Human papillomavirus vaccination. Committee Opinion 704.: ACOG; 2017

Epidemiology and prevention of vaccine-preventable diseases, 13th edn. In: Hamborsky J, Kroger A, Wolfe S (eds). : Public Health Foundation; 2015

Centers for Disease Control and Prevention. HPV and cancer: How many cancers are linked with HPV each year?. 2019a. (accessed 2 August 2020)

Centers for Disease Control and Prevention. Human papillomavirus: Vaccine schedule and dosing. 2019b. (accessed 15 August 2020)

Centers for Disease Control and Prevention. United states cancer statistics (USCS): Cancers associated with human papillomavirus, united states—2012–2016. 2019c. (accessed 22 August 2020)

Dempsey AF, Schaffer S. Middle- and high-school health education regarding adolescent vaccines and human papillomavirus. Vaccine. 2010; 28:(44)7179-7183

Esposito S, Principi N, Cornaglia G Barriers to the vaccination of children and adolescents and possible solutions. Clin Microbiol Infect.. 2014; 20:(5)25-31

Head KJ, Biederman E, Sturm LA, Zimet GD. A retrospective and prospective look at strategies to increase adolescent HPV vaccine uptake in the United States. Hum Vaccin Immunother. 2018; 14:(7)1626-1635

Hirth JM, Fuchs EL, Chang M, Fernandez ME, Berenson AB. Variations in reason for intention not to vaccinate across time, region, and by race/ethnicity, NIS-Teen (2008–2016). Vaccine. 2019; 37:(4)595-601

Lu P. J., Yankey D., Jeyarajah J., O'Halloran A., Elam-Evans L. D., Smith P. J., Stokley S., Singleton J.A., Dunne E. F. HPV vaccination coverage of male adolescents in the United States. Pediatrics. 2015; 136:(5)1-11

Reiter PL, Stubbs B, Panozzo CA, Whitesell D, Brewer NT. HPV and HPV vaccine education intervention: effects on parents, healthcare staff, and school staff. Cancer Epidemiol Biomarkers Prev.. 2011; 20:(11)2354-2361

Saslow D, Solomon D, Lawson HW American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. J Low Genit Tract Dis.. 2012; 16:(3)175-204

Shapiro GK, Guichon J, Kelaher M. Canadian school-based HPV vaccine programs and policy considerations. Vaccine. 2017; 35:(42)5700-5707

Thompson EL, Rosen BL, Vamos CA, Kadono M, Daley EM. Human papillomavirus vaccination: what are the reasons for nonvaccination among U.S. adolescents?. J Adolesc Health.. 2017; 61:(3)288-293

US Department of Health and Human Services. Immunization and infectious diseases. 2020.

Vorsters A, Van Damme P. HPV immunization programs: Ensuring their sustainability and resilience. Vaccine.. 2018; 36:(35)5219-5221

Williams CL, Walker TY, Elam-Evans LD Factors associated with not receiving HPV vaccine among adolescents by metropolitan statistical area status, United States, National Immunization Survey-Teen, 2016-2017. Hum Vaccin Immunother.. 2020; 16:(3)562-572

HPV immunisation: A review of parent and stakeholder attitudes on school-based programmes

02 August 2020
27 min read
Volume 1 · Issue 4



The purpose of this integrative review is to examine the benefits of school-based human papillomavirus (HPV) vaccination programmes in improving overall vaccine education and adherence among the recommended age groups.


The review explores qualitative and quantitative research published between 2010 and 2019 on benefits and barriers to HPV school-based vaccination programmes and stakeholder attitudes influencing implementation in school settings.


A literature review was performed from a United States perspective among ten articles revealing five themes; vaccine knowledge deficit, parental and patient hesitancy, lack of provider recommendation, vaccine safety and side effect and association with increasing sexual activity.


HPV-associated cancers and complications are considered a public health issue. However, stakeholder attitudes on school-based HPV vaccination programmes have shown a significant gap in clinical and vaccine knowledge. Moving forward, a multi-level approach through provider training and age-based recommendations among stakeholders is key in overcoming stigmas and barriers to improve vaccination education and uptake rates.

According to the Centers for Disease Control and Prevention (CDC) (2015) 8 billion dollars are spent annually in the United States on the management of complications for human papillomavirus (HPV) infections; exceeding the health-care and economic burden of any other sexually transmitted infection (STI) and leading to the importance of early HPV vaccination for both males and females. The CDC and the Advisory Committee on Immunization Practices (ACIP) recommend routine HPV vaccination for 9–26-year-olds to reduce HPV-associated cancers, preferably between the ages of 11 and 12 years (American College of Obstetricians and Gynaecologists [ACOG], 2017). Despite the clinical significance of routine vaccination, vaccination rates in adolescents in the United States are suboptimal.

HPV vaccination can help reduce the health-care burden by decreasing the incidence of cervical cancer, anogenital cancers, oropharyngeal cancers and genital warts. ACOG (2017) reports that only 41.9% of females and 28.1% of males in the recommended age groups received all of the recommended doses; proving the clinical significance of implementing an HPV vaccine school-based programme for males and females to prevent HPV-related cancers (CDC, 2015; ACOG, 2017).

Register now to continue reading

Thank you for visiting Journal of Child Health and reading some of our peer-reviewed resources for children’s health professionals. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month