Participation in the decision to become vaccinated against human papillomavirus by California high school girls and the predictors of vaccine status

J Pediatr Health Care. Jan-Feb 2010;24(1):14-24. doi: 10.1016/j.pedhc.2008.11.004. Epub 2009 Jun 4.


Background: State and national policymakers are actively debating the merits of legally mandating the human papillomavirus (HPV) vaccine.

Methods: This was a cross-sectional pilot study designed to identify factors associated with HPV vaccination in 170 high school girls and the decision making by girls about vaccination.

Results: Overall, 48.4% participated in the vaccination decision making and 37.8% were vaccinated, but there were significant vaccine-related knowledge gaps. Girls often lacked basic knowledge necessary to make vaccine decisions. Vaccination was significantly associated with older age, vaccine information sources, and higher vaccine-related knowledge, but not with estimates of risk of HPV-related diseases, religion, or frequency of health care visits.

Conclusions: This paper describes the first study to have identified factors associated with HPV vaccination among California high school girls and to have documented that a high percentage are participating in the vaccination decision making. These findings have implications for adolescent health education and nursing practice and provide new information relevant to the current public policy debates about mandatory vaccination.

MeSH terms

  • Adolescent
  • Analysis of Variance
  • Cross-Sectional Studies
  • Decision Making*
  • Dissent and Disputes
  • Educational Measurement
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Mandatory Programs
  • Nursing Methodology Research
  • Papillomavirus Vaccines*
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Education as Topic
  • Patient Participation / psychology
  • Patient Participation / statistics & numerical data
  • Pilot Projects
  • Psychology, Adolescent
  • San Francisco
  • Socioeconomic Factors
  • Students / psychology*
  • Students / statistics & numerical data
  • Vaccination / psychology*
  • Vaccination / statistics & numerical data


  • Papillomavirus Vaccines