Safety Concerns Prompt Parental Refusal of HPV Vaccine for Teens

HPV vaccine
HPV vaccine
Study highlights decreased confidence in the human papillomavirus vaccine in the United States.

An increasing number of adults report concern about the safety of and adverse events associated with the human papillomavirus (HPV) vaccine as a reason for refusal to permit their teenager to be vaccinated, according to a study cited in a research letter in JAMA Pediatrics.

Investigators analyzed data from the National Immunization Survey-Teen (NIS-Teen), a population-based survey from 2008 to 2019 of parents or guardians of adolescents aged 13 to 17 years and their primary care providers. The primary outcome was reporting safety concerns or adverse events as the main reason for HPV vaccine refusal by the parent or guardian.

The prevalence of safety concerns or adverse events as a reason for HPV refusal increased from 5.3% (95% CI, 4.4% to 6.5%) in 2008 to 12.9% (95% CI, 12.0-13.9) in 2015, with a slope of 0.9% increase per year. The prevalence further increased substantially to 26.2% in 2019 compared with 2015 (95% CI, 24.3-28.2), with a slope of 3.5% increase per year. The investigators reported the 2.6% change in slope before and after 2015 to be statistically significant (95% CI, 0.7-4.6; P =.03).

Parents or guardians of non-Hispanic White teenaged girls consistently reported higher rates of safety concerns or adverse events as the main reason for HPV vaccine refusal. Starting in 2014, the number of mothers with college degrees reporting these issues as reasons for vaccine refusal increased significantly compared with mothers who had less than 12 years of education.

The study authors noted that their findings highlight the decreased confidence in the HPV vaccine in the US, which can be addressed with public health education on vaccine safety and enlisting social media companies to counter misinformation online.

“Physicians have a crucial frontline role to play in addressing vaccine hesitancy during parent-physician encounters,” the study authors added.


Chido-Amajuoyi OG, Talluri R, Shete SS, Shete S. Safety concerns or adverse effects as the main reason for human papillomavirus vaccine refusal: National Immunization Survey-Teen, 2008 to 2019. JAMA Pediatr. Published online June 28, 2021. doi:10.1001/jamapediatrics.2021.1585