title: Vaccine hesitancy among parents of adolescents and its association with vaccine uptake.
abstract: BACKGROUND
  Addressing parental vaccine hesitancy may increase adolescent vaccination acceptance. However, no validated measure exists to identify parents hesitant toward adolescent vaccines.
  
  
  OBJECTIVE
  To determine if a modified version of the Parent Attitudes about Childhood Vaccines (PACV) survey, a previously validated tool to identify parental hesitancy toward vaccines in infants, predicts adolescent vaccine uptake at office visits.
  
  
  METHODS
  We modified the PACV for use in the adolescent setting and distributed it to a convenience sample of parents of adolescents aged 11 to 17 presenting for care at a diverse group of six pediatric practices in Oklahoma and South Carolina. We determined the vaccination status of the parents' adolescents for 3 vaccines (Tetanus-diphtheria-acellular pertussis [Tdap], meningococcal conjugate [MCV4], and human papillomavirus [HPV] vaccines). We used Fisher's exact tests to compare vaccination status with each survey item and with an overall general hesitancy scale that we constructed.
  
  
  RESULTS
  We analyzed 363 surveys. At the time of the visit, vaccination coverage was 84% for Tdap, 73% for MCV, and 45% for any dose of HPV. Thirty-nine percent of parents expressed concern about vaccine efficacy and 41% expressed concern about side effects. Forty-five percent of parents disagreed with the statement that "teens can get all of the vaccines that are due at a single visit." Two individual items were associated with not receiving a dose of HPV vaccine that was due. The overall modified PACV score failed to predict adolescent vaccine uptake at an office visit.
  
  
  CONCLUSIONS
  Several individual items were associated with vaccine uptake. The cumulative modified PACV, a general measure of vaccine hesitancy, was not associated with vaccination status despite illuminating parental hesitancy. We need to better understand vaccine-specific concerns for the adolescent population.
authors: Medical University of South Carolina, Department of Pediatrics, 135 Rutledge Ave, MSC 561, Charleston, SC 29425, USA. Electronic address: robertsj@musc.edu.
authors: James R
authors: JR
authors: Roberts
authors: University of Oklahoma Health Sciences Center, Department of Pediatrics, Section of General and Community Pediatrics, 1200 Children's Avenue, OUCPB Suite 12400, Oklahoma City, OK 73104, USA.
authors: David
authors: D
authors: Thompson
authors: University of Oklahoma Health Sciences Center, Department of Pediatrics, Section of General and Community Pediatrics, 1200 Children's Avenue, OUCPB Suite 12400, Oklahoma City, OK 73104, USA.
authors: Brianna
authors: B
authors: Rogacki
authors: University of Oklahoma Health Sciences Center, Department of Pediatrics, Section of General and Community Pediatrics, 1200 Children's Avenue, OUCPB Suite 12400, Oklahoma City, OK 73104, USA.
authors: Jessica J
authors: JJ
authors: Hale
authors: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Desk Ba3b, 200 First St SW, Rochester, MN 55905-0001, USA.
authors: Robert M
authors: RM
authors: Jacobson
authors: Seattle Children's Research Institute, JMB-6 Clinical and Translational Research, 1900 9th Ave, Seattle, WA 98101, USA.
authors: Douglas J
authors: DJ
authors: Opel
authors: University of Oklahoma Health Sciences Center, Department of Pediatrics, Section of General and Community Pediatrics, 1200 Children's Avenue, OUCPB Suite 12400, Oklahoma City, OK 73104, USA.
authors: Paul M
authors: PM
authors: Darden
mesh_terms: D000293:Adolescent; D002648:Child; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D022401:Meningococcal Vaccines / Q000008:administration & dosage; D009825:Oklahoma; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D010290:Parents / Q000523:psychology; D010342:Patient Acceptance of Health Care; D013022:South Carolina; D014611:Vaccination / Q000523:psychology*
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D022401:Meningococcal Vaccines; D053918:Papillomavirus Vaccines
keywords: Adolescent; Hesitancy; Immunization; Parent; Vaccine