Talking with parents about human papillomavirus (HPV) vaccination
The guide on this page will help you have productive and respectful conversations about human papillomavirus (HPV) vaccination. This guide aligns with the One-to-One method1 of talking about sexual health and can be used in conjunction with the SKAI communications approach.2
Information
You may be approached by a parent who is concerned about their adolescent receiving the human papillomavirus (HPV) vaccine. Their hesitancy may be related to strongly held morals, values or belief systems, a previous negative sexual experience or potential misperceptions about vaccines.3,4,5
This page supports you as a healthcare professional to respectfully respond to parents who have strong beliefs or attitudes about adolescent HPV vaccination.
This resource uses the overarching framework of the SKAI communications approach to help you reflect, listen and acknowledge the concerns a parent shares with you. These steps are followed by sharing your own health knowledge and offering a recommendation to vaccinate.
You can use the steps and scripts below when sharing your knowledge.
We know some parents feel hesitant, worried, shy or unsure about HPV vaccination. Talking about these concerns and how HPV vaccination relates to sexual health can make some people feel uncomfortable.
In our research, some healthcare professionals asked for specific guidance on how to have a supportive conversation about HPV vaccination while still respecting the values, beliefs or fears of the parent they are speaking too.
By using the steps outlined below, you can start normalising the topic of adolescent sexual health and clarify any potential HPV or vaccine misperceptions the parent brings up.
We integrated the One-to-One method1 of talking about sexual health into a broader SKAI communication approach2 originally developed by social scientist and vaccine communication expert Professor Julie Leask (University of Sydney) and a team of other researchers. We also reviewed the literature and consulted with consumers, healthcare professionals, social scientists and a multicultural communication expert to inform this work.
This resource aligns with best practice in sexual health and patient-centred communication,1,6 which emphasises fostering good relationships with patients and exploring information together to support health decision-making.6
A parent you are speaking to has brought up questions or concerns about HPV vaccination. These concerns could include someone thinking their adolescent is:
- too young for the vaccine
- not at risk of catching HPV
- only going to have one sexual partner in their life.
Here are the recommended steps for speaking with parents about HPV vaccination questions or concerns.
Be mindful of the parent’s lived experience.
People learn about sexual health in different ways.3,4,5 Some have had positive guidance from their parents or community, while others get little or no information. For others, previous negative sexual experiences can also shape how they see the topic of HPV vaccination.5
Think back to how you first learned about sexual health.
Who taught you?
What did you learn first?
Reflecting on your own experiences can help you approach parents with additional empathy and understanding.4
Don’t make assumptions about the parent you are speaking too.7 If you don’t know the parent’s background, avoid guessing what their religion, culture or ethnicity is based on their name or their appearance.8,9 A wrong guess can make the conversation more uncomfortable and make it harder to build rapport.8,9,10,11 Instead, ask open and neutral questions about them, their children or their family. Focus on non-verbal cues and allow personal information to be brought up in its own time.
If you know a parent’s background, consider contacting a multicultural health worker or other support service. These services can offer guidance or advice around how to safely discuss sexual health topics.7
If you think you need translation support, try to have some handy or arrange for this ahead of time.10 If you don’t know the parent’s preferred language, you can ask them directly. Some parents have limited English literacy or literacy in their own language, so relying on translated written information resources may not be enough. You may also need to arrange for an interpreter who is not the parent’s child or family member.10
“Do you speak a language other than English? I can look for some translated information in the language you prefer to speak or read.”
Talking about adolescent sexual health can feel awkward for anyone! Parents may show their discomfort by hesitating to speak or struggling to find the right words.1,12 Relieve any tension by openly acknowledging the awkwardness of the topic.
“I know it feels awkward to speak about sexual health. But talking about this openly will help you and your adolescent.”
Explore the parent’s questions or concerns.
Remind the parents that this is a private and confidential conversation.7 Then invite the parent to share what’s on their mind.1,2,6
“Having questions about the HPV vaccination is very common. Anything you share here is private and stays between us.”
“I’d like to hear what worries you most about HPV vaccination.”
Use a curious tone with your questions. This shows the parent you are open to their thoughts and encourages them to share their concerns in their own words.1,6
When the parent is speaking, stay quiet and let them finish.2,6 Do not correct any misperceptions at this time. Show you are listening to them by nodding and using open body language. This gives parents the space to voice their concerns,12 and you space to gather your thoughts. If you want to find out more about the parent’s background, you can also ask what has led to this concern.
“Can you share with me what has led to this concern?”
Acknowledge and affirm.
Tell the parent you value what they have shared. Use the parent’s own words in your response to show you were actively listening. This also allows you to clarify the parent’s concerns.2,3,12 It is also important to reassure the parent that their concerns are understandable and common.
“It sounds like you are concerned about...”
“Many parents share this worry. You are not alone in feeling this way.”
Summarise and set the agenda.
Confirm what you will discuss and ask permission to share your information.2,6,12 If the parent has listed many concerns, you can prioritise together what you will discuss. This shifts the conversation from listening to sharing.
