HPV vaccination knowledge, intentions, and practices among caregivers of childhood cancer survivors

Figures & data

Table 1. Caregiver demographics and vaccine experiences among the full sample and among caregivers whose child is age eligible vs. not age eligible for the HPV vaccine.

			Age eligibility for HPV vaccine
	Overall Sample (N = 145)		Child age eligible for HPV vaccine (N = 61)*		Child not age eligible for HPV vaccine (N = 84)*
Demographics	N	%	N	%	N	%	P value
Age at survey (years)
18–29	14	9.7	2	3.3	12	14.3	<0.001
30–39	79	54.9	22	36.7	57	67.9
40–49	39	27.1	25	41.7	14	16.7
50–59	12	8.3	11	18.3	1	1.2
Relationship with survivor
Mother	116	80.6	49	81.7	67	79.8	0.63
Father	25	17.4	9	15.0	16	19.1
Grandparent/Legal guardian	3	2.1	2	3.3	1	1.2
Gender
Female	116	81.1	48	81.4	68	80.1	>0.99
Male	27	18.9	11	18.6	16	19.1
Education
High school	23	16.2	11	18.6	12	14.5	0.67
Some college/tech	56	39.4	21	35.6	35	42.2
College graduate	63	44.4	27	45.8	36	43.4
Race
White	129	90.9	57	95.0	72	87.8	0.24
Other	13	9.2	3	5.0	10	12.2
Ethnicity
Non-Hispanic	124	89.2	52	91.2	72	87.8	0.59
Hispanic	15	10.8	5	8.8	10	12.2
Annual household income
<$20,000	10	7.3	6	10.3	4	5.0	0.11
$20,000-$39,999	20	14.5	10	17.2	10	12.5
$40,000-$59,999	26	18.8	10	17.2	16	20.0
$60,000-$79,999	22	15.9	4	6.9	18	22.5
$80,000-$99,999	21	15.2	8	13.8	13	16.3
>$100,000	39	28.3	20	34.5	19	23.8
Insurance status
Insured	133	93.7	55	93.2	78	94.0	>0.99
Uninsured	9	6.3	4	6.8	5	6.0
Marital status
Married/Living as married	127	88.2	49	81.7	78	92.9	0.06
Divorced/Separated/Never married	17	11.8	11	18.3	6	7.1
Rurality of Residence
Urban	116	80.6	47	78.3	69	82.1	0.67
Rural	28	19.4	13	21.7	15	17.9
Experiences with Vaccines
Providers give enough information on vaccines/potential side effects
Yes	107	76.4	46	76.7	61	76.3	>0.99
No	33	23.6	14	23.3	19	23.8
Cancer care team discussed when to restart vaccinations
Yes	66	48.5	15	25.9	51	65.4	<0.001
No	70	51.5	43	74.1	27	34.6
Oncologist or PCP recommended catch-up or booster vaccines
Yes	74	51.0	21	34.4	53	63.1	0.001
No	71	49.0	40	65.6	31	36.9

Some columns do not sum to total sample sizes due to missing data.

*Age eligible: child is age 11 or older at survey; Not age eligible: child is younger than age 11 at survey.

Table 2. Childhood cancer survivor demographics among the full sample and among caregivers whose child is age eligible vs. not age eligible for the HPV vaccine.

			Age eligibility for HPV vaccine
	Overall Sample (N = 145)		Child age eligible for HPV vaccine (N = 61)*		Child not age eligible for HPV vaccine (N = 84)*
	N	%	N	%	N	%	P value
Age at survey (years)
0–4	25	17.3	–	–	25	29.8	n/a
5–10	59	40.7	–	–	59	70.3
11–15	35	24.1	35	57.4	–	–
16–20	26	17.9	26	42.6	–	–
Gender
Female	71	51.0	20	32.8	51	60.7	0.001
Male	74	49.0	41	67.2	33	39.3
Race
White	129	89.6	56	91.8	73	88.0	0.58
Other	15	10.4	5	8.2	10	12.1
Ethnicity
Non-Hispanic	120	85.7	48	82.8	72	87.8	0.47
Hispanic	20	14.3	10	17.2	10	12.2
Insurance status
Insured	142	97.9	59	98.3	82	97.6	>0.99
Uninsured	3	2.1	1	1.7	2	2.4
Age at diagnosis (years)
0–4	53	36.6	–	–	53	63.1	na
5–9	39	26.9	8	13.1	31	36.9
10–14	33	22.8	33	54.1	–	–
15–17	20	13.8	20	32.8	–	–
Time since diagnosis
3 months to <1 year	77	53.1	36	59.0	41	48.8	0.07
1 year to <2 years	57	39.3	18	29.5	39	46.4
2 years to <3 years	11	7.6	7	11.5	4	4.8
Diagnosis
Leukemia	54	37.2	14	23.0	40	47.6	<0.001
Brain/Central Nervous System	21	14.5	5	8.2	16	19.1
Lymphoma	26	17.9	19	31.2	7	8.3
Other	44	30.3	23	37.7	21	25.0

Some columns do not sum to total sample sizes due to missing data.

*Age eligible: child is age 11 or older at survey; Not age eligible: child is younger than age 11 at survey.

Table 3. Caregiver knowledge and beliefs regarding the HPV vaccine among the full sample and among caregivers whose child is age eligible vs. not age eligible for the HPV vaccine.

			Age eligibility for HPV vaccine
	Overall Sample (N = 145)		Child age eligible for HPV vaccine (N = 61)*		Child not age eligible for HPV vaccine (N = 84)*
	N	%	N	%	N	%	P value
Have you heard of HPV?
Yes	127	87.6	54	88.5	73	86.9	0.49
No	18	12.4	7	11.5	11	13.1
Have you heard of the HPV vaccine?
Yes	116	84.1	48	81.4	68	86.1	0.30
No	22	15.9	11	18.6	11	13.9
Where did you hear about the HPV vaccine? (select all that apply)
Doctor or nurse	61	42.1	29	47.5	32	38.1	0.17
TV	45	31.0	12	19.7	33	39.3	0.009
Family/friends	32	22.1	14	23.0	18	21.4	0.49
Health department	26	17.9	16	26.2	10	11.9	0.02
Social Media	25	17.2	11	18.0	14	16.7	0.50
Websites other than social media	17	11.7	7	11.5	10	11.9	0.58
School	14	9.7	6	9.8	8	9.5	0.58
Radio	10	6.9	3	4.9	7	8.3	0.52
Newspapers	7	4.8	3	4.9	4	4.8	0.63
Other	5	3.5	4	6.6	1	1.2	0.10
Community health worker	3	2.1	3	4.9	0	0	0.07
Church	1	<1	0	0	1	1.2	0.58
Insurance company	1	<1	0	0	1	1.2	0.58
In general, do you think children ages 11–12 should get the HPV vaccine?
Yes	96	69.1	43	72.9	53	66.3	0.26
No	43	30.9	16	27.1	27	33.8
Among those who have not received the HPV vaccine:
How likely are you to get the HPV vaccine for your child?**
Very likely to somewhat likely	80	70.2	22	66.7	58	71.6	0.38
Unlikely to very unlikely	34	29.8	11	33.3	23	28.4
Why wouldn’t you get the HPV vaccine for your child? (select all that apply)**
Not enough information	30	25.2	12	33.3	18	21.7	0.25
Not the right age	27	22.7	8	22.2	19	22.8	>0.99
Side effects	26	21.9	7	19.4	19	22.9	0.81
No specific reason	23	19.3	6	16.7	17	20.5	0.80
Not sexually active	16	13.5	8	22.2	8	9.6	0.08
Unnecessary	10	8.4	0	0	10	12.5	0.03
Not recommended	9	7.6	0	0	9	10.8	0.06
I don’t vaccinate my kids	4	3.4	0	0	4	4.8	0.31
Costs	2	1.7	1	2.8	1	1.2	0.52
It will promote sexual activity	0	0	0	0	0	0	na
Other reason	5	4.2	1	2.8	4	4.8	>0.99

Some columns do not sum to total sample sizes due to missing data.

*Age eligible: child is age 11 or older at survey; Not age eligible: child is younger than age 11 at survey.

**Among parents whose child with cancer has not received any doses of the HPV vaccine (N = 119 among the overall sample; N = 36 among the age-eligible sample and N = 83 among the not age-eligible sample who responded to this question).

Table 4. Multivariable regressions of factors associated with HPV vaccination intentions reported by caregivers.

	In general, do you think children ages 11–12 should get the HPV vaccine?*			How likely are you to get the HPV vaccine for your child?**
	Relative Risk	95% CI	p-value	Relative Risk	95% CI	p-value
Child’s gender
Male (ref)	1		0.84	1		0.71
Female	0.98	0.79–1.22		0.96	0.76–1.21
Caregiver age at survey
<40 years (ref)	1		0.25	1		0.98
≥40 years	1.13	0.92–1.40		0.98	0.77–1.25
Time from diagnosis
3 months to 1 year (ref)	1		0.38	1		0.04
≥1 year	0.91	0.73–1.13		0.78	0.62–0.98
Providers give enough information on vaccines/potential side effects
No (ref)	1		0.01	1		0.009
Yes	1.78	1.15–2.77		1.85	1.16–2.94
Cancer care team discussed when to restart vaccinations
No (ref)	1		0.08	1		0.02
Yes	1.21	0.98–1.49		1.35	1.06–1.72

*Among all caregivers (N = 126 due to missing data).

**Sub-sample of caregivers whose child with cancer has not received any doses of the HPV vaccine (N = 104 due to missing data).

Table 5. Multivariable regression of factors associated with HPV vaccination reported by caregivers whose child is age eligible for the HPV vaccine (N = 56)*.

	Relative Risk	95% CI	p-value
Child’s gender
Male (ref)	1		0.17
Female	1.51	0.84–2.73
Caregiver age at survey
<40 years (ref)	1		0.06
≥40 years	2.05	0.96–4.37
Time from diagnosis
3 months to 1 year (ref)	1		0.67
≥1 year	1.14	0.62–2.09
Providers give enough information on vaccines/potential side effects
No (ref)	1		0.79
Yes	1.12	0.49–2.54
Cancer care team discussed when to restart vaccinations
No (ref)	1		0.81
Yes	0.91	0.44–1.92

* Sub-sample is limited to caregivers whose child with cancer was age 11 or older at survey with no missing data.

Figure 1. HPV vaccine receipt by caregiver and child factors reported by caregivers whose child is age eligible for the HPV vaccine (N = 61)*.

*Sub-sample of full sample, limited to caregivers whose child with cancer was age 11 or older at survey; Ns for each variable do not sum to 61 due to missing data. **Statistically significant at p < .05.

Figure 2. HPV vaccine receipt by provider and clinical factors reported by caregivers whose child is age eligible for the HPV vaccine (N = 61)*.

*Sub-sample of full sample, limited to caregivers whose child with cancer was age 11 or older at survey; Ns for each variable do not sum to 61 due to missing data.