Better together: Joint Parent-Student Decisions on HPV Vaccine

Human papillomavirus (HPV) affects an estimated 79 million Americans, presenting a significant public health threat through its association with several types of cancer. In 2006, a vaccine to prevent HPV was introduced for girls, with recommended vaccination being expanded to boys in 2011. However, despite these recommendations, overall rates of HPV vaccination among young adults remain below the 80 percent completion goal set by the U.S. Office of Disease Prevention and Health Promotion’s Healthy People 2020 program.

In a new study published in the Journal of Community Health, Matthew Lee Smith, PhD, co-director of the Texas A&M Center for Population Health and Aging and associate professor in the Environmental and Occupational Health Department at the Texas A&M School of Public Health, collaborated with Brittany Rosen, PhD, of the University of Cincinnati and Texas A&M colleagues examining parental involvement and other factors influencing college women’s decisions to receive the HPV vaccine. Previous research has found that parents have a significant role in college students’ health care decisions. Thus, the researchers compared how joint parent-daughter, solo and parent-only decisions affected vaccination rates.

Current recommendations are that girls and boys begin HPV vaccinations between the ages of 11 and 12, with those between the ages of 13 and 26 being eligible for catch-up vaccination. However, the vaccine initiation rates for adults aged 19 to 26 remain low, with 49 percent of young women and 13 percent of young men being vaccinated. The researchers cite such low numbers as a need for better understanding of vaccine decision making and improved targeted outreach toward young adults.

To better understand such factors, Smith and colleagues conducted a questionnaire of female students, aged 18 to 26, at two universities in Texas. They asked about HPV vaccination start dates and completion status, whether students were sexually active and who made decisions related to the HPV vaccine—parents only, parents and student together or the student on her own. The researchers also asked questions to determine students’ level of HPV knowledge, their insurance status and type, and whether they had talked to their parents about the HPV vaccine.

The study found that around 80 percent of the subjects had completed the HPV vaccination series and that more than half initiated the cycle at 18 years or older. Compared to women who jointly decided with their parent to get vaccinated, those who made their own solo decision were less likely to complete the three-shot vaccination cycle.  Women who made their own decision to be vaccinated and those whose parents made the decision independently were less likely to have discussed the HPV vaccine with their parents.

“While parent involvement in vaccination decisions may contribute to higher vaccination completion rates, these decisions should not be made unilaterally,” Smith said. “Parents and youth are encouraged to openly discuss vaccinations and other health-related topics.”

Although they are limited to a small subset consisting of young women at two Texas universities, these findings show the vital role that parental involvement plays in health care decisions for young adults. “Findings from this study highlight opportunities to educate families about the HPV vaccine and support the need to expand current efforts to target uninsured students and provide low-cost vaccinations,” Smith said. The findings from this study can help inform further in-depth research on HPV vaccination and efforts to improve vaccination rates for this wide-ranging and serious public health threat.