Original article
Knowledge and Early Adoption of the HPV Vaccine Among Girls and Young Women: Results of a National Survey

https://doi.org/10.1016/j.jadohealth.2009.04.021Get rights and content

Abstract

Purpose

In 2006, universal human papillomavirus (HPV) vaccination of females ages 9 to 26 years became a formal recommendation, yet little is known about knowledge and adoption of this vaccine.

Methods

A cross-sectional survey of females aged 13 to 26 years was drawn from a nationally representative panel, and developed and maintained by Knowledge Networks, Inc. (Menlo Park, CA). Outcome measures included: (a) knowledge about HPV and the HPV vaccine, (b) barriers to vaccine adoption, and (c) prevalence and correlates of early vaccine receipt.

Results

Overall, 1,011 of 2,143 subjects (47%) completed the survey. Thirty percent of 13- to 17-year-olds and 9% of 18- to 26-year-olds reported receipt of at least one HPV injection. Knowledge about HPV varied; however, 5% or fewer subjects believed that the HPV vaccine precluded the need for regular cervical cancer screening or safe-sex practices. Adjusting for healthcare utilization and sources of information, vaccine receipt was more likely among 13- to 17-year-olds who reported a recent healthcare visit (adjusted odds ratio [AOR] 7.31, confidence interval [CI] 2.00–26.8) and reported discussing the HPV vaccine (AOR 4.50, CI 1.02–19.90) with a healthcare provider; and more likely among 18- to 26-year-olds who reported discussing the HPV vaccine (AOR 3.08, CI 1.21–7.80) with family or a healthcare provider (AOR 11.92, CI 2.62–54.27).

Conclusions

Few girls and young women believe that the HPV vaccine is protective beyond the true impact of the vaccine. Despite moderate uptake, many females at risk of acquiring HPV have not yet received the vaccine. These findings suggest the important role of both healthcare providers and parents in HPV vaccine adoption.

Section snippets

Participants

We assembled a nationally representative probability sample [14], [15], [16] of 2,143 girls and young women ages 13 to 26 years that was randomly drawn from an existing research panel of more than 60,000 U.S. households developed and maintained by the survey research firm Knowledge Networks (Menlo Park, CA). Knowledge Networks uses random digit dialing to construct the survey panel, and provides participating households with Internet access via WebTV (Microsoft Inc, Redmond, WA) to permit

Participants

Overall, 1,159 of 2,143 individuals responded to the survey request (54% response rate) and 1,011 completed the survey (47% completion rate). This response rate is typical for surveys that include adolescent populations [18], [19], [20]. For those who completed the survey, item nonresponse was low (0.1%–2%). Compared with nonrespondents, respondents were more likely to be older (unweighted mean age 19.4 vs. 18.4 years, p < .01), white, non-Hispanic (unweighted 79% vs. 67%, p < .01), and have

Discussion

This study was designed to complement public health surveillance data on uptake of the HPV vaccine by obtaining information from females in the age-range eligible for the vaccine. Use of an existing Internet-based sample from Knowledge Networks permitted rapid entry into the field at a feasible cost. These data provide some of the first nationally representative estimates of both adolescents' and young womens' adoption of the HPV vaccine, barriers to vaccination, sources of information about

Conclusions

Despite variable knowledge about HPV, few adolescents and young women have the false beliefs that the HPV vaccine will protect them against sexually transmitted infections other than HPV, or that it will obviate their need for cervical cancer screening. Many females at risk for acquiring HPV have yet to be vaccinated. Both healthcare providers and family members are influential regarding HPV vaccine education and adoption among girls and young women in the United States.

Acknowledgments

Rachel Caskey had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Caskey, Lindau, Alexander. Acquisition of data, data analysis, and interpretation: Caskey, Lindau, Alexander. Manuscript preparation and intellectual content of the manuscript: Caskey, Lindau, Alexander. Statistical analysis: Caskey, Lindau, Alexander.

Dr. Alexander has served as a consultant to Astra Zeneca (2003)

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