Acceptance of the HPV Vaccine for Adolescent Girls: Analysis of State-Added Questions from the BRFSS

W. Jay Christian, Amy Christian, Claudia Hopenhayn

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Purpose: Previous research regarding human papillomavirus (HPV) awareness and vaccine acceptance has relied on convenience or other selected samples of the population. To assess the prevalence of HPV awareness and vaccine acceptance in Kentucky we added questions to the 2006 Kentucky Behavioral Risk Factor Survey System (BRFSS), a population-based survey of health behaviors. Methods: Women who participated in the statewide BRFSS were asked two HPV-related questions: one assessed previous awareness of HPV, and another assessed vaccine acceptance for girls 10 to 15 years old. We used crosstabulations and multivariate logistic regression to determine which factors were associated with HPV awareness and vaccine acceptance. Because the HPV vaccine Gardasil was approved in June 2006, we conducted an analysis of pre- and postapproval HPV awareness and vaccine acceptance. We also compared results across Appalachian and non-Appalachian counties, two distinct regions of Kentucky. Results: Overall, 57.6% of women had heard of HPV, and 70.2% accepted vaccination for girls. HPV awareness increased after Gardasil's approval, but the increase was much smaller among Appalachian women. Prevalence of vaccine acceptance was unchanged in both regions. Awareness of HPV was not associated with vaccine acceptance, and factors significantly associated with vaccine acceptance in multivariate analysis differed by Appalachian status. Conclusions: This population-based survey of Kentucky women found relatively high vaccine acceptance for girls. Also, many respondents reported not knowing whether they accept vaccination, and factors associated with vaccine acceptance varied by Appalachian status. These findings suggest that acceptance of the HPV vaccine for girls may improve with targeted interventions.

Original languageEnglish
Pages (from-to)437-445
Number of pages9
JournalJournal of Adolescent Health
Issue number5
StatePublished - May 2009

Bibliographical note

Funding Information:
Financial support was provided by the National Cancer Institute's Cancer Information Service—Mid South Region


  • Appalachia
  • Behavioral Risk Factor Surveillance System
  • HPV
  • Human papillomavirus
  • Kentucky
  • Vaccine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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