Parental Acceptance of a Mandatory Human Papillomavirus (HPV) Vaccination Program

Daron Ferris; Leslie Horn; Jennifer L. Waller

doi:10.3122/jabfm.2010.02.090091

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Table 1.

Association between Demographic Variables and Parent's Agreement with Adding the Human Papilloma Virus Vaccine to School Entry Requirements

Variable	Do you Think the HPV Vaccine should be Added to the List of School Entry Vaccine Requirements?		P^*
Variable	No (n [%])	Yes (n [%])	P^*
Gender			.47
Male	19 (51.4)	18 (48.7)
Female	163 (57.6)	120 (42.4)
Age (years)			.19
18–29	30 (53.6)	26 (46.4)
30–39	81 (55.9)	64 (44.1)
40–49	49 (54.4)	41 (45.6)
50+	22 (75.9)	7 (24.1)
Race			.50
White	103 (56.6)	79 (43.4)
African American	67 (54.9)	55 (45.1)
Asian	1 (50.0)	1 (50.0)
Hispanic	9 (75.0)	3 (25.0)
Other	2 (100.0)	0 (0.0)
Ages of Children, 9–11			.91
No	75 (57.3)	56 (42.8)
Yes	107 (56.6)	82 (43.4)
Ages of Children, 12–14			.05
No	126 (60.9)	81 (39.1)
Yes	56 (49.6)	57 (50.4)
Ages of Children, 15–17			.80
No	112 (57.4)	83 (42.6)
Yes	70 (56.0)	55 (44.0)
Income			.03
≤$20,000	17 (37.8)	28 (62.2)
$20,001-$50,000	77 (57.9)	56 (42.1)
$50,001-$100,000	54 (64.3)	30 (35.7)
>$100,000	34 (58.6)	24 (41.4)
Education			.09
<High school	5 (38.5)	8 (61.5)
High school or GED	63 (51.6)	59 (48.4)
≥College	114 (61.6)	71 (38.4)
Health insurance			.01
None	9 (50.0)	9 (50.0)
Private	135 (61.6)	84 (38.4)
Medicaid	26 (40.6)	38 (59.4)
Medicare	2 (100.0)	0 (0.0)
Other	9 (75.0)	3 (25.0)
Tricare	1 (20.0)	4 (80.0)
Ever had HPV			.04
Yes	18 (42.9)	24 (57.1)
No	155 (60.3)	102 (39.7)
Not sure	9 (42.9)	12 (57.1)
Ever had genital warts			.78
Yes	8 (53.3)	7 (46.7)
No	174 (57.1)	131 (43.0)
Abnormal Papanicolaou test (women only)			.55
Yes	67 (56.8)	51 (43.2)
No	98 (58.7)	69 (41.3)
Not sure	17 (48.6)	18 (51.4)

* χ² test.
HPV, human papillomavirus; GED, General Educational Development test.

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Table 2.

Association of Parental Attitudes, Beliefs, and Agreement with Adding the Human Papillomavirus Vaccine to School Entry Requirements

Variable	Do You Think the HPV Vaccine Should be Added to the List of School Entry Vaccine Requirement?		P^*
Variable	No (n [%])	Yes (n [%])	P^*
Support government-mandated vaccine requirements			<.0001
No	33 (97.1)	1 (2.9)
Yes	148 (51.9)	137 (48.1)
Familiar with HPV			.02
Not familiar	20 (45.5)	24 (54.6)
Somewhat familiar	117 (63.6)	67 (36.4)
Very familiar	45 (48.9)	47 (51.1)
Likelihood of child to contract HPV			.03
Not at all likely	85 (57.8)	62 (42.2)
Somewhat likely	93 (59.6)	63 (40.4)
Very likely	4 (25.0)	12 (75.0)
Important for child to receive HPV vaccine			<.0001
Not at all important	42 (84.0)	8 (16.0)
Somewhat important	96 (72.7)	36 (27.3)
Very important	43 (31.6)	93 (68.4)
Concerned about side effects of HPV vaccine			.56
Not at all concerned	20 (60.6)	13 (39.4)
Somewhat concerned	75 (53.6)	65 (46.4)
Very concerned	86 (59.3)	59 (40.7)
HPV vaccine reduces risk of cervical cancer			.001
No	30 (83.3)	6 (16.7)
Yes	117 (51.5)	110 (48.5)
No girls	32 (60.4)	21 (39.6)
HPV vaccine reduces risk of genital warts			.06
No	74 (63.8)	42 (36.2)
Yes	104 (52.8)	93 (47.2)
Want child to receive HPV vaccine			<.0001
No	55 (90.2)	6 (9.8)
Yes	123 (48.2)	132 (51.8)
Child has received HPV vaccine			.008
No	166 (59.7)	112 (40.3)
Yes	16 (38.1)	26 (61.9)
Physician supports HPV vaccine			.07
No	4 (50.0)	4 (50.0)
Yes	43 (47.3)	48 (52.8)
Not Discussed	135 (61.1)	86 (38.9)
Most influences decision to get HPV vaccine			.006
Doctor	97 (51.1)	93 (49.0)
Spouse	14 (82.4)	3 (17.7)
Child	13 (48.2)	14 (51.9)
Parent	2 (28.6)	5 (71.4)
Mandatory school requirement	14 (70.0)	6 (30.0)
None	41 (70.7)	17 (29.3)
Comfortable with mandated HPV vaccine			<.0001
Not comfortable	87 (97.8)	2 (2.3)
Somewhat comfortable	87 (53.4)	76 (46.7)
Very comfortable	7 (10.5)	60 (89.6)
Mandatory HPV vaccine program helpful			<.0001
Not helpful	45 (97.8)	1 (2.2)
Somewhat helpful	125 (64.1)	70 (35.9)
Very helpful	12 (15.2)	67 (84.8)
Mandatory HPV vaccine program important			<.0001
Not important	47 (94.0)	3 (6.0)
Somewhat important	123 (67.2)	60 (32.8)
Very important	12 (13.8)	75 (86.2)
Federal government to pay for HPV vaccine			<.0001
No	90 (82.6)	19 (17.4)
Yes	91 (43.3)	119 (56.7)
Interested in HPV vaccination for child			<.0001
Not interested	52 (91.2)	5 (8.8)
Somewhat interested	100 (66.2)	51 (33.8)
Very interested	30 (26.8)	82 (73.2)

