Understanding HPV Vaccine Hesitancy

While we’re focused on COVID-19, there are various other health issues that continue to require our attention. One in particular is HPV or human papillomavirus (HPV), which is the most common sexually transmitted infection (STI) in the United States. In many ways though, the lessons from other diseases, like vaccine hesitancy, can help us with our response to COVID-19.

The Centers for Disease Control and Prevention (CDC) reports that prevalence for any and high-risk HPV is higher in men than women and during 2011-2014, prevalence of any HPV in the United States was 7.3%.

What makes HPV so critical for public health efforts though, is the associated cancer that occurs as a result of infection. The CDC notes that from 2013-2017, there were 45,300 HPV-associated cancers in the United States, of which a majority were in women. “in general, HPV is thought to be responsible for more than 90% of anal and cervical cancers, about 70% of vaginal and vulvar cancers, and more than 60% of penile cancers. Oropharyngeal cancers traditionally have been caused by tobacco and alcohol, but recent studies show that about 70% of cancers of the oropharynx may be linked to HPV.”

Not surprisingly, the need for the HPV vaccine is incredibly significant and makes battling hesitancy and refusal that much more important. This is especially vital for teenagers. A new study published in JAMA Pediatrics sought to address the safety concerns for vaccine refusal in a national immunization survey for teenagers from 2008 to 2019. This particularly study reviewed self reports of safety concerns or adverse effects as the main driver for HPV vaccine refusal in those teenagers 13-17 years of age. The authors noted a concerning finding—hesitancy increased over the study period. They reported that “the prevalence increased from 5.3% (95% CI, 4.4-6.5) in 2008 to 12.9% (95% CI, 12.0-13.9) in 2015 with a slope of 0.9% increase per year. However, the prevalence substantially increased from 12.9% (95% CI, 12.0-13.9) in 2015 to 26.2% (95% CI, 24.3-28.2) in 2019 with a slope of 3.5% increase per year. The change in slope before and after 2015 was statistically significant (0.9% vs 3.5%; difference, 2.6%; 95% CI, 0.7-4.6; P = .03). Throughout the study period, higher rates of safety concerns or adverse effects as the main reason for nonvaccination were reported by non-Hispanic White parents or guardians and by parents or guardians of teenaged girls.

From 2008 to 2013, mothers who were college graduates had rates of reporting safety concerns or adverse effects comparable with those among mothers with less than 12 years of education.” There was however a significant increase in those safety concerns reported as the main reason for refusing the vaccine by mothers with college degrees when compared to those with less than 12 years of education.

Ultimately, this study emphasizes that the concerns for the safety of vaccines has increased and that there is a desperate need to promote HPV vaccine safety as a strategy for addressing the disease and resulting cancers.