Understanding the reasons why mothers do or do not have their adolescent daughters vaccinated against human papillomavirus

Ann Epidemiol. 2009 Aug;19(8):531-8. doi: 10.1016/j.annepidem.2009.03.011. Epub 2009 Apr 25.


Purpose: The objective of this study was to compare the reasons why mothers do or do not have their adolescent daughters vaccinated against HPV.

Methods: Mothers of vaccinated and unvaccinated 11- to 17-year-old girls seen during preventive care visits in outpatient family medicine or pediatric clinics underwent an audiotaped structured telephone interview that used open-ended questions to assess the reasons underlying maternal decisions about HPV vaccination. Qualitative methods categorized maternal responses into themes.

Results: Interviews of 52 mothers (19 declining vaccination, 33 accepting) identified several distinct factors underlying their decisions about HPV vaccination. Lack of knowledge about HPV, age-related concerns, and low perceived risk of infection were commonly cited reasons for declining vaccination. Desire to prevent illness, physician recommendation, and a high perceived risk of infection were commonly identified motivating factors. Both groups of mothers had significant concerns about vaccine safety. Locus of control (e.g., mother or daughter) of health-related decisions arose as a novel factor influencing this decision that had not been previously described in the context of HPV vaccination.

Conclusions: Addressing safety concerns, educating parents about the age-specific risk of HPV infection, and promoting strong physician recommendation for vaccination may be the most useful targets for future interventions to increase HPV vaccine utilization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Decision Making*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Middle Aged
  • Mothers / psychology*
  • Motivation
  • Papillomavirus Vaccines / administration & dosage*
  • Risk Assessment
  • Socioeconomic Factors
  • Vaccination / psychology*


  • Papillomavirus Vaccines