* χ² test.
HPV, human papillomavirus.

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Table 3.

Association of Parental Attitudes, Beliefs, and Possible Responses to a Mandatory Human Papillomavirus Vaccine

Variable	If the HPV Vaccine was Mandatory to Attend School, Which of the Following Statements Most Agrees with Your View?			P^*
Variable	Would Sign a Waiver to Prevent my Child from Receiving the Vaccine (n [%])	Would have My Child Vaccinated (n [%])	Would do Whatever My Doctor Recommends (n [%])	P^*
Gender				.95
Male	6 (16.2)	25 (67.6)	6 (16.2)
Female	52 (18.4)	186 (65.7)	45 (15.9)
Age (years)				.84
18–29	11 (19.6)	36 (64.3)	9 (16.1)
30–39	23 (15.9)	95 (65.5)	27 (18.6)
40–49	17 (18.9)	61 (67.8)	12 (13.3)
50+	7 (24.1)	19 (65.5)	3 (10.3)
Race				.40
White	40 (22.0)	114 (62.6)	28 (15.4)
African American	18 (14.8)	84 (68.9)	20 (16.4)
Asian	0 (0.0)	1 (50.0)	1 (50.0)
Hispanic	0 (0.0)	10 (83.3)	2 (16.7)
Other	0 (0.0)	2 (100.0)	0 (0.0)
Ages of children, 9–11				.91
No	25 (19.1)	86 (65.7)	20 (15.3)
Yes	33 (17.5)	125 (66.1)	31 (16.4)
Ages of children, 12–14				.02
No	39 (18.8)	127 (61.4)	41 (19.8)
Yes	19 (16.8)	84 (74.3)	10 (8.9)
Ages of children, 15–17				.23
No	41 (21.0)	123 (63.1)	31 (15.9)
Yes	17 (13.6)	88 (70.4)	20 (16.0)
Income				.54
≤$20,000	6 (13.3)	33 (73.3)	6 (13.3)
$20,001-$50,000	22 (16.5)	88 (66.2)	23 (17.3)
$50,001-$100,000	21 (25.0)	49 (58.3)	14 (16.7)
>$100,000	9 (15.5)	41 (70.7)	8 (13.8)
Education				.84
>High school	2 (15.4)	9 (69.2)	2 (15.4)
High school or GED	20 (16.4)	85 (69.7)	17 (13.9)
≥College or more	36 (19.5)	117 (63.2)	32 (17.3)
Health insurance				.06
None	2 (11.1)	10 (55.6)	6 (33.3)
Private	47 (21.5)	139 (63.5)	33 (15.1)
Medicaid	5 (7.8)	51 (79.7)	8 (12.5)
Medicare	0 (0.0)	2 (100.0)	0 (0.0)
Other	3 (25.0)	5 (41.7)	4 (33.3)
Tricare	1 (20.0)	4 (80.0)	0 (0.0)
Ever had HPV				.19
Yes	10 (23.8)	30 (71.4)	2 (4.8)
No	46 (17.9)	165 (64.2)	46 (17.9)
Not sure	2 (9.5)	16 (76.2)	3 (14.3)
Ever had genital warts				.22
Yes	3 (20.0)	12 (80.0)	0 (0.0)
No	55 (18.0)	199 (65.3)	51 (16.7)
Abnormal Papanicolaou test (women only)				.62
Yes	23 (19.5)	80 (67.8)	15 (12.7)
No	31 (18.6)	106 (63.5)	30 (18.0)
Not sure	4 (11.4)	25 (71.4)	6 (17.1)
Support government mandated vaccines requirements				<.0001
No	17 (50.0)	10 (29.4)	7 (20.6)
Yes	40 (14.0)	201 (70.5)	44 (15.4)
Familiar with HPV				.02
Not familiar	7 (15.9)	30 (68.2)	7 (15.9)
Somewhat familiar	30 (16.3)	115 (62.5)	39 (21.2)
Very familiar	21 (22.8)	66 (71.7)	5 (5.4)
Likelihood of child to contract HPV				<.0001
Not at all likely	36 (24.5)	76 (51.7)	35 (23.8)
Somewhat likely	20 (12.8)	120 (76.9)	16 (10.3)
Very likely	2 (12.5)	14 (87.5)	0 (0.0)
Important for child to receive HPV vaccine				<.0001
Not at all important	29 (58.0)	10 (20.0)	11 (22.0)
Somewhat important	23 (17.4)	81 (61.4)	28 (21.2)
Very important	5 (3.7)	119 (87.5)	12 (8.8)
Concerned about side effects of HPV vaccine				.08
Not at all concerned	8 (24.2)	20 (60.6)	5 (15.2)
Somewhat concerned	16 (11.4)	102 (72.9)	22 (15.7)
Very concerned	34 (23.5)	87 (60.0)	24 (16.6)
HPV vaccine reduces risk of cervical cancer				<.0001
No	20 (55.6)	10 (27.8)	6 (16.7)
Yes	25 (11.0)	169 (74.5)	33 (14.5)
No girls	11 (20.8)	30 (56.6)	12 (22.6)
HPV vaccine reduces risk of genital warts				.02
No	30 (25.9)	70 (60.3)	16 (13.8)
Yes	26 (13.2)	136 (69.0)	35 (17.8)
Want child to receive HPV vaccine				<.0001
No	35 (57.4)	10 (16.4)	16 (26.2)
Yes	21 (8.24)	199 (78.0)	35 (13.7)
Child has received HPV vaccine				.001
No	57 (20.50)	173 (62.2)	48 (17.28)
Yes	1 (2.4)	38 (90.5)	3 (7.1)
Physician supports HPV vaccine				.0004
No	3 (37.5)	2 (25.0)	3 (37.5)
Yes	7 (7.7)	75 (82.4)	9 (9.9)
Not discussed	48 (21.7)	134 (60.6)	39 (17.7)
Most influences decision to get HPV vaccine				<.0001
Doctor	20 (10.5)	137 (72.1)	33 (17.4)
Spouse	5 (29.4)	8 (47.1)	4 (23.5)
Child	2 (7.4)	21 (77.8)	4 (14.8)
Parent	0 (0.0)	5 (71.4)	2 (28.6)
Mandatory school requirement	4 (20.0)	15 (75.0)	1 (5.0)
None	27 (46.6)	24 (41.4)	7 (12.1)
Somewhat comfortable	8 (4.91)	128 (78.5)	27 (16.6)
Very comfortable	0 (0.00)	64 (95.5)	3 (4.5)
Mandatory HPV vaccine program helpful				<.0001
Not helpful	31 (67.4)	9 (19.6)	6 (13.0)
Somewhat helpful	27 (13.9)	127 (65.1)	41 (21.0)
Very helpful	0 (0.0)	75 (94.9)	4 (5.1)
Mandatory HPV vaccine program important				<.0001
Not important	32 (64.0)	12 (24.0)	6 (12.0)
Somewhat important	25 (13.7)	118 (64.5)	40 (21.9)
Very important	1 (1.2)	81 (93.1)	5 (5.8)
Federal government to pay for HPV vaccine				<.0001
No	42 (38.5)	48 (44.0)	19 (17.4)
Yes	16 (7.6)	162 (77.1)	32 (15.2)
Interested in HPV vaccination for child				<.0001
Not interested	41 (71.9)	7 (12.3)	9 (15.8)
Somewhat interested	16 (10.6)	102 (67.6)	33 (21.9)
Very interested	1 (0.9)	102 (91.1)	9 (8.0)
HPV vaccine should be added to the list of school entry vaccine requirements				<.0001
No	57 (31.3)	86 (47.3)	39 (21.4)
Yes	1 (0.7)	125 (90.6)	12 (8.7)