Pediatric HPV vaccination: Provider recommendations matter among hesitant parents

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. HPV-associated diseases are preventable with vaccination, but HPV vaccine coverage remains below other vaccines recommended during childhood and adolescence. We examined correlates of pediatric HPV vaccination among parents who have reported hesitancy toward the HPV vaccine. In addition to sociodemographic correlates, we investigated the relationships between the social process of healthcare provider recommendations and pediatric HPV vaccination.

We utilized phone survey data (N = 2201) collected in October 2022 via random digit dialing of Arkansan adults-Black and Hispanic respondents were oversampled for adequate representation. The survey was provided in English and Spanish. The analysis focused on a subsample of parents of children ages 9 to 17 years who reported HPV vaccine hesitancy (n = 201). Analyses include descriptive statistics, bivariate logistic regression, and multivariate logistic regression with Full Information Maximum Likelihood estimation.

A third (32.96%) of vaccine-hesitant parents reported their child(ren) had received at least one dose of the HPV vaccine. Only half (50.93%) of vaccine-hesitant parents received a healthcare provider recommendation to vaccinate their child(ren) between the ages of 9 and 17 against HPV. Adjusted odds of pediatric HPV vaccination were four times greater when vaccine-hesitant parents received a healthcare provider's recommendation (OR = 4.67; 95% CI[1.89, 11.55]) compared to when they had not. Pediatric HPV vaccination for parents whose provider did not recommend the HPV vaccine was not significantly different from those with no provider.

Healthcare provider recommendations are important for promoting HPV vaccination even among parents who are vaccine hesitant. Additional research is needed to understand why pediatric HPV vaccine recommendations are not made more often or consistently, particularly among vaccine-hesitant populations. This study demonstrates support for the growing body of research on hesitant adopters.