title: Human papillomavirus vaccine initiation in an area with elevated rates of cervical cancer.
abstract: OBJECTIVE
  We assessed human papillomavirus (HPV) vaccination of adolescent girls living in communities with elevated cervical cancer rates.
  
  
  METHODS
  During July to October 2007, we conducted interviews with a probability sample of parents (or guardians) of 10- to 18-year-old girls in five North Carolina counties with cervical cancer rates substantially higher than the national average. Estimates are weighted.
  
  
  RESULTS
  We interviewed 889 (73%) of 1220 eligible parents; 38% were black. Overall, 10.3% (95% confidence interval [CI] 7.7%-13.5%) of daughters had received at least 1 dose of HPV vaccine. Only 6.4% of 10- to 12-year-olds had initiated vaccination, versus 17.5% of 16- to 18-year-olds (odds ratio [OR] 3.1, 95% CI 1.4-6.9). Older age of daughters and doctor's recommendation were the only factors independently associated with vaccine initiation. Main reasons reported for not initiating HPV vaccine were: needing more information (22%) or never having heard of the vaccine (14%), believing daughter is too young (16%) or not yet sexually active (13%), and not having gone to the doctor yet (13%). Only 0.5% of parents cited concern about HPV vaccine making a teenage girl more likely to have sex as a main reason for not vaccinating. Of 780 parents with unvaccinated daughters, 62% reported their daughters "probably" or "definitely" will, and 10% reported their daughters "definitely won't" get HPV vaccine in the next year.
  
  
  CONCLUSIONS
  Approximately 1 year after its introduction, HPV vaccine had been initiated by only 10% of adolescent girls in an area with elevated cervical cancer rates; however, most parents intended for their daughters to be vaccinated. Additional efforts are needed to ensure that parents' intentions to vaccinate are realized.
authors.affiliation: Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. sgottlieb@cdc.gov
authors.forename: Sami L
authors.initials: SL
authors.lastname: Gottlieb
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
authors.forename: Maya R
authors.initials: MR
authors.lastname: Sternberg
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.forename: Karen
authors.initials: K
authors.lastname: Ziarnowski
authors.forename: Nicole
authors.initials: N
authors.lastname: Liddon
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002648:Child; D005260:Female; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D053918:Papillomavirus Vaccines