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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Epidemiology and Prevention
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1422839
This article is part of the Research Topic Exploring HPV's Role in Genitourinary Cancers Beyond Cervical Cancer View all 3 articles

Impact of Social Determinants and Medical Mistrust on Parent-Child HPV Vaccination in Economically Disadvantaged Communities: Implications for Cancer Prevention

Provisionally accepted
Marcelo Sleiman Jr. Marcelo Sleiman Jr. 1*Mary Rose Yockel Mary Rose Yockel 1Mingqian Liu Mingqian Liu 1Joanne Wendolowski Joanne Wendolowski 2,3Lucile L Adams-Campbell Lucile L Adams-Campbell 1Chiranjeev Dash Chiranjeev Dash 1Lisa Carter-Bawa Lisa Carter-Bawa 2Abraham Aragones Abraham Aragones 2Sahana Arumani Sahana Arumani 1Kenneth Tercyak Kenneth Tercyak 1
  • 1 Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C., District of Columbia, United States
  • 2 Hackensack University Medical Center, Hackensack, New Jersey, United States
  • 3 Hackensack Meridian Health, Montclair, California, United States

The final, formatted version of the article will be published soon.

    Human papillomavirus (HPV) vaccination remains underutilized in the United States among youth and adults, and especially among families with fewer resources. HPV vaccination status, vaccination intentions, their correlates, and barriers to vaccination were assessed in age-eligible parents and their children living in communities that were economically disadvantaged. Parents (N=198; 45% Black, 42% Latine, 57% educated <=high school [HS], 74% income <$60k annually) with children ages 10-17 from the Washington, DC and Hackensack, NJ regions were intercepted at community events and surveyed. Among age-eligible parents, 20% were vaccinated against HPV. Comparing vaccinated to unvaccinated parents, those who were non-white (OR=5.5, 95% CI=3.5, 9.4, p<0.001) and with unvaccinated children (OR=8.9, 95% CI=3.7, 23.3, p<0.001) were less likely to be vaccinated themselves. Among children, 37% were vaccinated. Unvaccinated children were more likely to have parents who were non-white (OR=2.7, 95% CI=2.6, 2.8, p<.01), with a <=HS education (OR=3.0, 95% CI=1.52, 6.25, p<.01), and were unvaccinated themselves (OR=10.2, 95% CI=4.01, 28.61, p<.001). Nearly two-thirds (63%) of parents with unvaccinated children expressed an intention to vaccinate within the next year: 48% confirmed receiving advice from a healthcare provider to do so. Common HPV vaccine barriers included lack of information (35%), safety concerns (16%), and perceptions of sexual inactivity (13%). An adjusted model revealed an interaction between parent education and medical mistrust (B=.35, SE=.13, 95% CI=0.09, 0.61, p<.01). For parents with <=HS education, when levels of provider trust were strong, they were more open to vaccinating their children. HPV vaccine prevalence was low among parents and children living in disadvantaged communities. Comprehensive education and intervention to build trust are warranted to prevent the spread of HPV-linked cancers and reduce cancer disparities.

    Keywords: cancer prevention, cancer disparities, Children, Families, Vaccination

    Received: 24 Apr 2024; Accepted: 03 Dec 2024.

    Copyright: © 2024 Sleiman Jr., Yockel, Liu, Wendolowski, Adams-Campbell, Dash, Carter-Bawa, Aragones, Arumani and Tercyak. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Marcelo Sleiman Jr., Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C., 20057, District of Columbia, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.