Public reluctant to support teen HPV vaccination without parental consent

July 18, 2012 Volume 16 Issue 2
  • Most US adults support laws allowing teens to get medical care for sexually transmitted infections without parental consent.
  • In contrast, less than half of US adults support laws allowing teens to receive HPV vaccine without their parents’ consent.
  • For those opposing teen vaccination without parental consent, the parental decision-making role was most important.

Teens are less likely to get human papillomavirus (HPV) vaccine than any other recommended immunization for adolescents. Reasons for low vaccination rates are not entirely clear. HPV vaccination can protect against genital warts, a common sexually transmitted infection (STI), and prevents development of cervical cancer and other types of cancer. Vaccination against human papillomavirus (HPV) has been recommended for adolescent and young women since 2007 and for adolescent and young men since 2011.

To increase HPV vaccination rates, some public health officials have suggested that vaccination be available to adolescents without parental consent. This idea builds on existing state laws that allow adolescents to receive testing and treatment for STIs without their parents’ consent.

In January 2012, the C.S. Mott Children’s Hospital National Poll on Children’s Health asked a national sample of adults to share their opinions about allowing adolescents age 12-17 years to receive HPV vaccination without parental consent.

Beliefs about Adolescent Vaccines

Three-quarters of US adults agree (74%) that getting vaccines is a good way to protect adolescents from disease. However, only 35% agree that HPV vaccines are safe for adolescents.

Support for Laws Allowing Medical Care Without Parental Consent

The majority of US adults indicate they would support state laws allowing adolescents to receive medical care for treatment or prevention of STIs.

In contrast, the majority of US adults would not support state laws allowing HPV vaccination without parental consent, for females or males. There were no differences between parents and non-parents regarding the level of support for parental consent laws (Figure 1).

Among those who would NOT support HPV vaccination without parental consent, their reasons included:

  • HPV vaccination should be a parent’s decision (86%)
  • Risk of side effects with HPV vaccine (43%)
  • Moral or ethical concerns about HPV vaccine (40%)
  • Have read or heard problems with HPV vaccine (39%)
  • Adolescents age 12-17 are too young to receive HPV vaccine (36%)
  • Do not support any state laws for vaccination (36%)
  • HPV vaccines are not effective (24%)
  • Cost of HPV vaccine is too high (22%)

Implications

The relatively low HPV vaccination rates for adolescents have prompted public health officials to consider ways to make the vaccine more available.  The current approach to vaccination of minors requires that all vaccines be authorized with specific consent from a parent or guardian. This requires that a parent accompany the adolescent for care. In the case of HPV, the discussion about consent may raise questions about the adolescent’s sexual activity, which can be uncomfortable for many parents.

In contrast, the approach to medical care of STIs allows minors to receive confidential testing and treatment, as well as family planning services, without parental consent. Expanding the STI model to include prevention of genital warts has the potential to increase access to HPV vaccination for a broader array of adolescents.

Results of this Poll demonstrate that the majority of US adults support current laws that facilitate prevention and treatment of STIs for adolescents without parental consent. However, the majority of adults view HPV vaccination as distinct from STI prevention and do not support vaccination without parental consent. Opponents of HPV vaccination without parental consent are nearly unanimous in their agreement that vaccination should be a parent’s decision. Cited less frequently are concerns about HPV vaccine safety, morality, and effectiveness.

Interestingly, the level of support for state laws around adolescent care without consent did not differ between parents and non-parents. While parents were more likely than non-parents to believe that HPV vaccine is safe, they expressed equal opposition to a possible law to allow vaccination without parent consent.

Based on these data, policymakers and public health officials considering ways to improve HPV vaccination rates should proceed with caution when pursuing laws to allow minors to be vaccinated without their parent’s consent. The public seems reluctant to adopt STI management approaches when it comes to adolescent vaccination—even though HPV is fundamentally linked to sexual behavior.

Data Source

This report presents findings from a nationally representative household survey conducted exclusively by Knowledge Networks, Inc. (KN), for C.S. Mott Children’s Hospital via a method used in many published studies.  The survey was administered in January 2012 to a randomly selected, stratified group of adults age 18 and older (n=2,131) from the KN standing panel that closely resembles the U.S. population. The sample was subsequently weighted to reflect population figures from the Census Bureau. The survey completion rate was 62% among panel members contacted to participate. The margin of error is ± 3 to 5 percentage points.

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH
Web Editor: Anna Daly Kauffman, BA

Findings from the C.S. Mott Children's Hospital National Poll on Children's Health do not represent the opinions of the investigators or the opinions of the University of Michigan. The University of Michigan reserves all rights over this material.


 

Human papillomavirus (HPV) vaccines are approved by the FDA for girls and boys age 9 and older to prevent some genital cancers and genital warts.

Q1.  For each statement below, please mark one response that is closest to your opinion.

Please check one box in each row
 

  Strongly agree Agree Neutral Disagree Strongly disagree
Getting vaccines is a good way to protect adolescents from disease          
New vaccines are safe for adolescents          
HPV vaccines are safe for adolescents          

Q2. State laws allow adolescents age 12-17 to receive the following services without the consent of a parent or guardian. Do you support these state laws?

Please check one box in each row

  Support Do not support
Medical care for the treatment of a sexually transmitted infection    
Family planning services (including birth control pills)    

Q3. Would you support state laws for adolescents age 12-17 to receive any of the following without the consent of a parent or guardian?

Please check one box in each row

  Support Do not support
Medical care related to the prevention of a sexually transmitted infection    
Human papillomavirus (HPV) vaccines for girls    
Human papillomavirus (HPV) vaccines for boys    

[If Q3= ‘do not support’ the HPV vaccine for either boys or girls]

Q3a. Please indicate reasons why you would NOT support a state law allowing adolescents age 12-17 to receive HPV vaccine – without the consent of a parent or guardian.

[yes/no]

  • HPV vaccination should be a parent’s decision
  • I have read or heard about problems with the HPV vaccine
  • The risk of side effects with HPV vaccines is too great
  • Adolescents age 12-17 are too young to receive HPV vaccines
  • I don’t think HPV vaccines are effective in preventing HPV
  • I don’t support state laws for vaccinations
  • I have moral or ethical concerns about HPV vaccines
  • The cost of the vaccine is too high
  • Other

Participants were also asked demographic questions on political party, gender, race/ethnicity, annual household income, education and insurance status.

All information is the sole property of the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health. It can only be used if there is an acknowledgment that "The information came from, is copyright by and is owned by and belongs to the Regents of the University of Michigan and their C.S. Mott Children's Hospital National Poll on Children's Health. It cannot be republished or used in any format without prior written permission from the University."

C.S. Mott Children’s Hospital National Poll on Children’s Health
Director: Matthew M. Davis, MD, MAPP
Associate Director: Sarah J. Clark, MPH
Manager & Editor: Dianne C. Singer, MPH
Data Analyst: Amy T. Butchart, MPH
Web Editor: Anna Daly Kauffman, BA

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Public reluctant to support teen HPV vaccination without parental consent

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