Immunization Science

Attitudes Toward Vaccines Against STI

The article

Parental perspectives on vaccinating children against sexually transmitted infections. Mays RM, Sturm LA, and Zimet GD. Social Science & Medicine 2004;58(7):1405-1413

NNii’s explanatory note: Several vaccines intended to protect against the consequences of certain predominantly sexually transmitted infections (STI) are under development. Currently, the only vaccine available that prevents the late complications of a STI is the hepatitis B vaccine—although many at risk of this infection do not acquire hepatitis B infection through sex or by needlestick (indeed about 30% of children who acquire Hepatitis B have no known risk factors). Since some adolescents become sexually experienced during the teen years and individuals can become infected with STIs shortly after beginning to have sex, and because we can not always predict when an individual will become sexually experienced, these vaccines will need to be given to pre- or young adolescents in order to be maximally effective. Health care providers have been concerned that parents of children in this age group may be uncomfortable considering vaccines to prevent STI for their children.

The question

What are parents’ attitudes toward vaccines directed at sexually transmitted infections for their children?

The study

This is a qualitative study that used in-depth interviews to elicit attitudes from 34 parents (aged 26-55) about accepting vaccines for genital herpes, human immunodeficiency virus, human papillomavirus and gonorrhea for their children—aged 8 through 17. There are currently no licensed vaccines for these diseases.

Researchers interviewed parents taking their children for care at an urban clinic and a suburban private office in Marion County, Indiana. They asked the parents to assume that a safe and effective vaccine that can provide ten years of protection existed for each illness—after that time a booster would be needed. They then provided a description of the diseases and asked about the likelihood that they would give each vaccine to their children.

The interviewers classified respondents as “rejecters” (a parent who refused one or more of the vaccines) or “acceptors” (parents who would agree to their children receiving the four vaccines). They also categorized the reasons for accepting and refusing the vaccines. This was the first phase of an ongoing study.

The findings

The study found that more than 70% of the interviewed parents approved the administration of all four of the STI vaccines proposed. HIV was the most acceptable of the vaccines presented, with 31 (91%) of the parents accepting it. The rates of acceptance for the other vaccines were: 27 (79%) for a genital herpes vaccine, 26 (76%) for a gonorrhea vaccine and 25 (73%) for a human papillomavirus vaccine.

Parents’ reasons for acceptance included wanting to protect their children, being concerned about specific disease characteristics, and previous experience with the infections.

Parents who declined the vaccines did so primarily because they perceived their children to be at low risk for the infections or they had low concern about features of the diseases.

Most parents thought they should be the decision-maker regarding their children receiving an STI vaccine.

The relevance/bottom line

Parents’ overall acceptance rates of STI vaccines for pre-adolescent and adolescent children were high for all of the four infections although about a quarter of the parents had reservations about these vaccines. Consistent with other research, the perceived severity of the infection was a key factor. Parents believe that they should make the decisions for their adolescents with regards to vaccines.

NNii’s comment

An understanding of these types of attitudes will be essential when policy makers consider recommendations for the use of STI vaccines once they become available.