Validation of a parent HPV vaccine misperceptions scale and its association with children's HPV vaccination status

Human papillomavirus (HPV) infection is the cause of nearly all cervical and anal cancers and the majority of vaginal, oropharyngeal, vulvar, and penile cancers in the United States (US). A safe and effective vaccine for the most common cancer-causing HPV types has been available in the US since 2006; however, uptake among age-eligible children remains below that of vaccines administered at similar ages. Hesitancy fueled by misperceptions about the HPV vaccine may contribute to this gap. We assessed HPV vaccine misperceptions using a 12-item Likert scale in a population health assessment in a large county in California. We validated the scale using exploratory factor analysis and exploratory graph analysis. We further assessed concurrent validity by examining parent report of youth vaccination through weighted logistic regression. The HPV Vaccine Misperceptions scale had high internal consistency (Cronbach's alpha = 0.94) and a strong primary dimension. Further, the 12-item scale sum score was associated with increased odds (Odds Ratio_{per SD} = 2.09; 95 % Confidence Interval = 1.26-3.45) of age-eligible children being unvaccinated for HPV in multivariable-adjusted logistic regression models. This Parent HPV Vaccine Misperceptions Scale can be used to identify parent barriers to vaccination for tailored health education to increase uptake of the HPV vaccine in age-eligible children.