Low rates of free human papillomavirus vaccine uptake among young women

Objective: To determine uptake of quadrivalent human papillomavirus recombinant vaccine (quadrivalent; Gardasil, Merck, New Jersey, USA) offered under optimal conditions to women 18 to 24 years of age, and to identify predictors of uptake. Methods: Young women (n≤209) were recruited from a university health clinic. After completing a self-administered questionnaire, women received a free voucher for the entire vaccine series. Results: Only 59 women (28.2%) who were offered this free service completed the series. Just over half (50.7%) received the first dose. Of those, 78.3% returned to receive the second and 55.7% returned for the third. Young women who felt their mothers might not want them to be vaccinated were much less likely to complete the series compared with those who felt their mothers would 'definitely' want them to be vaccinated (P≤0.0002). Also, young women who indicated that they would take the time to return to the clinic for doses two and three were far more likely to complete the series (P≤0.0004). Several measures failed to achieve even bivariate significance with vaccine uptake, including being sexually active in the past 12 months, ever having a Pap test or an abnormal Pap test result, and ever having a sexually transmissible infection. Conclusions: Even under ideal conditions, uptake of Gardasil among women 1824 years of age may be quite low. Maternal endorsement and young women's perceptions about the time needed to return for subsequent doses are important determinants of vaccine uptake. Fortunately, these two determinants lend themselves to intervention efforts.