U.S. parents not in favor of HPV vaccine mandates

May 24 2007

While debate in several state governments continues to grow over school mandates for Gardasil – a vaccine recommended by the Centers for Disease Control and Prevention for girls ages 11 to 12 that is designed to provide protection against human papillomavirus, or HPV, the virus linked to cervical cancer and genital warts – the majority of U.S. parents have already reached a decision on the issue: They do not want the vaccine to be mandated.

According to a new report released today by the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health, only 44 percent of parents are in favor of a school mandate for the HPV vaccine. The report also reveals that parents with children older than 6 are less likely to support a HPV vaccine mandate.

“We found that a minority of U.S. parents are in favor of an HPV vaccine mandate for school entry, and that more than one-quarter of parents unequivocally disagree with HPV vaccine mandates,” says Matthew M. Davis, M.D., M.A.P.P., director of the National Poll on Children's Health, part of the U-M Department of Pediatrics and Communicable Diseases and the Child Health Evaluation and Research (CHEAR) Unit in the U-M Division of General Pediatrics.

While state mandates that require certain vaccinations upon school entry have provided an effective means to prevent the spread of infectious diseases such as mumps, measles, polio, whooping cough and chicken pox, they have become increasingly controversial – and the HPV vaccine, which also is licensed for females ages 13 to 26 and girls as young as 9, is no exception.

“In the case of the HPV vaccine, proponents of the mandates argue that states should encourage parents to prevent their daughters from getting cervical cancer caused by HPV infection, which is spread through sexual contact,” says Davis, associate professor of general pediatrics and internal medicine at the U-M Medical School, and associate professor of public policy at the Gerald R. Ford School of Public Policy. “Opponents, however, argue that the vaccine is expensive and that the infection can be prevented without vaccination.”

Although the CDC and the American Academy of Pediatrics support universal HPV vaccination for girls ages 11 to 12, neither supports school entry mandates for HPV vaccine. Still, 24 states, including the District of Columbia, have introduced bills to mandate the vaccine, and Virginia in early 2007 passed a law requiring HPV vaccination for entry into junior high school. But are mandates for the HPV vaccine what parents really want for their children?

To answer that questions, and gain more insight into parental opinion about new vaccines, the National Poll on Children's Health, in collaboration with Knowledge Networks, Inc., conducted a national online survey in March 2007. The survey was administered to a random sample of 2,076 adults, ages 18 and older, who are a part of Knowledge Network's online KnowledgePanelSM. The sample was subsequently weighted to reflect the U.S. population figures from the U.S. Census Bureau. About two-thirds of the sample were parents.

Parents were asked if they would support a state law that requires girls to get the HPV vaccine before entering into ninth grade. They also were asked if they would support a state law that would require boys and girls to get the new booster vaccine that protects against tetanus, diphtheria and whooping cough, or Tdap, before entering ninth grade.

The survey found that 68 percent of parents support a mandate for the Tdap vaccine, while only 44 percent are in favor of a mandate for the vaccine to protect against HPV. The National Poll on Children's Health also revealed that parents with children younger than 6 were more likely to support a mandate for the HPV vaccine than parents with children ages 6 to 12 or ages 13 to 17.

Most notably, 85 percent of parents surveyed feel that vaccines are a good way to protect their children from infectious disease, Davis says. It was parents' attitudes, however, about the safety of new vaccines that ultimately factor into their support of mandates for the HPV vaccine. While 43 percent of parents agree new vaccines are safe for children, nearly half of all parents feel neutral about the safety of new vaccines.

Not surprisingly, a higher proportion of parents who do not believe new vaccines are safe are opposed to a mandate for the HPV vaccine, compared with parents who view new vaccines as being safe.

Davis also notes that nearly 70 percent of the survey group lives in states with HPV vaccine mandates or pending HPV vaccine mandate legislation. Overall, he says, there were no significant differences in parents' opinions on state mandate for HPV vaccination when comparing parents in states with mandates or pending legislation, and those in states with no mandates or pending legislation. For the 25 states including D.C. with existing mandates or pending legislation, 45 percent of parents are in favor of mandates, while 42 percent of parents are in favor of mandates in states that have not introduced HPV mandate legislation.