Immunization Science

Acceptance of HPV Vaccine Among Californian Parents

The article

Acceptance of Human Papillomavirus Vaccination among Californian Parents of Daughters: A representative Statewide Analysis. Constantine NA and Jerman P. Journal of Adolescent Health 2007; 40:108-115.


A vaccine to prevent infection with two strains of human Papillomavirus (HPV) that cause 70% of cases of cervical cancer has recently been recommended for routine administration to 11-12 year old girls and for ‘catch up’ immunization of older girls and young women. Immunization of girls before they become sexually active is important for maximum benefit from the vaccine. Parental acceptance of this vaccine will be critical to the successful implementation of this strategy.

The question

How well do parents accept vaccination against HPV for their young adolescent daughters?

The study

The data were derived from a statewide survey of Californian parents’ opinions about sexuality education and adolescent sexual health. The telephone survey interviewed 522 parents with daughters 18 years of age or younger living at home with them. The parents were asked whether they would immunize their daughter against HPV before her 13th birthday, before her 16th birthday, and why.

The findings

The people interviewed were from diverse ethnic/racial, parental education, religious, and household income groups.

Seventy-five percent said that they would likely vaccinate their daughter before 13 years of age and an additional 6% said that they would likely vaccinate them before age 16. Eighteen percent said they would be unlikely to vaccinate their daughters by either age.

The age or sex of the parent did not influence the results. However, Hispanic parents were more likely—whereas Asian-American and African-American parents were least likely—to immunize their daughters before age 13.

Groups more likely to endorse vaccination before 13 years of age were those with lower parental education levels, Catholic religion, those who rarely attended religious services, and political liberals. Groups less like to endorse HPV immunization before this age were college graduates, born-again or evangelical Christians, ‘other’ Christian groups, those reporting no religion, and political conservatives.

Parents who were likely to immunize their daughters before 13 gave reasons of their daughter’s health and safety. Parents gave similar reasons for being willing to immunize their daughters before 16, but these parents also expressed concerns about vaccine safety and/or the possible effects of the vaccine on their daughter’s sexual behavior.

Parents who were unlikely to immunize their daughters expressed concerns about possible effects on their daughter’s sexual or moral behavior, concerns about vaccine safety—both for this vaccine or for vaccines in general—or the belief that she would have no need for the vaccine.

The relevance/bottom line

Three quarters of Californian parents accepted the potential benefits of the HPV vaccine for their daughters. Asian-American and African American parents were least likely to accept the vaccine. Parents who are less likely to immunize their daughters have concerns about the message of a vaccine to prevent a sexually transmitted infection and are also concerned about vaccine safety.

NNii’s comment

Parental decisions to immunize their young adolescent daughters appear to be largely based upon the parents’ perceptions of the danger of disease, the safety of the vaccine, and their daughter’s susceptibility to infection.