Acceptance of human papillomavirus vaccination among Californian parents of daughters: a representative statewide analysis

J Adolesc Health. 2007 Feb;40(2):108-15. doi: 10.1016/j.jadohealth.2006.10.007. Epub 2006 Dec 6.


Purpose: To examine likelihood of parental acceptance of human papillomavirus (HPV) vaccination for young adolescent girls, together with reasons for acceptance and nonacceptance. The ultimate goal of this research is to inform policy decisions and educational planning in this area.

Methods: A random-digit-dial telephone survey of parents in California households was conducted, yielding 522 parents with an eligible daughter. Cross tabulations and odds ratios were employed to analyze likelihood of vaccination acceptability. Reasons provided for acceptance or nonacceptance were analyzed qualitatively.

Results: Overall, 75% of the sample reported that they would be likely to vaccinate a daughter before age 13 years. Hispanic parents were more likely to accept vaccination than were non-Hispanic parents, whereas African-American and Asian-American parents were less likely. Other subgroups less likely to accept vaccination were identified. Five clusters of reasons by nonaccepting parents emerged: pragmatic concerns about effects on sexual behavior, specific HPV vaccine concerns, moral concerns about sexual behavior, general vaccine concerns, and denial of need. A sixth group of interest comprised those who would vaccinate before age 16 years, but not age 13.

Conclusions: Consistent with previous studies on this topic, a large majority of California parents endorsed HPV vaccination for daughters by the recommended age. Although important subgroup disparities were found, majorities of all subgroups supported vaccination. This information, together with the identified clusters of cognitive decision factors for nonacceptance, has implications for policy decisions and educational planning in this area. Suggestions for further research on subgroup disparities and on cognitive factors involved in parents' decisions arise from these findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health*
  • Chi-Square Distribution
  • Child
  • Demography
  • Female
  • Health Promotion
  • Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Papillomavirus Infections / prevention & control*
  • Papillomavirus Infections / psychology
  • Papillomavirus Vaccines*
  • Parents / psychology*
  • Patient Acceptance of Health Care* / psychology
  • Sexually Transmitted Diseases / prevention & control
  • Surveys and Questionnaires
  • United States


  • Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18
  • Papillomavirus Vaccines