Associations between risk-perception, self-efficacy and vaccine response-efficacy and parent/guardian decision-making regarding adolescent HPV vaccination

OBJECTIVES: To evaluate associations of risk perception, self-efficacy and response-efficacy with HPV vaccination decisions among parents/guardians of adolescents. METHODS: A cross-sectional survey of parents/guardians of adolescents was conducted at the Minnesota State Fair. Risk perception was measured by participant rankings of HPV infection and vaccine risks against diseases/side-effects for which numerical risks were provided. Response efficacy was measured as perceived ability of the vaccine to prevent HPV infection, and self-efficacy was measured as the perceived ability to prevent infection without vaccination (scale 0–100). Chi-squared and Fisher's exact tests compared risk perception, self-efficacy and response-efficacy of vaccinators to non-vaccinators. RESULTS: Of 405 eligible participants, 355 completed vaccination questions; 304 (86%) were vaccinators and 51 (14%) were non-vaccinators. Non-vaccinators had lower risk-perception of HPV-related cancers (p < 0.05) and higher risk-perception of vaccine-related side-effects (p < 0.05). Self-efficacy was higher (64 ± 24 vs. 30 ± 29; p < 0.0001) and perceived HPV vaccine response efficacy was lower (52 ± 31 vs. 83 ± 19; p < 0.0001) among non-vaccinators compared to vaccinators. CONCLUSIONS: Lower HPV-related cancer risk perception and higher self-efficacy were associated with the decision not to vaccinate. HPV vaccination decisions were similar to meningococcal vaccination decisions, suggesting reluctance to vaccinate in general rather than resistance to the HPV vaccine specifically drove the results.