HPV Vaccination Hesitancy Among Latina Immigrant Mothers Despite Physician Recommendation

Purpose: Human papillomavirus (HPV) vaccination uptake continues to be low in the United States. While a recommenda­tion from a health care provider (HCP) has been shown to be associated with vaccine acceptability among parents, little is known about factors associated with hesitancy despite HCP recommendation. We exam­ined factors associated with HPV vaccine hesitancy, despite a physician recommenda­tion, among Latina immigrant mothers of daughters aged 9-12 years.Methods: As part of a group randomized trial to promote HPV vaccination between 2013 and 2016, we conducted a baseline interviewer-administered survey of mothers to assess sociodemographics, knowledge and perceived risk of cervical cancer/HPV infection, self-efficacy, and intention to vaccinate their unvaccinated daughters. Hesitancy was defined as “don’t know/not sure” (DK/NS) in response to the question: “If your daughter’s doctor recommended that she gets the HPV vaccine, would you let her get it?”Results: Of the 317 participants, 35.3% indicated hesitancy to vaccinate their daughters if their physician recommended it. Although a number of variables were as­sociated with HPV vaccine hesitancy in the univariate model, five remained significant in the final multivariable model: daughter’s health insurance status; HPV awareness; perceived risk of HPV infection for their daughters; perceived self-risk of cervical cancer; and a self-efficacy score of ability to complete the HPV vaccination series.Conclusions: A recommendation by a health care provider may be not enough to motivate Latina immigrant mothers to vaccinate their daughters. Further efforts should focus on increasing awareness re­garding HPV and cervical cancer, heighten­ing perceived risk of HPV infection among daughters and boosting self-efficacy to get their children vaccinated against HPV.Ethn Dis. 2020; 30(4):661-670; doi:10.18865/ed.30.4.661