Vaccination rates against human papilloma virus are far lower than they should be, even though the virus causes most cases of cervical cancer in the United States, as well as putting people at higher risk of many other kinds of cancer. Now a new study shows that physicians may have been misinterpreting the reasons why more pre-teenagers and teens aren’t vaccinated. Doctors might have a much bigger impact on parents’ decisions than they think.
The study, published in the November issue of the Journal of Adolescent Health, looked at the results of surveys in 2010 and 2016 that asked parents who weren't having their children vaccinated the reasons for their decision.
The most common reason, the study found, was more about lack of knowledge than about any concerns that their children might become sexually active.
Studies have repeatedly found that sexual behavior is not changed by being vaccinated. The most recent study confirming this was published just last month in the Canada Medical Association Journal. And in fact, the Adolescent Health study found, parents seem to be getting the message: Only a small minority give that as a reason, and the number has dropped considerably since 2010.
Yet vaccination rates, though improving, remain troubling. According to a release from John Hopkins University, whose researchers led the study:
Despite efforts to include the HPV vaccine as part of the routine childhood vaccination series, current use of the vaccine in the U.S. remains relatively low. In 2016, the most recent year for which data on vaccination rates are available, only 50 percent of eligible females and 38 percent of eligible males had completed the vaccine series.
“We wanted to better understand why parents choose not to vaccinate their children against HPV, since that information is critical for developing improved public health campaigns and provider messages to increase vaccination rate,” says study author Anne Rositch, assistant professor in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health.
The reasons parents give differ depending on whether they're making the decision about a son or daughter, the study found. For girls, concerns about sexual activity weren’t even among the top four. Instead, the top reasons were perceived safety (22 percent), parents’ beliefs that the vaccine wasn’t needed (20 percent), lack of any knowledge about the vaccine (13 percent) and the fact that their child’s physician hadn’t actively recommended it to them (10 percent). Meanwhile, concerns about sexual activity shrank by nearly half, from 19 percent in 2010 to 10 percent in 2016.
In other words, among parents of girls, the top four reasons added up to nearly two-thirds of parents, all of whose concerns could be addressed by their children’s doctors without getting into issues that parents might find uncomfortable. Helping parents understand the risks of cancer to their daughters, the many studies showing the safety of the vaccine, and even just informing parents that it exists and recommending it to them, could result in dramatically improved rates of vaccination.
For boys, the top four reasons were parents’ beliefs that the vaccine wasn’t necessary (22 percent); lack of doctor recommendation (17 percent); lack of knowledge (14 percent) and concerns about sexual activity (9 percent).
“We think all physicians need to be champions of this vaccine that has the potential to prevent tens of thousands of cases of cancers each year,” Anna Beavis, an assistant professor in Johns Hopkins Department of Gynecology and Obstetrics, who also was involved in the study, said in the university's release. “Providing a strong recommendation is a powerful way to improve vaccination rates.”
According to Beavis, the results also mean that public health campaigns should focus on the safety and importance of the vaccines for both boys and girls. Doctors might be more likely to bring up the topic, and urge parents to vaccinate their children, if they realized that they could address most parents’ concerns with basic medical information or even with a simple recommendation.
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