Reasons for Lack of HPV Vaccine Initiation in NIS-Teen Over Time: Shifting the Focus From Gender and Sexuality to Necessity and Safety

Purpose: To describe changes in parents’ reasons for lack of HPV vaccine initiation in American male and female adolescents from 2010 to 2016. Methods: Log binomial regression was used to examine prevalence and trends across time in reasons parents do not intend to vaccinate from the National Immunization Survey – Teen (NIS-Teen). Results: In females, safety concerns were the most common reasons in 2010 (23%) and 2016 (22%). Lack of necessity (21% vs. 20%), knowledge (14% vs. 13%), and recommendation (9% vs. 10.0%) remained stable, whereas child's lack of sexual activity decreased from 19% to 10% (p<.01). For males, lack of necessity (24% vs. 22%), recommendation (22% vs. 17%), and knowledge (16% vs. 14%), and child's lack of sexual activity (16% vs. 9%) and gender (13% vs. 2%) decreased from 2010 to 2016 (p<.05). Safety concerns increased (5% vs. 14%) (p<.01). Conclusions: Vaccine messages should reflect current trends and focus on persistent concerns about knowledge, safety, and necessity, rather than sexuality and gender.