Study: HPV Vaccine Hesitancy Increasing in Hispanic Communities

Vaccine hesitancy has been prominent in the United States in response to COVID-19, but resistance to vaccination has been presenting public health challenges long before the start of the pandemic.

A new study found that while hesitancy about the human papillomavirus (HPV) vaccine had been declining for several years, it later stabilized—and even increased—in certain subgroups. In Hispanic communities, almost two-thirds of the parents included in the study remained hesitant about the HPV vaccine as of 2019.

The study’s findings were presented at the 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved in early October.

The HPV Vaccine

The HPV vaccine is given to adolescents to prevent cervical cancer—which has a higher incidence rate in Hispanic communities—as well as several other cancer types including anal, penile, vulvar, vaginal, and oropharyngeal cancers.

More than 135 million doses of the HPV vaccine have been distributed in the United States since it was approved by the U.S. Food and Drug Administration (FDA), in 2006. According to the Centers for Disease Control and Prevention (CDC), robust data have demonstrated that HPV vaccines are safe and effective.

The HPV vaccine is given in two doses and just like any other vaccine or medication, can have side effects. The most common side effects of the HPV vaccine that have been reported to the CDC's Vaccine Adverse Event Reporting System (VAERS) are:

• Pain
• Redness or swelling in the arm where the vaccine was given
• Dizziness
• Fainting (syncope)
• Nausea
• Headache

With the exception of fainting (which is more common in adolescents after receiving any vaccine, not just the HPV vaccine), there have been no confirmed adverse events occurring at higher than expected rates following HPV vaccination, according to the CDC.

The Study

The new study tracked parental opinion about the HPV vaccine using data from the 2010–2019 National Immunization Survey (NIS)–Teen.

The researchers identified 16,383 adolescents who had not received the HPV vaccine and asked their parents how likely it was that their teen would receive HPV shots in the next 12 months.

The parents who responded “not too likely,” “not likely at all,” or “not sure/don’t know” were deemed to be vaccine-hesitant.

The result showed that while HPV vaccine hesitancy decreased from approximately 69% in 2010 to 63% in 2019, there were certain subgroups seeing stalled or even increased rates of hesitancy.

Mothers with Hispanic children saw an average hesitancy decrease of 6.24% per year from 2010 to 2013, but an average increase of 1.19% per year from 2013 to 2019.

Vaccine hesitancy also decreased among mothers with male adolescents, mothers aged 35-44, mothers over 45, mothers who had a college degree/higher or high school diploma, and married mothers—but eventually began to stabilize. 

“I expected hesitancy to be decreasing, albeit not drastically, but still decreasing rather than being stable or even increasing slightly,” Eric Adjei Boakye, PhD, MA, lead author of the study, tells Verywell. 

In the first couple of years, Adjei Boakye says that the decrease was expected because the vaccine “had just approved for adolescent boys and there was a lot of communication about it.”

However, Adjei Boakye thinks that “we focused so much on getting people to receive the vaccination and forgot to put the same focus on those who were hesitant. The practices that worked well for the general population may not work for vaccine-hesitant individuals.”

Reasons for Hesitancy 

Melva Thompson-Robinson, DrPH, a professor of social and behavioral health at the University of Nevada Las Vegas, tells Verywell that there are many factors that drive vaccine hesitancy, particularly within Hispanic communities.

“First and foremost is that there is an underlying lack of trust of the government and healthcare providers who are providing these vaccinations,” says Thompson-Robinson. “In some cases, over the years, communities of color have been experimented on without their permission. In other cases, healthcare providers base care on assumptions about patients from communities of color without checking the facts.”

According to Thompson-Robinson, vaccine hesitancy can also be the result of a “lack of access to vaccines and care” which can lead to people feeling “suspicious about things that are not readily available in their community.”

With the HPV vaccine specifically, Thompson-Robinson says that parents are often not willing to accept that their child might be sexually active, or they falsely believe that giving their child the shot will encourage them to become sexually active. Talking about sexually transmitted infections (STIs) also carries a stigma, and parents may assume that their child would not associate with anyone who has or might be at risk for STIs.

Adjei Boakye says that more hesitancy in these communities could also be driven by language barriers, health care access barriers, lack of knowledge, or lack of recommendations from healthcare providers.

“It is possible there are cultural barriers too,” says Adjei Boakye. “Future research should try to understand the nuances behind this subgroup.”

Addressing Barriers

To tackle these barriers, Adjei Boakye says that we need to develop culturally sensitive education programs, which would ideally be delivered by other Hispanic individuals.

Healthcare providers should also continue to recommend and educate Hispanic parents about the cancer prevention benefits of the vaccine. Adjei Boakye also says that the HPV vaccine should be taken directly into these communities whenever possible to address transportation barriers.

Misinformation, particularly on social media, must also be addressed—especially in light of the increase in the circulation of false health-related information amid the pandemic.

“As a public health community, we need to understand who is vaccine-hesitant and why,” says Thompson-Robinson. “We then need to tailor our messaging and education to address the issues and concerns that give rise to vaccine hesitancy.”

Thompson-Robinson says that it’s also up to healthcare providers to “meet their patients where they are and more thoroughly explain why these vaccines are needed and address the potential side effects that one may experience. Parents are needing more transparency around HPV vaccination so that they can make better decisions for their children.”