How Can We Communicate About Vaccines With Adolescents and Their Parents?

Abstract

Objective: To describe parents’ and adolescents’ perceptions about vaccination. Methods: Qualitative interviews of 22 mothers/grandmothers and 25 10- to 14-year-olds. Results: Themes emerged in 3 focus areas. (a) Understanding: Both adults and adolescents had difficulty understanding concepts of risks, benefits, prevention, and vaccination. (b) Decision making: Adults saw vaccination as an opportunity to help their adolescent develop skills for transition to adulthood. Adolescents worried about being lied to (reinforced by being told “it won’t hurt”), physical pain, and cleanliness. ( c) Preventing sexually transmitted infections: Adults were divided between those who felt their child would not need such a vaccine and those who wanted to “be safe” to protect their child in the future. Conclusions: At the same time that even basic concepts about vaccination should be explained to both adults and adolescents, adolescence represents a time for learning about responsible decision making. Discussion regarding the risks and benefits of vaccines can be part of transitioning to adult decision making.

Keywords

vaccination immunization adolescent

Get full access to this article

View all access options for this article.

References

Middleman AB , Rosenthal SL , Rickert VI , Neinstein L. , Fishbein DB , D’Angelo L. ; Society for Adolescent Medicine. Adolescent immunizations: A position paper of the Society for Adolescent Medicine. J Adolesc Health. 2006;38:321-327.

Fishbein DB , Broder KR , Markowitz L. , Messonnier N. New, and some not-so-new, vaccines for adolescents and diseases they prevent . Pediatrics. 2008;121(suppl 1): S5-S14.

Ball LK , Evans G. , Bostrom A. Risky business: challenges in vaccine risk communication. Pediatrics. 1998;101:453-458.

Benin AL , Wisler-Scher DJ , Colson E. , Shapiro ED , Holmboe ES Qualitative analysis of mothers’ decision-making about vaccines for infants: the importance of trust. Pediatrics. 2006;117:1532-1541.

Parikh RK

Fighting for the reputation of vaccines: lessons from

American politics. Pediatrics. 2008;121:621-622.

Farrell RM , Rome ES Adolescents’ access and consent to the human papillomavirus vaccine: a critical aspect for immunization success. Pediatrics. 2007;120:434-437.

Millstein SG , Halpern-Felsher BL Perceptions of risk and vulnerability. J Adolesc Health. 2002;31(1 suppl):10-27.

Hoover DR , Carfioli B. , Moench EA Attitudes of adolescent/young adult women toward human papillomavirus vaccination and clinical trials. Health Care Women Int. 2000;21:375-391.

Slonim AB , Roberto AJ , Downing CR , et al. Adolescents’ knowledge, beliefs, and behaviors regarding hepatitis B: insights and implications for programs targeting vaccine-preventable diseases. J Adolesc Health. 2005;36:178-186.

10.

Zimet GD , Mays RM , Winston Y. , Kee R. , Dickes J. , Su L. Acceptability of human papillomavirus immunization. J Womens Health Gend Based Med. 2000;9:47-50.

11.

Zimet GD , Liau A. , Fortenberry JD Health beliefs and intention to get immunized for HIV. J Adolesc Health. 1997;20:354-359.

12.

Rosenthal SL , Lewis LM , Succop PA , Bernstein DI , Stanberry LR College students’ attitudes regarding vaccination to prevent genital herpes. Sex Transm Dis. 1999;26:438-443.

13.

Rosenthal SL , Kottenhahn RK , Biro FM , Succop PA Hepatitis B vaccine acceptance among adolescents and their parents. J Adolesc Health. 1995;17:248-254.

14.

Zimet GD , Perkins SM , Sturm LA , Bair RM , Juliar BE , Mays RM Predictors of STI vaccine acceptability among parents and their adolescent children. J Adolesc Health. 2005;37:179-186.

15.

Webb PM , Zimet GD , Mays R. , Fortenberry JD HIV immunization: acceptability and anticipated effects on sexual behavior among adolescents. J Adolesc Health. 1999;25:320-322.

16.

Zimet GD , Blythe MJ , Fortenberry JD Vaccine characteristics and acceptability of HIV immunization among adolescents . Int J STD AIDS. 2000;11:143-149.

17.

Strauss A. , Corbin J. Basics of Qualitative Research. 2nd ed. Thousand Oaks, CA: Sage; 1998.

18.

Patton MQ Qualitative Research and Evaluation Methods. 3rd ed. Thousand Oaks, CA: Sage; 2002.

19.

Mays N. , Pope C. Qualitative research in health care. Assessing quality in qualitative research . BMJ. 2000;320: 50-52.

20.

Moore-Caldwell SY , Werner MJ , Powell L. , Greene JW Hepatitis B vaccination in adolescents: knowledge, perceived risk, and compliance. J Adolesc Health. 1997;20: 294-299.

21.

Ginsburg KR , Slap GB , Cnaan A. , Forke CM , Balsley CM , Rouselle DM Adolescents’ perceptions of factors affecting their decisions to seek health care. JAMA. 1995;273: 1913-1918.

22.

Ginsburg KR , Menapace AS , Slap GB Factors affecting the decision to seek health care: the voice of adolescents. Pediatrics. 1997;100:922-930.

23.

Middleman AB , Robertson LM , Young C. , Durant RH , Emans SJ Predictors of time to completion of the hepatitis B vaccination series among adolescents. J Adolesc Health. 1999;25:323-327.

24.

Davis K. , Dickman ED , Ferris D. , Dias JK Human papillomavirus vaccine acceptability among parents of 10- to 15-year-old adolescents. J Low Genit Tract Dis. 2004;8: 188-194.

