Safety concerns related to vaccination may be among the common reasons that cancer survivors declined to participate in a study evaluating the human papillomavirus (HPV) vaccine, a new study indicated.
“Compared with the general population, adolescent and young adult cancer survivors are at increased risk for the development of subsequent malignancies associated with HPV. The HPV vaccine offers protection against most oncogenic HPV subtypes,” study researchers wrote. “Despite their increased risk for developing HPV‐related cancers, HPV vaccine initiation rates among adolescent and young adult cancer survivors remain low.”
Researchers were conducting an open-label study of the immunogenicity and safety of the HPV vaccine in vaccine-naive cancer survivors aged 9-26 and conducted this secondary analysis among those who declined to participate. The study was conducted from January 2013 to October 2018.
Among the 301 survivors that refused to participate, the majority (71.4%) refused for reasons related to the HPV vaccine. The remaining survivors refused to participate for reasons unrelated to the HPV vaccine. More parents (76.7%) refused participation for vaccine-related reasons as compared with young adults (60%; P=.004).
Among the vaccine-related reasons for refusal were vaccine hesitancy/disinterest, external influences, vaccine-related information deficits, and health beliefs/family decisional processes. Female survivors were more than twice as likely than males to refuse for reasons related to health beliefs/family decisional processes.
Survivors approached during the latter years of the trial were more than three times more likely to refuse because of safety concerns. During the first trial period from 2013-2016, less than 10% of survivors who were approached declined participation due to safety concerns. From 2016-2018, 25% of survivors refused participation due to safety concerns.
“Oncology providers can address concerns regarding HPV vaccine safety among young cancer survivors and their parents by using data supporting the safety and immunogenicity of the HPV vaccine in this vulnerable population,” the researchers wrote.
The researchers wrote that many of the concerns identified in this study can be addressed through communication-focused strategies.
“Communication approaches that address parental concerns about the HPV vaccine reduce vaccine hesitancy,” the researchers wrote. “Additionally, cancer survivors desire information about vaccination from their oncology providers; thus, messages that address common reasons for HPV vaccine refusal among cancer survivors can potentially be incorporated into oncology practices.”