title: Reasons for not vaccinating adolescents: National Immunization Survey of Teens, 2008-2010.
abstract: OBJECTIVE
  To determine the reasons adolescents are not vaccinated for specific vaccines and how these reasons have changed over time.
  
  
  METHODS
  We analyzed the 2008-2010 National Immunization Survey of Teens examining reasons parents do not have their teens immunized. Parents whose teens were not up to date (Not-UTD) for Tdap/Td and MCV4 were asked the main reason they were not vaccinated. Parents of female teens Not-UTD for human papillomavirus vaccine (HPV) were asked their intent to give HPV, and those unlikely to get HPV were asked the main reason why not.
  
  
  RESULTS
  The most frequent reasons for not vaccinating were the same for Tdap/Td and MCV4, including "Not recommended" and "Not needed or not necessary." For HPV, the most frequent reasons included those for the other vaccines as well as 4 others, including "Not sexually active" and "Safety concerns/Side effects." "Safety concerns/Side effects" increased from 4.5% in 2008 to 7.7% in 2009 to 16.4% in 2010 and, in 2010, approaching the most common reason "Not Needed or Not Necessary" at 17.4% (95% CI: 15.7-19.1). Although parents report that health care professionals increasingly recommend all vaccines, including HPV, the intent to not vaccinate for HPV increased from 39.8% in 2008 to 43.9% in 2010 (OR for trend 1.08, 95% CI: 1.04-1.13).
  
  
  CONCLUSIONS
  Despite doctors increasingly recommending adolescent vaccines, parents increasingly intend not to vaccinate female teens with HPV. The concern about safety of HPV grew with each year. Addressing specific and growing parental concerns about HPV will require different considerations than those for the other vaccines.
authors.affiliation: Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. paul-darden@ouhsc.edu
authors.forename: Paul M
authors.initials: PM
authors.lastname: Darden
authors.forename: David M
authors.initials: DM
authors.lastname: Thompson
authors.forename: James R
authors.initials: JR
authors.lastname: Roberts
authors.forename: Jessica J
authors.initials: JJ
authors.lastname: Hale
authors.forename: Charlene
authors.initials: C
authors.lastname: Pope
authors.forename: Monique
authors.initials: M
authors.lastname: Naifeh
authors.forename: Robert M
authors.initials: RM
authors.lastname: Jacobson
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D022422:Diphtheria-Tetanus Vaccine; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D022401:Meningococcal Vaccines; D053918:Papillomavirus Vaccines; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D014481:United States; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data / Q000639:trends
chemical_list: D022422:Diphtheria-Tetanus Vaccine; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D022401:Meningococcal Vaccines; D053918:Papillomavirus Vaccines