25.

Mays RM , Sturm LA , Zimet GD Parental perspectives on vaccinating children against sexually transmitted infections. Soc Sci Med. 2004;58:1405-1413.

26.

Zimet GD , Mays RM , Sturm LA , Ravert AA , Perkins SM , Juliar BE Parental attitudes about sexually transmitted infection vaccination for their adolescent children. Arch Pediatr Adolesc Med. 2005;159:132-137.

27.

Liddon N. , Pulley L. , Cockerham WC , Lueschen G. , Vermund SH , Hook EW Parents’/guardians’ willingness to vaccinate their children against genital herpes. J Adolesc Health. 2005;37:187-193.

28.

Olshen E. , Woods ER , Austin SB , Luskin M. , Bauchner H. Parental acceptance of the human papillomavirus vaccine. J Adolesc Health. 2005;37:248-251.

29.

Waller J. , Marlow LA , Wardle J. Mothers’ attitudes towards preventing cervical cancer through human papillomavirus vaccination: a qualitative study. Cancer Epidemiol Bio-markers Prev. 2006;15:1257-1261.

30.

Marlow LA , Waller J. , Wardle J. Parental attitudes to pre-pubertal HPV vaccination. Vaccine . 2007;25:1945-1952.

31.

Springen K.

Why are HPV vaccine rates so low?

Newsweek. February 11, 2008. http://www.newsweek.com/id/115329 . Accessed, February 10, 2009.

32.

Basu S. , Chapman GB , Galvani AP Integrating epidemiology, psychology, and economics to achieve HPV vaccination targets. Proc Natl Acad Sci USA. 2008;105: 19018-19023.

33.

Dempsey AF , Zimet GD , Davis RL , Koutsky L. Factors that are associated with parental acceptance of human papillomavirus vaccines: a randomized intervention study of written information about HPV . Pediatrics. 2006;117: 1486-1493.

34.

Davis TC , Fredrickson DD , Kennen EM , et al. Childhood vaccine risk/benefit communication among public health clinics: a time-motion study. Public Health Nurs. 2004;21: 228-36.

35.

Davis TC , Fredrickson DD , Arnold CL , et al. Childhood vaccine risk/benefit communication in private practice office settings: a national survey. Pediatrics. 2001; 107:E17.

36.

LeBaron CW , Rodewald L. , Humiston S. How much time is spent on well-child care and vaccinations? Arch Pediatr Adolesc Med. 1999;153:1154-1159.

37.

Marlow LA , Waller J. , Wardle J. Trust and experience as predictors of HPV vaccine acceptance. Hum Vaccin. 2007;3:171-175.

38.

Kahn JA , Zimet GD , Bernstein DI , et al. Pediatricians’ intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes. J Adolesc Health. 2005;37:502-10.

39.

Kahn JA , Rosenthal SL , Tissot AM , Bernstein DI , Wetzel C. , Zimet GD Factors influencing pediatricians’ intention to recommend human papillomavirus vaccines. Ambul Pediatr. 2007;7:367-373.

40.

Szilagyi PG , Rand CM , McLaurin J. , et al; Working Group on Adolescent Vaccination in the Medical Home. Delivering adolescent vaccinations in the medical home: a new era? Pediatrics. 2008;121(suppl 1):S15-S24.

41.

Broder KR , Cohn AC , Schwartz B. , et al; Working Group on Adolescent Prevention Priorities. Adolescent immunizations and other clinical preventive services: a needle and a hook ? Pediatrics. 2008;121(suppl 1):S25-S34.

42.

Ortega-Sanchez IR , Lee GM , Jacobs RJ , et al; Working Group on Leading Economic Issues for Neww Vaccine for Adolescents. Projected cost-effectiveness of new vaccines for adolescents in the United States. Pediatrics . 2008;121(suppl 1):S63-S78.

43.

English A. , Shaw FE , McCauley MM , Fishbein DB Legal basis of consent for health care and vaccination for adolescents. Pediatrics. 2008;121(suppl 1):S85-S87.

44.

Horlick G. , Shaw FE , Gorji M. , Fishbein DB Delivering new vaccines to adolescents: the role of school-entry laws. Pediatrics. 2008;121(suppl 1):S79-S84.

45.

Lindley MC , Boyer-Chu L. , Fishbein DB , et al; Working Group on the Role of Schools in Delivery of Adolescent Vaccinations. The role of schools in strengthening delivery of new adolescent vaccinations. Pediatrics. 2008;121 (suppl 1):S46-S54.

46.

McCauley MM , Fishbein DB , Santoli JM Introduction: strengthening the delivery of new vaccines for adolescents. Pediatrics. 2008;121(suppl 1):S1-S4.

47.

Schaffer SJ , Fontanesi J. , Rickert D. , et al; Working Group on Complementary Settings. How effectively can health care settings beyond the traditional medical home provide vaccines to adolescents? Pediatrics. 2008;121(suppl 1): S35-S45.

48.

Sneller VP , Fishbein DB , Weinbaum CM , et al; Working Group on Vaccination of High-Risk Adolescents. Vaccinating adolescents in high-risk settings: lessons learned from experiences with hepatitis B vaccine. Pediatrics. 2008;121(suppl 1):S55-S62.

49.

Dempsey AF , Freed GL Human papillomavirus vaccination: expected impacts and unresolved issues. J Pediatr. 2008;152:305-309.

50.

Colgrove J. The ethics and politics of compulsory HPV vaccination . N Engl J Med. 2006;355:2389-2391.