Social Networks for Human Papillomavirus Vaccine Advice Among African American Parents

Abstract

Purpose Despite that human papillomavirus (HPV) vaccination could prevent ~90% of HPV-associated cancers, only 60.6% of American adolescents initiate vaccination. African Americans have the highest prevalence of morbidity and mortality from HPV-associated cancers. Mounting evidence suggests that advice from social contacts is associated with vaccine acceptance. The current study examines the associations of social processes with HPV vaccine refusal among African American parents. Methods A cross sectional survey was conducted among African American parents of children ages 10–12 years prior to a healthcare visit at which HPV vaccine was offered by the healthcare provider. Data from the 353 parents who named at least one social contact who advised them about vaccines were included in these analyses. Results Only 54.4% of the participants consented to HPV vaccination for their children. On average, parents had 2 to 3 social contacts who provided vaccine advice. Vaccine advice networks were generally dense, family-centric, and homophilous. Slightly over 80% of all parents trusted family members and friends for vaccine advice “some or “a lot.” Controlling for sociodemographic characteristics and reason for the healthcare visit, perceived high exposure to anti-HPV vaccine viewpoints and low exposure to pro-HPV vaccine viewpoints were both associated with HPV vaccine refusal (AOR=1.5, 95% CI=1.01, 2.3, and AOR=1.7, 95% CI=1.2, 2.6, respectively). Conclusions Social processes may be associated with HPV vaccine refusal among African American parents. Interventions designed to educate African American parents about HPV vaccine to increase uptake should consider leveraging vaccine advice networks for greater impact.