Parental HPV vaccine hesitancy remains resilient despite slight decline and targeted efforts

A new analysis reveals that parental hesitation towards the HPV vaccine in the US persists at high levels, influenced by race, family background, and healthcare provider recommendations, with recent progress stalling.

A new analysis of U.S. survey data suggests that parental hesitation about the human papillomavirus vaccine has eased only modestly over the past decade, and that the pattern differs sharply by family background, race and whether a clinician recommended the shot.

Using the National Immunisation Survey-Teen, researchers examined responses from 218,335 parents of adolescents who had not started the HPV vaccine series between 2010 and 2022. They found that 134,717 of those parents, or 66.0%, were classed as hesitant, a figure that remained stubbornly high even as the share of hesitant parents fell from 72% in 2010 to 61% in 2022. The study was published in the journal Cancer and drew on a nationally representative sample of families with children aged 13 to 17.

The strongest divide was between families who had heard a recommendation from a health professional and those who had not. Parents whose child had not been advised to get the vaccine were significantly more likely to be hesitant. The researchers also found that parents of adolescents who were non-Hispanic Black or Hispanic had lower odds of hesitancy than parents of non-Hispanic White adolescents, and that families living below the poverty line were also less likely to be hesitant than those above it. Mothers with less than a high-school education and those who were not married were likewise less likely to be hesitant than college-educated or married mothers.

Trends over time were not uniform. According to the study, hesitation among parents of boys fell early in the period and then flattened, while parents of girls saw a longer-term decline that included a brief rise between 2012 and 2018 before falling again after 2018. Across racial and ethnic groups, most of the improvement came in the early years of the study, with little change after 2012 for many groups. The authors said the early drop may reflect the national expansion of routine HPV vaccination recommendations for boys in 2011, but they argued that later progress has stalled.

The findings come against a backdrop of persistent underuse of the vaccine nationwide. CDC data from the 2023 National Immunisation Survey-Teen showed that 61.4% of adolescents aged 13 to 17 were up to date on the HPV series, little changed from 62.4% the year before. In the 2024 survey, coverage edged up to 62.9%, still well short of the Healthy People 2030 target of 80% completion. The CDC has said continued efforts are needed to improve uptake, even as coverage for some other adolescent vaccines has improved.

The study’s authors said HPV vaccination remains the best way to prevent most cancers linked to the virus, which is common in the United States and associated with tens of thousands of new cancer cases each year. They argued that clinicians remain central to improving uptake, especially because provider recommendation was one of the clearest predictors of whether parents were willing to vaccinate. The broader message, they said, is that public health campaigns may have made early gains, but those gains have not been enough to eliminate deep-seated doubts that continue to shape vaccination decisions.