433 - HPV vaccine hesitancy among parents of adolescents and young adults with Down Syndrome

Poster Number: 433
Publication Number: 433.323

Diane L. Langkamp, Akron Children's Hospital, Akron, OH, United States; Tara Weixel, Kent State University, Kent, OH, United States; Beth Wildman, Kent State University, Kent, OH, United States

Background: Underimmunization is a particular risk in Down syndrome (DS) due to multiple anatomic and immune differences. Young children with DS have been shown to have lower immunization rates than the general population. Little is known about vaccine hesitancy among parents of adolescents and young adults (AYA) with DS.

Objective: To describe factors associated with vaccine hesitancy among parents of AYA with DS with a focus on HPV (human papilloma virus) vaccine.

Design/Methods: Parents of 224 AYA with DS (12-21 years old) completed an anonymous online survey about vaccine hesitancy.  Parents were recruited by email from regional DS support groups, DS-Connect, and the National Down Syndrome Congress. The survey included 2 validated questionnaires - the Emory Vaccine Confidence Index (EVCI) and the Vaccine Hesitancy Survey (VHS) - and questions about whether the AYA had received recommended vaccines including the HPV vaccine.  The survey did not include questions about influenza vaccine.

Results: Respondents were mostly mothers (92%), White (95%) and college graduates (81%). Most (89%) reported their AYA had received all recommended vaccines.  Nearly half (46%) reported they had ever been reluctant about a vaccine for their AYA with DS and 26% had refused a vaccine for their AYA. Most (55%) said their AYA had received HPV vaccine, or they planned to receive it in the future (16%). Many parents (44%) disagreed/strongly disagreed that the chance of their AYA contracting HPV later in life was great. Parents whose AYA had not received HPV vaccine/did not plan to receive it in the future agreed/strongly agreed that "New vaccines carry more risks" (46.2% vs. 24.5%, p< .001) and agreed/strongly agreed that they were "Concerned about serious adverse risks of vaccines" (61.5% vs. 25.2%, p< .001) compared with parents of AYA who had received/planned to receive HPV vaccine.  Parents of AYA who had not received HPV vaccine/did not plan to receive it in the future had less confidence in scientists who develop vaccines and government agencies that make vaccine recommendations as shown by lower confidence scores on the EVCI (13.4 vs. 18.5, p< .001).

Conclusion(s): HPV vaccine has been recommended since 2006 but has a low acceptance rate among parents of AYA with DS.  Many parents felt that the chance of their AYA with DS contracting HPV later in life was low; this suggests that parents of AYA with DS do not think their AYA is likely to be sexually active.  When making decisions about HPV vaccine, parents of AYA with DS may not consider that individuals with developmental disabilities are at higher risk of sexual maltreatment.