Parents With More Education Less Likely to Let Their Daughters Get HPV Shots

A new study finds that parents with more education were more likely to decline permission to have their daughters vaccinated against human papillomavirus (HPV).

Lead author Dr. Gina Ogilvie and colleagues surveyed parents of sixth-grade girls who were eligible to receive the HPV vaccine through a free, school-based program in British Columbia in the 2008-09 school year. The goal was to see what drove parents' decisions to grant or decline permission for their daughters to be vaccinated. Approximately half of the 4,000-plus randomly selected households agreed to participate in the study. More than 65 percent of girls in these households received the vaccine, while 35 percent of parents declined permission.

Almost half (47.9 percent) of parents who let their daughters be vaccinated said they did so due to confidence in the effectiveness of the vaccine. Doctors' advice and health concerns also played into "yes" decisions. Among parents who said "no," concern about vaccine safety was the main reason for their decision (29.2 percent), followed by concern that their daughters were too young for the vaccine (15.6 percent).

According to Ogilvie, the "main surprise" was that girls from two-parent households were less likely to have the shots and parents with more education were less likely to grant permission for vaccination. "This is a flip from our traditional understanding," she said.

"I think it's the combination of people who are used to making decisions, people who believe they can become experts by reading things on the Internet which would trump what public health officials or academics or doctors are saying," said vaccine expert Dr. Paul Offit of Children's Hospital of Philadelphia, who was not involved in the study.

Public health officials must do a better job of communicating accurate information about the safety and effectiveness of the HPV vaccine, said Ogilvie. "One of my big concerns is that in communities, very often ... educated parents can be opinion leaders for other parents. So we need to also make sure that those educated parents have at their disposal the balanced information and evidenced-based information so they can make their decisions," she said. "If [the Internet] is where parents are getting information, we need to be there" as well.

The study, "A Population-Based Evaluation of a Publicly Funded, School-Based HPV Vaccine Program in British Columbia, Canada: Parental Factors Associated with HPV Vaccine Receipt," was published in the journal PLoS Medicine (2010;7(5):e10000270.doi:10.1371/journal.pmed.1000270).

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