ASPO Abstracts
HPV Vaccine Decision-Making in the Transition between Adolescence and Adulthood
Category: Behavioral Science & Health Communication
Conference Year: 2019
Abstract Body:
Purpose: Young adulthood is characterized by changes in health care decision-making, insurance coverage, and sexual risk. Although the human papillomavirus (HPV) vaccine is now approved for adults up to age 45, and catch up vaccination is currently recommended for women up to age 26 and men up to 21, vaccination rates remain low in young adults. This study explored perspectives on HPV vaccination among young adults receiving care at the student health center of a large public university.Methods: We conducted semi-structured interviews (n=27) and 4 focus groups (n=18) with undergraduate and graduate students and semi-structured interviews with health care providers (n=6). Interviews and focus groups explored perceived risk of HPV infection, benefits of the HPV vaccine, and motivations for and barriers to HPV vaccination. Results: Many young adults cited their parents as influential on their decision-making process. Some were hesitant to pursue the vaccine if they felt their parents did not approve. Others were unsure if they had already received the vaccine. Sexual history also affected vaccine motivation with abstinent respondents expressing lower motivation for vaccination, despite the fact that the vaccine is recommended for delivery before the sexual debut. Some participants were unsure of the value of the vaccine for men and at older ages. Barriers to vaccination included uncertainty over insurance coverage for the vaccine, concerns about balancing the vaccine schedule with school obligations, and potential side effects. Provider recommendation appeared influential on vaccine motivation. Women’s health providers expressed a strong motivation to vaccinate their patients. Primary care providers endorsed the vaccine’s importance, but perceived more challenges to vaccinating this age group. Strategies suggested by providers to increase vaccination included emphasizing its role in cancer prevention and offering the vaccine at every clinic visit. Conclusions: Although college may be an opportune time to reach young adults for HPV vaccination, obstacles including lack of awareness of vaccination status, concerns about losing insurance coverage before series completion, and discomfort with independent decision-making may impede vaccination during this time.
Keywords: Human papillomavirus vaccine; young adult; decision-making; health care access