Annenberg Survey Finds Little Support for Mandatory HPV Vaccinations

A study by the Annenberg School for Communication at the University of Pennsylvania shows that the majority of respondents either oppose or are neutral to proposed legislation making it mandatory for school-age girls to obtain the Human Papillomavirus (HPV) vaccine before they can enter school.

The same study found that Americans are, however, in favor of government-run education programs to help the population understand the value of the vaccine, and allowing parents to make their own decisions about vaccinating their daughters. Americans are also generally in favor of government subsidies to pay for the vaccine for the uninsured.

The responses were obtained from representative samples of adults over 18 years of age, beginning in June 2006, by the Center for Excellence in Cancer Communication Research (CECCR) at the Annenberg School for Communication. Researchers at the CECCR have been studying media coverage of the HPV vaccine and its effects on knowledge, public opinion, and intentions to vaccinate. The work is done through the Annenberg National Health Communication Survey (ANHCS), a monthly survey that collects data from samples of U.S. adults. The survey is updated monthly, giving CECCR researchers an up-to-the-minute view of the public’s position on cancer-related and other health-related topics. The results of the surveys are to be presented this week during the Centers for Disease Control’s annual Cancer Conference in Atlanta.

Respondents were questioned on a variety of public policy topics, including:

• The necessity of parental consent prior to obtaining the HPV vaccine for girls and young women under 18,
• Whether doctors should recommend the vaccine to their eligible female patients,
• Support for the federal government to run a public education campaign on the HPV vaccine,
• Who pays for the vaccine? The government, insurers, or individuals? And,
• Should the vaccine be a requirement for young girls before they can be admitted to middle school?

Legislators in at least 41 states and the District of Columbia have introduced legislation to require, fund, or educate the public about the HPV vaccine, and at least 17 states have enacted this legislation. “There is evidence to support the position that state laws requiring immunization as a condition of school enrollment increases the use of vaccines, but a significant proportion of the population views such legislation as infringing on civil liberties and parental rights,” said Amy Leader, MPH, Research Director at the CECCR.

“We used the Annenberg survey to get a real-time view of the public’s opinion about this array of policy issues surrounding the HPV vaccine. As state legislatures return from summer recesses in the coming weeks, the subject of mandatory HPV vaccination may well turn up again.”

In June 2006 – the same month that the vaccine received FDA approval – 634 adults were surveyed about vaccination intentions and policy opinions. Next, from January through June of this year, a new sample was recruited monthly to answer one question about mandatory vaccination.

Nearly half the survey participants oppose mandatory vaccinations in schools; only 15.8 percent support such legislation, while 34.7 percent are neutral on the subject. Additionally, nearly half (45.4 percent) of the participants are against vaccinating girls under the age of 18 without parental consent.

At the same time, respondents generally supported the idea of physicians recommending the vaccine to eligible patients (60.2 percent), they supported the government covering the vaccine for the uninsured (57.1 percent), and felt insurers should pay for the vaccine (64.7 percent). A total of 58.2 percent said the government should sponsor an educational campaign about the vaccine.

These current surveys follow a related work by the CECCR performed in 2006, where 635 U.S. adults over the age of 18 (49 percent of whom were women) were randomly assigned to read one of three variations of a paragraph describing the vaccine. How the vaccine was described, the survey showed, affected how respondents felt about obtaining it. For example, when told the vaccine protects against cervical cancer, 63 percent said they were “very likely” or “somewhat likely” to get the vaccine. However, women who read that the vaccine protects against cervical cancer and any sexually transmitted infection, only 43 percent responded they were “very likely” or “somewhat likely” to become vaccinated.

"ANHCS makes it possible for us to be responsive to fast-breaking developments in health care and health care policy. The survey gives an ongoing monthly picture of the public's health communication practices," said Joseph Cappella, Ph.D., the Gerald R. Miller Professor of Communication at Annenberg. "It also allows us to assess the public’s responses to health innovations including how different ways of communicating about them will bias their reactions."

ANHCS is made possible through support from the Annenberg Foundation Trust at Sunnylands and the Annenberg School for Communication at Penn.