Low rates of free human papillomavirus vaccine uptake among young women
Gregory R. Moore A B C , Richard A. Crosby B D E , April Young B and Richard Charnigo BA University Health Service, University of Kentucky, 830 South Limestone, Lexington, KY 40536-0582, USA.
B College of Public Health, University of Kentucky, 121 Washington Avenue, Lexington, KY 40536-0003, USA.
C College of Medicine, University of Kentucky, 740 South Limestone Street, Lexington, KY 40508, USA.
D Rural Cancer Prevention Center, University of Kentucky, 138 Leader Avenue, Lexington, KY 40506-9983, USA.
E Corresponding author. Email: Crosby@uky.edu
Sexual Health 7(3) 287-290 https://doi.org/10.1071/SH09136
Submitted: 2 December 2009 Accepted: 25 February 2010 Published: 19 August 2010
Abstract
Objective: To determine uptake of quadrivalent human papillomavirus recombinant vaccine (quadrivalent; Gardasil®, Merck, New Jersey, USA) offered under optimal conditions to women 18 to 24 years of age, and to identify predictors of uptake. Methods: Young women (n = 209) were recruited from a university health clinic. After completing a self-administered questionnaire, women received a free voucher for the entire vaccine series. Results: Only 59 women (28.2%) who were offered this free service completed the series. Just over half (50.7%) received the first dose. Of those, 78.3% returned to receive the second and 55.7% returned for the third. Young women who felt their mothers might not want them to be vaccinated were much less likely to complete the series compared with those who felt their mothers would ‘definitely’ want them to be vaccinated (P = 0.0002). Also, young women who indicated that they would take the time to return to the clinic for doses two and three were far more likely to complete the series (P = 0.0004). Several measures failed to achieve even bivariate significance with vaccine uptake, including being sexually active in the past 12 months, ever having a Pap test or an abnormal Pap test result, and ever having a sexually transmissible infection. Conclusions: Even under ideal conditions, uptake of Gardasil among women 18–24 years of age may be quite low. Maternal endorsement and young women’s perceptions about the time needed to return for subsequent doses are important determinants of vaccine uptake. Fortunately, these two determinants lend themselves to intervention efforts.
Additional keyword: female university students.
Acknowledgements
This study was supported, in part, by the William Gallion Family Foundation through the University of Kentucky’s Markey Cancer Center. Dr Moore has worked as a consultant for Merck & Co.
[1] Charo RA. Politics, parents, and prophylaxis: Mandating HPV vaccination in the United States. N Engl J Med 2007; 356 1905–8.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed | [verified July 2006].
[4] Markowitz LE, Dunne EF, Saraiya M, Lawson HW, Chesson J, Unger ER. Quadrivalent human papillomavirus vaccine: Recommendations of the advisory committee on immunization practices. MMWR Morb Mort Wkly Rev 2007; 56 1–24.
[5] Zimet GD. Improving adolescent health: focus on HPV vaccine acceptance. J Adolesc Health 2005; 37 S17–23.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[6] Zimet G, Mays RM, Fortenberry JD. Vaccines against sexually transmitted infections: promise and problems of the magic bullets for prevention and control. Sex Transm Dis 2000; 27 49–52.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[7] Crosby RA, Schoenberg N, Hopenhayn C, Moore G, Melhan W. Correlates of intent to be vaccinated against HPV: An exploratory study of college-age women. Sex Health 2007; 4 71–3.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[8] Gerend MA, Magloire ZF. Awareness, knowledge, and beliefs about human papillomavirus in a racially diverse sample of young adults. J Adolesc Health 2008; 42 237–42.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[9] Jones M, Cook R. Intent to receive an HPV vaccine among university men and women and implications for vaccine administration. J Am Coll Health 2008; 57 23–32.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[10] Conroy K, Rosenthal SL, Zimet GD, Jin Y, Bernstein DI, Glynn S, et al. Human papillomavirus vaccine uptake, predictors of vaccination, and self-reported barriers to vaccination. J Women’s Health 2009; 18 1679–86.
| Crossref | GoogleScholarGoogle Scholar |
[11] Neubrand TP, Breitkopf CR, Rupp R, Breitkopf D, Rosenthal SL. Factors associated with completion of the human papillomavirus vaccine series. Clin Pediatr 2009; 48 966–9.
| Crossref | GoogleScholarGoogle Scholar |
[12] Jain N, Euler G, Shefer A, Lu P, Yankey D, Markowitz L. Human papillomavirus (HPV) awareness and vaccination initiation among women in the United States National Immunization Survey – Adult 2007. Prev Med 2009; 48 426–31.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[13] Caskey R, Lindau ST, Alexander GC. Knowledge and early adoption of the HPV vaccine among girls and young women: results of a national survey. J Adolesc Health 2009; 45 453–62.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[14] Brabin L, Roberts SA, Stretch R, Baxter D, Chambers G, Kitchener H, et al. Uptake of first two doses of human papillomavirus vaccine by adolescent schoolgirls in Manchester: prospective cohort study. BMJ 2008; 336 1056–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[15] Weinstock HS, Bolan G, Moran JS, Peterman TA, Polish L, Reingold AL. Routine hepatitis B vaccination in a clinic for sexually transmitted diseases. Am J Public Health 1995; 85 846–9.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[16]
[17] DiClemente RJ, Wingood GM, Crosby RA, Cobb BK, Harrington K, Davies SL. Parent-adolescent communication about sexuality-related topics and adolescents’ risky sexual behaviors, communication with sex partners, and self-efficacy to discuss sexuality-related issues with sex partners. J Pediatr 2001; 139 407–12.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[18] Crosby RA, DiClemente RJ, Wingood GM, Cobb BK, Harrington K, Davies SL, et al. STD-protective benefits of living with moms in supportive families: A study of high-risk African American female teens. Prev Med 2001; 33 175–8.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[19] Slomovitz BM, Sun CC, Frumovitz M, Soliman PT, Schmeler KM, Pearson HC, et al. Are women ready for the HPV vaccine? Gynecol Oncol 2006; 103 151–4.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[20] Waller J, Marlow LAV, Wardle J. Mother’s attitudes towards preventing cervical cancer through human papillomavirus vaccination: A qualitative study. Cancer Epidemiol Biomarkers Prev 2006; 15 1257–61.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[21] Lazcano-Ponce E, Rivera L, Arillo-Santillán E, Salmerón J, Hernández-Avila M, Muñoz N. Acceptance of Human Papillomavirus (HPV) trial vaccine among mothers of adolescents in Cuernavaca, Mexico. Arch Med Res 2001; 32 243–7.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |