Olivia Aspiras

The human papillomavirus or HPV vaccine is nearly 100% effective at preventing infection, and its ability to reduce the risk for HPV infections remains high even a decade after the initial vaccination. The vaccine reduces cervical cancer among women and prevents cancers likely caused by an HPV infection among men.

The HPV vaccine is nearly 100% effective at preventing HPV infection, and its ability to reduce the risk for HPV infections remains high even a decade after the initial vaccination. The HPV vaccine also reduces the risk for other HPV-related cancers, including certain cancers of the throat and mouth.

It’s recommended that children begin the HPV vaccination series around 11-12 years of age before becoming sexually active, although it can be started as young as age 9. Children under the age of 15 receive two doses of the vaccine approximately 6-12 months apart. Children who begin vaccination after the age of 15 receive two doses approximately 1-2 months apart and a third dose approximately six months later.

The vaccine is covered by insurance, and the federal Vaccine for Children entitlement program covers costs for children and adolescents who do not have adequate coverage through insurance.

 

Despite high efficacy and accessibility, only about 60% of children have received a full course of the vaccine.

What can we do to improve vaccination rates?
As a psychologist, I want to understand how people’s thoughts and feelings influence their decisions to engage in health behaviors like obtaining the HPV vaccine. By studying the processes that underlie health behavior decisions, we can develop interventions that more effectively encourage people to engage in behaviors that support their health and reduce their risk for negative health outcomes like cancer.

One strategy for encouraging HPV vaccination is health communication that educates parents about the vaccine and its importance for preventing HPV infection and cervical cancer. Research shows that the more knowledgeable parents are about the HPV vaccine, the more positively they feel about it and the more likely they are to obtain the vaccine for their child.

Educational health communication about HPV vaccination may be a particularly beneficial strategy for increasing vaccine uptake because many parents are unaware that the vaccine is recommended for both girls and boys, leading to especially low vaccination rates among boys.

How does HPV protect girls?
Nearly all cervical cancer is caused by human papillomavirus (HPV), a viral infection that can be transmitted through sexual contact. Fortunately, there is an HPV vaccine that drastically reduces the risk of HPV infection and, as a result, cervical cancer.

Cervical cancer is the fourth most common cancer among women worldwide. About 7.5 per 100 women are diagnosed with cervical cancer each year in the U.S. Cervical cancer disproportionately affects African Americans.

The incidence rate for cervical cancer is 22% higher for African American women than white women, and African American women are 65% more likely to die from cervical cancer than white women. Cervical cancer can have long-term effects on physical health and psychological well-being.

It’s also costly. It is estimated that patients with cervical cancer spent about $172 million on out-of-pocket patient costs in 2019.

Why should boys get vaccinated, you ask?
It is estimated that over 15,000 men each year are diagnosed with cancer that was likely caused by HPV infection and could potentially have been prevented through HPV vaccination.

In a 2018 survey of young adults conducted by the Centers for Disease Control, only about 27% of men said they had ever received one or more doses of the vaccine compared to over 50% of women. Although HPV vaccination among boys has gradually increased over time, data suggests that vaccination rates are still about 4% lower among boys compared to girls.

The role of health communication
Although general educational messages about the HPV vaccine are undoubtedly important, health communication may be even more effective when tailored to the specific audience receiving it.

I am particularly interested in how health messaging can be designed to best promote receptivity to the HPV vaccine among African Americans, who are less likely to have completed the full HPV vaccination series.

One significant barrier to HPV vaccine uptake among African Americans is racism-related medical mistrust. Parents with high medical mistrust have greater HPV vaccine hesitancy and are less likely to obtain the HPV vaccine for their children.

Health messages that are mindful of medical mistrust as a barrier and intentionally and thoughtfully developed to avoid evoking racism-related thoughts like medical mistrust are crucial for improving HPV vaccine uptake among African Americans and reducing disparities in cervical cancer.

Nevertheless, individual health decisions are only one piece of the puzzle when working to promote healthy behaviors and reduce health disparities.

Health communication strategies and interventions should be implemented alongside structural changes to healthcare systems and policies that seek to eliminate other psychological, social, and economic barriers to engagement in health behaviors and healthcare services. By addressing drivers of health behaviors at all levels, we can build a healthier community for all its members.

For more information about the HPV vaccine, explore these resources:

 

I am an experimental psychologist whose research focuses on social psychology in the context of health and well-being. I am particularly interested in the basic judgment and decision-making processes that underlie health behaviors and the application of health communication and brief interventions to promote health- and treatment-related outcomes.

Olivia Aspiras, PhD
Research Associate
Charles Stewart Mott Department of Public Health
College of Human Medicine

 

January 18, 2023