Fewer Teens Vaccinated for HPV

HPV and other teen vaccination rates improving but safety concerns increasing about HPV

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Vaccines are important for babies, but teens should stay up to date on their vaccines as well. This is especially true for the tetanus, pertussis, meningitis and HPV vaccines.

A recent study looked at how teen vaccination rates for these vaccines have changed over three years. The study also looked into why teens might not be receiving some vaccines.

In general, the researchers found that vaccine rates are gradually improving.

However, some parents are deciding not to vaccinate their daughters against HPV. They cite increasing concerns about safety and side effects.

"Vaccinate your children according to the CDC schedule."

The study, led by Paul M. Darden, MD, of the Department of Pediatrics in the College of Medicine at the University of Oklahoma Health Sciences Center, Oklahoma City, investigated teen vaccination rates over time and why they might be increasing or decreasing.

The researchers used data from the three National Immunization Surveys of Teens from 2008 through 2010. The researchers specifically focused on three vaccines to see if teens were up to date on them. Those who were not up to date were asked why.

The vaccines studied were the Tdap or Td, the MCV4 and the HPV. The Tdap protects teens against tetanus, diphtheria and pertussis, or whooping cough. The Td only protects against tetanus and diphtheria.

The MCV4 is the meningococcal vaccine that protects against meningitis, a potentially fatal brain and nervous system disease, and other related diseases. The HPV vaccine protects against multiple strains of human papillomavirus, a sexually transmitted infection which can cause cervical cancer.

The number of teens found not to be up to date on their Tdap/Td shots remained fairly steady over all three years. It was 22.4 percent in 2008, 20.4 percent in 2009 and 21 percent in 2010.

The percentage of teens not up to date on the MCV4 vaccine is slowly dropping, from 68.8 percent in 2008 to 63.7 percent in 2009 to 62.6 percent in 2010. This trend parallels an increasing trend in healthcare providers recommending the vaccine to parents for their teens.

The percentage of teens not up to date on the HPV shot is also dropping as more clinicians are recommending the shot, though far more teens are not up to date. The percentage not up to date in 2008 was 83.8 percent, which dropped to 76.2 percent in 2009 and 75.2 percent in 2010.

Among teens who were not up to date on the Tdap/Td or MCV4, the parents most frequently said the reason was that the vaccine was "not recommended" or "not needed or not necessary."

However, parents gave additional reasons for not vaccinating their children against HPV besides saying it was "not recommended" or "not necessary."

A number of parents said their daughters did not receive the HPV vaccine because she was "not sexually active." The HPV vaccine is recommended specifically before a child becomes sexually active to ensure she is protected later when she does.

Another common reason given was "safety concerns/side effects." There are no documented serious side effects for the HPV vaccine, yet the percentage of parents concerned about safety has increased.

In 2008, 4.5 percent of parents reported concerns about safety and side effects. That number rose to 7.7 percent in 2009 and 16.4 percent in 2010, nearly the same as the 17.4 percent in 2010 who said "not needed or not necessary."

Overall, the number of parents who said they did not intend to vaccinate their daughters against HPV rose from 39.8 percent in 2008 to 43.9 percent in 2010.

The only known side effects of the HPV vaccine are headache, nausea, sore arm at injection site and similar minor effects. Some girls also faint after receiving the shot, which is linked to the injection itself rather than the vaccine.

Early reports of concerns related to blood clots from the HPV vaccine were established to be the result of birth control pills that the teen girls were taking. No girl has ever died, suffered brain injury or developed a serious medical condition as a result of the HPV vaccine.

"Despite doctors increasingly recommending adolescent vaccines, parents increasingly intend not to vaccinate female teens with HPV," the authors wrote. "Addressing specific and growing parental concerns about HPV will require different considerations than those for the other vaccines."

The study was published March 18 in the journal Pediatrics. The research was funded by the US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program.

One author has been a consultant and advisory board member for Pfizer, and another has been involved with two vaccine studies funded by Pfizer and another funded by Novartis. He is a safety review committee member for one vaccine study and a member of a data and safety monitoring board for two other vaccines studies, all of which are funded by Merck. No other disclosures were noted.

Reviewed by: 
Review Date: 
March 17, 2013
Last Updated:
May 3, 2013