More Parents Express Concern About HPV Vaccination, Yet Reported Adverse Reactions Fall Interview with:

Dr. Sonawane

Kalyani Sonawane, PhD
Assistant Professor of Management, Policy and Community Health
UTHealth School of Public Health in Houston What is the background for this study?

Response: Safety concern regarding the HPV vaccine is one of the most significant barriers to vaccination. Our objective was to determine how many US adolescents did not initiate the HPV vaccine during 2015-2018 because their parents had concerns regarding the vaccine’s safety.

We also analyzed vaccine adverse event reporting data, in parallel, to understand if the public sentiment of HPV vaccine safety is in alignment with evidence from the vaccine safety surveillance system. What are the main findings?

Response: We found that more adolescents had not initiated the HPV vaccine in 2018 (259,157; 23.4%) than in 2015 (170,046; 13.0%) because their parents had safety concerns, translating to an 80% increase in HPV vaccine hesitancy due to safety concerns. Safety concerns increased in 30 states with notable increases (over 200%) in California, Hawaii, South Dakota, and Mississippi.

However, when we analyzed the adverse event reporting data from the US Vaccine Adverse Event Reporting System (VAERS), the overall HPV vaccine adverse event reporting rate (per 100 000 vaccine doses distributed) decreased to 29.4 in 2018 from 44.7 in 2015. These data suggest that the growing sentiment of HPV vaccine safety concerns do not align with largely documented evidence (from both pre-and post-marketing studies) that the vaccine is safe. What should readers take away from your report? 

Response: Our study shows that the sentiment that the HPV vaccine is not safe among vaccine-hesitant parents is unfounded. There is a lot of misinformation floating around in traditional and social media that the HPV vaccine has severe side effects. The vaccine has been around for more than a decade, multiple studies (both from the US and other countries) suggest that it is safe, and it can protect children from up to six cancers (cervical, vaginal, vulvar, penile, anal, and oropharyngeal). I highly encourage parents to talk to their healthcare providers and discuss any concerns they may have regarding the safety of the HPV vaccine. We should also prepare and train providers in making effective HPV vaccine recommendations and addressing parents’ concerns using evidence-based resources and tools such as the CDC’s Answering Parents’ Questions about HPV Vaccine and the Same Way Same day app. What recommendations do you have for future research as a result of this work?

Response: We need research to understand what factors are contributing to HPV vaccine safety concerns and identify strategies to combat them. Is there anything else you would like to add?

Response: A significant proportion (nearly 11%) of US adolescents may not be initiating the HPV vaccine due to vaccine hesitancy arising from safety concerns (CDC study). In the past, HPV vaccine-related misinformation nearly collapsed vaccination programs in countries including Denmark and Japan. A strategic national plan to combat vaccine misinformation in the US is urgently needed to continue our progress and achieve the 80% HPV vaccination goal.

No disclosures.


Sonawane K, Lin Y, Damgacioglu H, et al. Trends in Human Papillomavirus Vaccine Safety Concerns and Adverse Event Reporting in the United States. JAMA Netw Open. 2021;4(9):e2124502. doi:10.1001/jamanetworkopen.2021.24502



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Last Updated on September 17, 2021 by Marie Benz MD FAAD