Table 3.

Factors negatively associated with HPV vaccination outcomes among U.S. female and male adolescents ages 9-17 years

Target population	Outcome
	Initiation
Female adolescents	Parent psychosocial factors
	Lack of knowledge, require information37
	HPV vaccine36
	Beliefs
	Low perceived need36,37
	Low perceived susceptibility36,37
	Concerns about vaccine safety25,37,39
	Concerns about vaccine effectiveness32,36,37
	Concerns about cost39
	Concerns about sexual activity*26,32
	Dissatisfaction with information on vaccine25
	Adolescent behavior
	Interaction with healthcare system
	Lack of recent preventive care visit25
	Provider behavior
	Lack of recommendation36,37
Male adolescents	Parent psychosocial factors
	Lack of knowledge28
	Beliefs
	Low perceived benefit28
	Low perceived need28
	Provider behavior
	Lack of recommendation28
Female and male adolescents	Parent psychosocial factors
	Lack of knowledge, require information28,33,40
	Beliefs
	Low perceived need26,28,39,40
	Low perceived susceptibility27,33,38
	Concerns about vaccine safety32,33,38,40
	Concerns about cost28,37,40
	Parent behavior
	Previous refusal to vaccinate child26
	Provider behavior
	Lack of recommendation28

^*Mixed results found for association between factor and vaccination outcomes