The role of trust in HPV vaccine uptake among racial and ethnic minorities in the United States: a narrative review

Nicole Harrington; Yuku Chen; Alana M O'Reilly; Carolyn Y Fang; Nicole Harrington; Yuku Chen; Alana M O'Reilly; Carolyn Y Fang

doi:10.3934/publichealth.2021027

AIMS Public Health

2021, Volume 8, Issue 2: 352-368. doi: 10.3934/publichealth.2021027

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Review

The role of trust in HPV vaccine uptake among racial and ethnic minorities in the United States: a narrative review

1.
Immersion Science Program, Fox Chase Cancer Center, Philadelphia, PA, USA
2.
Cancer Prevention & Control Program, Fox Chase Cancer Center, Philadelphia, PA, USA
3.
Molecular Therapeutics Program, Fox Chase Cancer Center, Philadelphia, PA, USA

Received: 26 January 2021 Accepted: 31 March 2021 Published: 06 April 2021

Despite the clinically proven benefits of the human papillomavirus (HPV) vaccine in preventing cervical and other HPV-associated cancers, vaccination coverage has been suboptimal among adolescents and young adults in the United States (US), particularly among racial and ethnic minority adolescents. Historical legacies, combined with current racial/ethnic disparities in healthcare, may contribute to suboptimal uptake and completion of the HPV vaccine in part through differing levels of trust in doctors and healthcare institutions. The purpose of this narrative review was to characterize trust and its role in decision making about HPV vaccine uptake among US racial and ethnic minorities. We conducted a literature search using the PubMed database, and our search terms yielded 1176 articles. We reviewed 41 full-text articles for eligibility and included 20 articles in this review. These studies used varied measures of trust or mistrust and assessed trust in not only doctors/healthcare providers, but also other sources including pharmaceutical companies, media, and clergy. Our review findings revealed generally high levels of trust in doctors and healthcare providers, but less so in pharmaceutical companies. Mistrust of either healthcare providers, government agencies or pharmaceutical companies was consistently associated with less favorable attitudes and lower vaccine uptake. The downstream effects of mistrust may occur through selected health beliefs regarding the perceived efficacy and safety of the vaccine. Minority groups were more likely to report trust in family members, religious organizations, and media sources compared to their white counterparts. Decision making about vaccine uptake is a multilayered process that involves comparing the perceived benefits of the vaccine against its perceived risks. Understanding how trusted sources can effectively harness the tools of social and traditional media to increase knowledge and awareness may help combat misinformation about the HPV vaccine and improve engagement with diverse communities.
- human papillomavirus,
- vaccination,
- trust,
- United States,
- racial/ethnic minorities
Citation: Nicole Harrington, Yuku Chen, Alana M O'Reilly, Carolyn Y Fang. The role of trust in HPV vaccine uptake among racial and ethnic minorities in the United States: a narrative review[J]. AIMS Public Health, 2021, 8(2): 352-368. doi: 10.3934/publichealth.2021027

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Abstract

Despite the clinically proven benefits of the human papillomavirus (HPV) vaccine in preventing cervical and other HPV-associated cancers, vaccination coverage has been suboptimal among adolescents and young adults in the United States (US), particularly among racial and ethnic minority adolescents. Historical legacies, combined with current racial/ethnic disparities in healthcare, may contribute to suboptimal uptake and completion of the HPV vaccine in part through differing levels of trust in doctors and healthcare institutions. The purpose of this narrative review was to characterize trust and its role in decision making about HPV vaccine uptake among US racial and ethnic minorities. We conducted a literature search using the PubMed database, and our search terms yielded 1176 articles. We reviewed 41 full-text articles for eligibility and included 20 articles in this review. These studies used varied measures of trust or mistrust and assessed trust in not only doctors/healthcare providers, but also other sources including pharmaceutical companies, media, and clergy. Our review findings revealed generally high levels of trust in doctors and healthcare providers, but less so in pharmaceutical companies. Mistrust of either healthcare providers, government agencies or pharmaceutical companies was consistently associated with less favorable attitudes and lower vaccine uptake. The downstream effects of mistrust may occur through selected health beliefs regarding the perceived efficacy and safety of the vaccine. Minority groups were more likely to report trust in family members, religious organizations, and media sources compared to their white counterparts. Decision making about vaccine uptake is a multilayered process that involves comparing the perceived benefits of the vaccine against its perceived risks. Understanding how trusted sources can effectively harness the tools of social and traditional media to increase knowledge and awareness may help combat misinformation about the HPV vaccine and improve engagement with diverse communities.

Acknowledgments

This project was partially supported by the TUFCCC/HC Regional Comprehensive Cancer Health Disparity Partnership, Award Number U54 CA221704 (Contact PIs: Grace X. Ma, PhD and Olorunseun O. Ogunwobi, MD, PhD) and P30 CA06927 (PI: Richard Fisher). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NCI/NIH.

Conflict of interest

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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