title: Parent attitudes about school requirements for human papillomavirus vaccine in high-risk communities of Los Angeles, California.
abstract: BACKGROUND
  Human papillomavirus (HPV) immunization requirements for school entry could increase HPV vaccine uptake but are controversial. This study assessed parents' attitudes about HPV immunization requirements.
  
  
  METHODS
  During October 2007 to June 2008, we conducted telephone surveys with 484 parents of girls attending middle/high schools serving communities in Los Angeles County with elevated cervical cancer rates.
  
  
  RESULTS
  Parents were mostly Hispanic (81%) or African American (15%); 71% responded in Spanish. Many parents did not know if HPV vaccine works well (42%) or is unsafe (41%). Overall, 59% of parents agreed that laws requiring HPV vaccination for school attendance "are a good idea." In multivariable analysis, African Americans and Hispanics responding in English were less likely than Hispanics responding in Spanish to agree (aOR 0.1, 95% CI: 0.1-0.3; aOR 0.4, 95% CI: 0.2-0.8, respectively). Parents were less likely to agree with these laws if they did not believe the vaccine works well (aOR 0.2, 95% CI: 0.1-0.5) but more likely to agree if they believed the vaccine is not "too new for laws like these" (aOR 4.5, 95% CI: 2.6-8.0). Agreement with laws increased to 92% when including agreement that "these laws are okay only if parents can opt out."
  
  
  CONCLUSIONS
  In this at-risk community, more than half of the parents agreed with HPV immunization requirements generally, and the vast majority agreed when including opt-out provisions.
  
  
  CONCLUSIONS
  Support for HPV vaccine requirements may depend on race/ethnicity and inclusion of opt-out provisions. Information about vaccine efficacy and safety may increase support and reduce uncertainty about HPV vaccine in high-risk populations.
authors.affiliation: Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Robitz
authors.forename: Sami L
authors.initials: SL
authors.lastname: Gottlieb
authors.forename: Christine J
authors.initials: CJ
authors.lastname: De Rosa
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Guerry
authors.forename: Nicole
authors.initials: N
authors.lastname: Liddon
authors.forename: Akbar
authors.initials: A
authors.lastname: Zaidi
authors.forename: Susan
authors.initials: S
authors.lastname: Walker
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.forename: Noel T
authors.initials: NT
authors.lastname: Brewer
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
mesh_terms: D000293:Adolescent; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015141:Los Angeles; D030361:Papillomavirus Infections / Q000517:prevention & control; D053918:Papillomavirus Vaccines; D010290:Parents; D012574:Schools / Q000331:legislation & jurisprudence*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control
chemical_list: D053918:Papillomavirus Vaccines