“I have information that could help address your concerns. Would it be useful if I shared some of this?”
Give clear, simple facts and evidence that support HPV vaccination.13 Choose information that best matches the parent’s main concerns, beliefs and values.12 We have provided some examples below:
A suggested response is:
“Research shows that adolescents who are vaccinated at younger ages do not engage in early sexual activity.”
If needed, you can add these details:
“We also know that even adults who are sexually active with one partner can still get an HPV infection.”
A suggested response is:
“Anyone who becomes sexually active is at risk for HPV. This is because most people with an HPV infection don’t have symptoms, so many don’t know they have the virus.”
If needed, you can add these details:
“Research studies show that even adults who only have one partner can still get an HPV infection.”
A suggested response is:
“I do not recommend waiting to vaccinate. Research shows the vaccine provides the best protection if given before an adolescent is exposed to the virus.”
If needed, you can add these details:
“By vaccinating your adolescent on time, they are much less likely to catch HPV when they are older.”
Make a clear recommendation to vaccinate.13 You could say:
“This is why it is very important to vaccinate.”
Re-check understanding and intentions.
At the end of your conversation, check to see how the parent feels about HPV vaccination. This helps you confirm their understanding.
“Does this information answer your questions or is there still something that is unclear?”
“Are you happy to go ahead and vaccinate?”
Share credible resources.
Share SKAI and other credible sources of information with the parent for them to read. Some people will take time to digest what you have told them. They may need to contact you or another provider again.
“If you want more information about what we discussed, you can visit the SKAI website. You can also contact me again or book another appointment.”
Be patient and keep offering opportunities for a parent to vaccinate their adolescent against HPV.
This resource is part of the SKAI package to support vaccine conversations between healthcare professionals and community members.
You can find more resources to support vaccine communication for other population groups in the healthcare professionals section of the SKAI website.
If you would like to provide feedback on this resource, please get in touch.
Please note: In this guide, ‘parent’ refers to any guardian entrusted with making health decisions for an adolescent.
Drafts of this guidance were reviewed and revised based on advice from Dipti Zachariah, Associate Director – Patient and Carer Experience Clinical Governance, Western Sydney Local Health District, who is an expert in multicultural health communication practice.
- Sensoa. Talking about sexual health using the One to One method. Sensoa website, n.d., available from: https://www.sensoa.be/talking-about-sexual-health-using-one-one-method
- Leask J, Kinnersley P, Jackson C, et al. Communicating with parents about vaccination: a framework for health professionals. BMC Pediatrics 2012;12:154. https://doi.org/10.1186/1471-2431-12-154
- Jones J, Mitchell A, Walsh, JA: Australian National Council on AIDS and Related Diseases (ANCARD). Talking sexual health: a parents’ guide. Canberra: ANCARD; 1999. Available from: https://www.vic.gov.au/sexuality-education-parents#talking-sexual-health-%E2%80%93-parents%E2%80%99-guide
- Borms R, Geuens S. Talking sexuality. In: Geuens S, Polona Mivšek, A, Gianotten, W (eds). Midwifery and Sexuality. Cham: Springer International Publishing; 2023. pp. 309-324.
- Christou-Ergos M, Wiley KE, Leask J, Shapiro GK. Traumatic Events and Vaccination Decisions: A Systematic Review. Vaccines (Basel) 2022; 10(6):911. https://doi.org/10.3390/vaccines10060911
- King A, Hoppe RB. "Best practice" for patient-centered communication: a narrative review. Journal of Graduate Medical Education 2013; (3):385-93. https://doi.org/10.4300/JGME-D-13-00072.1
- NSW Health. Sexual health promotion with culturally & linguistically diverse young people. Play Safe Pro website, n.d., available from: https://pro.playsafe.health.nsw.gov.au/tools/sexual-health-promotion-with-culturally-linguistically-diverse-young-people.
- Bohren MA, Vazquez Corona M, Odiase OJ, et al. Strategies to reduce stigma and discrimination in sexual and reproductive healthcare settings: A mixed-methods systematic review. PLOS Global Public Health 2022; 2(6):e0000582. https://doi.org/10.1371/journal.pgph.0000582
- Healy M, Richard A, Kidia K. How to Reduce Stigma and Bias in Clinical Communication: a Narrative Review. Journal of General Internal Medicine 2022; 37(10):2533-2540. doi: 10.1007/s11606-022-07609-y.
- Multicultural Centre for Women’s Health. (2012). Common Threads: Best Practice Guide – Working with immigrant and refugee women in sexual and reproductive health. Accessed from: https://www.mcwh.com.au/downloads/publications
- Stangl AL, Earnshaw VA, Logie CH, et al. The Health Stigma and Discrimination Framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC Medicine 2019; 15;17(1):31. https://doi.org/10.1186/s12916-019-1271-3 . PMID: 30764826; PMCID: PMC6376797.
- Kelder I, