Temporal Patterns of Human Papillomavirus Vaccine Safety Concerns from NIS-Teen, 2008-2012. Open Access

Wurster, Jessica Lee (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/pr76f402c?locale=en


Background: The HPV vaccine is the first vaccine targeted to prevent cervical cancer, but it is sub-optimally used. We sought to test the hypothesis that parental safety concerns leading to non-vaccination were proportionally higher among HPV vaccine non-recipients compared to tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine and meningococcal conjugate (MCV4) vaccine non-recipients.

Methods: We analyzed the CDC National Immunization Survey-Teen (NIS-Teen) public use data files for years 2008 through 2012. The proportion of parents who reported safety concerns as the main reason for not vaccinating was compared between HPV and MCV4, and HPV and Tdap vaccines using a chi square test for each year. For year 2012, reasons for not vaccinating adolescents for HPV were evaluated between three groups: 1) those who received Tdap and MCV4 vaccines, but not HPV, 2) those who received Tdap or MCV4 but not HPV and 3) those who had not received Tdap, MCV4, and HPV. We used a log binomial regression to evaluate changes in the frequency of citing safety concerns relative to the level in 2008.

Results: Parental safety concerns as a reason for non-vaccination were higher for HPV vaccine non-recipients compared to both MCV4 and Tdap non-recipients across all years 2008 to 2012. Among parents of adolescents who received zero HPV vaccines and were not up to date for Tdap, the proportion of parents citing safety concerns as the main reason for non-vaccination was significantly higher for the HPV vaccine compared to MCV4 for all years and Tdap in all years except for 2008 (p=0.1165). There was a significant difference among parents who indicated safety concerns as the primary reason for not vaccinating their adolescent for HPV between those who have received Tdap and MCV4, but not HPV (12.4%) to those who had not received Tdap, MCV4 nor HPV (7.6%, p<0.0001).

Conclusions: Significantly higher safety concerns among the HPV vaccine compared to MCV4 and Tdap indicate that education about the documented safety of the HPV vaccine is needed by both parents and health care providers to combat the fear of safety concerns.

Table of Contents



Study Population & Data Source...3

Comparison of Safety Concerns between MCV4, Tdap, and HPV Vaccines...4

Comparison of Non-Vaccination Reasons for HPV...4

Changes in Safety Concerns...4

Statistical Analysis...5


Study Population Characteristics...6

Comparison of Safety Concerns between MCV4, Tdap, and HPV Vaccines...6

Comparison of Non-Vaccination Reasons for HPV...7

Changes in Safety Concerns...7





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