Human papillomavirus vaccine initiation in an area with elevated rates of cervical cancer

J Adolesc Health. 2009 Nov;45(5):430-7. doi: 10.1016/j.jadohealth.2009.03.029. Epub 2009 Jun 24.


Purpose: We assessed human papillomavirus (HPV) vaccination of adolescent girls living in communities with elevated cervical cancer rates.

Methods: During July to October 2007, we conducted interviews with a probability sample of parents (or guardians) of 10- to 18-year-old girls in five North Carolina counties with cervical cancer rates substantially higher than the national average. Estimates are weighted.

Results: We interviewed 889 (73%) of 1220 eligible parents; 38% were black. Overall, 10.3% (95% confidence interval [CI] 7.7%-13.5%) of daughters had received at least 1 dose of HPV vaccine. Only 6.4% of 10- to 12-year-olds had initiated vaccination, versus 17.5% of 16- to 18-year-olds (odds ratio [OR] 3.1, 95% CI 1.4-6.9). Older age of daughters and doctor's recommendation were the only factors independently associated with vaccine initiation. Main reasons reported for not initiating HPV vaccine were: needing more information (22%) or never having heard of the vaccine (14%), believing daughter is too young (16%) or not yet sexually active (13%), and not having gone to the doctor yet (13%). Only 0.5% of parents cited concern about HPV vaccine making a teenage girl more likely to have sex as a main reason for not vaccinating. Of 780 parents with unvaccinated daughters, 62% reported their daughters "probably" or "definitely" will, and 10% reported their daughters "definitely won't" get HPV vaccine in the next year.

Conclusions: Approximately 1 year after its introduction, HPV vaccine had been initiated by only 10% of adolescent girls in an area with elevated cervical cancer rates; however, most parents intended for their daughters to be vaccinated. Additional efforts are needed to ensure that parents' intentions to vaccinate are realized.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Attitude to Health
  • Child
  • Female
  • Health Surveys
  • Humans
  • Immunization Programs / statistics & numerical data*
  • Interviews as Topic
  • Male
  • Middle Aged
  • North Carolina / epidemiology
  • Papillomavirus Vaccines / therapeutic use*
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / prevention & control*


  • Papillomavirus Vaccines