Impact of a physician recommendation and parental immunization attitudes on receipt or intention to receive adolescent vaccines

Hum Vaccin Immunother. 2013 Dec;9(12):2627-33. doi: 10.4161/hv.25823. Epub 2013 Jul 24.


Four vaccines are recommended by the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices for adolescents. Parental attitudes may play a key role in vaccination uptake in this age group. In 2011, we conducted a cross-sectional survey among parents of adolescents in one county in Georgia to identify parental attitudes toward adolescent vaccination, reasons for vaccine acceptance or refusal, and impact of a physician recommendation for vaccination. Physician recommendation was reported as one of the top reasons for receipt or intent to receive any of the vaccines. Physician recommendation of any of the four vaccines was associated with receipt of Tdap (p<0.001), MCV4 (p<0.001), and HPV (p = 0.03) and intent to receive Tdap (p = 0.05), MCV4 (p = 0.005), and HPV (p = 0.05). Compared with parents who did not intend to have their adolescent vaccinated with any of the vaccines, parents who did intend reported higher perceived susceptibility (3.12 vs. 2.63, p = 0.03) and severity of disease (3.89 vs. 3.70, p = 0.02) and higher perceived benefit of vaccination (8.48 vs. 7.74, p = 0.02). These findings suggest that future vaccination efforts geared toward parents may benefit from addressing the advantages of vaccination and enhancing social norms. Physicians can play a key role by providing information on the benefits of adolescent vaccination.

Keywords: adolescent; attitudes; health belief model; theory of reasoned action; vaccine.

Publication types

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

MeSH terms

  • Adolescent
  • Child
  • Cross-Sectional Studies
  • Diphtheria-Tetanus-acellular Pertussis Vaccines / administration & dosage*
  • Female
  • Georgia
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Meningococcal Vaccines / administration & dosage*
  • Papillomavirus Vaccines / administration & dosage*
  • Parents / psychology*
  • Patient Acceptance of Health Care / psychology*
  • Physician-Patient Relations*
  • Vaccination / psychology
  • Vaccination / statistics & numerical data*


  • Diphtheria-Tetanus-acellular Pertussis Vaccines
  • Meningococcal Vaccines
  • Papillomavirus Vaccines