% of teens had gotten the Tdap vaccine and about 63% had received the MCV4 vaccine. Only about one-third of girls were immunized against HPV, however. That still was an increase from 2008, when only 16% were vaccinated.

Even though more clinicians are recommending the HPV vaccine, parents said they are more hesitant because:

• The vaccine was not specifically recommended for their child;
• Their lack of knowledge about the vaccine;
• Questions about the vaccine’s necessity;
• Concerns that the vaccine is inappropriate for the child’s age;
• Worry about safety/side effects; and
• Views that the vaccine isn’t needed because the child isn’t sexually active.

“The vaccine works better the younger the child is, and it doesn’t work after the child is grown up and is exposed to the virus, so our message should be: ‘Give this vaccine now to your child while your child is young and responsive to it,’” Jacobson said.

“Despite doctors increasingly recommending adolescent vaccines, parents increasingly intend not to vaccinate female teens with HPV,”the study concludes. “The concern about safety of HPV grew with each year. Addressing specific and growing parental concerns about HPV will require different considerations than those for the other vaccines.”

In most U.S. states and territories, pharmacists can administer the HPV vaccine through prescription or protocol. As of June 2012, according to data from the American Pharmacists Association, 43 states or territories had granted authority to pharmacists to administer the HPV vaccine, with most having specific age limitations.

U.S. Pharmacist Social Connect