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Parent-Provider Communication of HPV Vaccine Hesitancy

Laura Aubree Shay · Austin S. Baldwin · Andrea C. Betts · Emily G. Marks · Robin T. Higashi · Richard Lewis Street +2 more

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Vaccine Coverage and Hesitancy Cervical Cancer and HPV Research Ethics and Legal Issues in Pediatric Healthcare

Abstract

OBJECTIVES: To prevent human papillomavirus (HPV)-related cancers, providers must effectively communicate with HPV vaccine-hesitant parents. Here, we developed a typology characterizing parent-provider communication around HPV vaccine hesitancy. METHODS: We audio-recorded 43 visits with unvaccinated adolescents at 6 pediatric clinics in Dallas, Texas in which parents were undecided about HPV vaccination. We qualitatively coded how parents verbally expressed hesitancy (assertive response, asking a question, or expressing concern) and whether providers responded with acquiescence (agree to defer vaccination) and/or persistence (continue discussion). We described the frequency of parent and provider communication codes and same-day vaccination. RESULTS: Among the 43 visits, 37 parents expressed hesitancy ≥1 times in many ways. Assertive responses were most common (27 visits), followed by questions (16 visits), and concerns (12 visits). When the first expression of hesitancy was a question or concern, 71% and 75% of adolescents, respectively, received same-day vaccinations, whereas 33% of adolescents who received an initial assertive response were vaccinated. Providers responded with only persistence in 18 visits, a mix of acquiescence and persistence in 13 visits, and only acquiescence in 6 visits. When providers only used persistence, 17 of 18 adolescents were vaccinated; when providers responded with only acquiescence, no adolescents received the vaccine. CONCLUSIONS: Our exploratory analysis reveals that providers engaging hesitant parents and addressing their concerns can lead to same-day HPV vaccination. Data reveal that even parents making assertive statements are amenable to influence by providers. Our findings reveal an important missed opportunity when providers simply acquiesce to parental hesitation.

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References

2014Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: A systematic review of published literature, 2007–2012 2014Effective Messages in Vaccine Promotion: A Randomized Trial 2012Communicating with parents about vaccination: a framework for health professionals 2008Parents With Doubts About Vaccines: Which Vaccines and Reasons Why 2006Qualitative Analysis of Mothers' Decision-Making About Vaccines for Infants: The Importance of Trust 2010Parental Vaccine Safety Concerns in 2009 2013A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy 2011Sources and Perceived Credibility of Vaccine-Safety Information for Parents

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2019Vaccination perspectives among adolescents and their desired role in the decision-making process 2018Variations in reason for intention not to vaccinate across time, region, and by race/ethnicity, NIS-Teen (2008–2016)2023Examining multilevel influences on parental HPV vaccine hesitancy among multiethnic communities in Los Angeles: a qualitative analysis 2021Health care provider trust in vaccination: a systematic review and qualitative meta-synthesis

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