Trends in Reasons for Human Papillomavirus Vaccine Hesitancy: 2010-2020

Pediatrics. 2023 Jun 1;151(6):e2022060410. doi: 10.1542/peds.2022-060410.


Objectives: We sought to identify trends in the main reasons United States parents of unvaccinated children gave for not intending to vaccinate their adolescent children against HPV from 2010 to 2020. As interventions designed to increase vaccine uptake have been implemented across the United States, we predicted that reasons for hesitancy have changed over this period.

Methods: We analyzed data from the 2010 to 2020 National Immunization Survey-Teen, which included 119 695 adolescents aged 13 to 17 years. Joinpoint regression estimated yearly changes in the top five cited reasons for not intending to vaccinate using annual percentage changes.

Results: The five most frequently cited reasons for not intending to vaccinate included "not necessary," "safety concerns," "lack of recommendation," "lack of knowledge," and "not sexually active." Overall, parental HPV vaccine hesitancy decreased by 5.5% annually between 2010 and 2012 and then remained stable for the 9-year period of 2012 through 2020. The proportion of parents citing "safety or side effects" as a reason for vaccine hesitancy increased significantly by 15.6% annually from 2010 to 2018. The proportion of parents citing "not recommended," "lack of knowledge," or "child not sexually active" as reasons for vaccine hesitancy decreased significantly by 6.8%, 9.9%, and 5.9% respectively per year between 2013 and 2020. No significant changes were observed for parents citing "not necessary."

Conclusions: Parents who cited vaccine safety as a reason for not intending to vaccinate their adolescent children against HPV increased over time. Findings support efforts to address parental safety concerns surrounding HPV vaccination.

MeSH terms

  • Adolescent
  • Child
  • Health Knowledge, Attitudes, Practice
  • Human Papillomavirus Viruses
  • Humans
  • Papillomavirus Infections* / prevention & control
  • Papillomavirus Vaccines*
  • Parents
  • United States
  • Vaccination
  • Vaccination Hesitancy


  • Papillomavirus Vaccines