HealthDay News — Concern about safety was one of the most commonly given reasons among parents who choose not to have their teenage daughters immunized against human papillomavirus (HPV), along with the perception that their child was not yet sexually active, results from a national survey indicate.

More than 40% of parents who participated in the National Immunization Survey of Teens from 2008 through 2010 reported they did not intend to vaccinate their adolescent female children to protect against HPV, Paul Darden, MD, of the University of Oklahoma Health Sciences Center in Oklahoma City, and colleagues reported in Pediatrics.

To determine the thought process behind vaccination refusal, the researchers surveyed parents who said their teens did not complete the three-shot HPV vaccine series, as well as those who said their children had not been vaccinated for tetanus toxoid, diphtheria toxoid, and acellular pertussis/tetanus toxoid and reduced diphtheria toxoid (Tdap/Td), or quadrivalent meningococcal conjugate vaccine (MCV4).

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Reasons for refusing the HPV vaccine differed from those given for other vaccines, they found. For the Tdap/Td vaccine parents most commonly stated that the vaccines were “not recommended” and “not needed or not necessary.”

Meanwhile, among those who refused the HPV vaccine, the percentage concerned about “safety concerns/side effects” rose from 4.5% in 2008 to 7.7% in 2009 to 16.4% in 2010 — approaching the most commonly cited reason that the vaccine is “not needed or not necessary” at 17.4%.

The percentage of parents intending not to vaccinate their children against HPV rose from 39.8% in 2008 to 43.9% in 2010, despite the fact that clinicians are increasingly recommending the vaccine.

The proportion of parents who reported their healthcare provider recommended the HPV vaccine rose from 46.8% in 2008 to 52.4% in 2010, survey data indicate.

“Addressing specific and growing parental concerns about HPV will require different considerations than those for the other vaccines,” the researchers wrote.

Study limitations include reliance on parent survey and parental reporting without verifying vaccination status through a healthcare provider survey, and the cross-sectional design, which compared three distinct cohorts across multiple years


  1. Darden PM et al. Pediatrics. 2013; 131: 645–651.