PC3018: Parental Perceptions of the HPV Vaccine for Prevention of Anogenital and Oropharyngeal Cancers: A Qualitative Study

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is implicated in the development of both anogenital and oropharyngeal cancers. Despite evidence that HPV vaccination prevents 90% of anogenital cancers and is thought to prevent a large percentage of head and neck cancers, vaccination rates are still low, especially among males, compared with other recommended age-concordant vaccines. Known barriers to HPV vaccination are knowledge gaps and vaccine acceptability. These knowledge gaps are particularly pronounced for males and for protection against oropharyngeal cancers. As the recommended age for HPV vaccination is 11-12 and parental consent is required, more information about the knowledge and beliefs of parents of older children and adolescents is key. The objectives of this qualitative study were to explore parental knowledge, perceptions, and decision-making processes around HPV and HPV vaccination for both anogenital and oropharyngeal cancers and to assess differences in knowledge, beliefs, and vaccination intentions for parents of male vs. female children and adolescents.

Methods: Parents of children and adolescents ages 8-18 were recruited to participate in this study using convenience sampling. Subjects participated in semi-structured telephone interviews about their knowledge and perceptions around HPV and HPV vaccination. Qualitative data were analyzed using thematic analyses, informed by an inductive approach. Data analysis was performed with NVivo. This study was approved by both the Nemours Children’s Health and Thomas Jefferson University Institutional Review Boards.

Results: A total of 31 parents participated in the study. Six themes emerged from the interview data: 1) knowledge about HPV vaccines, 2) perceptions of and attitudes towards anogenital and oropharyngeal cancers, 3) the role of the child’s gender in HPV vaccination, 4) decision-making processes towards vaccinating children and adolescents with the HPV vaccine, 5) communication with health care providers around HPV vaccination, and 6) the influence of their social networks. There were significant gaps in knowledge about the HPV vaccine’s indication and effects, especially for males and oropharyngeal cancer prevention. Participants noted that information about the vaccine’s effects against oropharyngeal cancer would influence their decision to vaccinate male children. Parents had concerns about the risks of the HPV vaccine, especially long-term side effects and future fertility. They cited their children’s health care providers as important sources of information about HPV vaccination and noted that they were critical to their decision making.

Conclusion: This study identified many knowledge gaps related to HPV vaccination in parents of older children and adolescents, with information about males, oropharyngeal cancer prevention, and risks particularly lacking. As parents identified pediatricians as the most important source of information regarding HPV vaccination, this information should empower pediatricians to educate patients and families about this important preventative health measure, with a focus on addressing concerns about the vaccine risks.