Sex differences in parental reasons for lack of intent to initiate HPV vaccination among adolescents ages 13-17 years: National Immunization Survey - Teen 2019-2021

Abstract

Background: This study aimed to evaluate parents' main reasons for lack of intent to vaccinate their adolescent against human papillomavirus (HPV) from 2019 to 2021 and to examine changes in these main reasons stratified by sex of the adolescent.

Methods: NIS-Teen data from 2019 to 2021 were used. Parents who had not vaccinated their adolescent aged 13-17 against HPV and had no intent to do so in the next 12 months were asked the main reason behind this decision. Reasons were grouped into eight domains. A multinomial logistic regression model stratified by sex was used to assess changes in the likelihood of each domain for 2020 and 2021 in comparison to 2019.

Results: A significant interaction between the reasons for lack of intent to vaccinate against HPV and year by sex was documented (p < 0.001). For males, the odds of parents reporting vaccine misinformation (ORadj: 1.30, 95 % CI: 1.26, 1.35), safety and effectiveness concerns (ORadj: 1.08, 95 % CI: 1.05, 1.12), systemic barriers (ORadj: 2.57, 95 % CI: 2.48, 2.66), lack of knowledge (ORadj: 1.44, 95 % CI: 1.39, 1.49), sociocultural barriers (ORadj: 3.20, 95 % CI: 3.09, 3.32), already UTD (ORadj: 2.48, 95 % CI: 2.39, 2.56), and handicapped/special needs/illness (ORadj: 1.88, 95 % CI: 1.79, 1.97), were significantly higher in 2021 compared to 2019. Whereas for females, the odds of reporting all domains were significantly lower in 2021 compared to 2019.

Conclusion: The main domain reported was vaccine misinformation. Parents of males were more likely to report all domains in 2021 compared to 2019, the inverse of females. These can be addressed through public health interventions such as launching media campaigns to combat vaccine misinformation tailored to parents of male adolescents.

Keywords: HPV vaccine; NIS-Teen; Vaccine hesitancy.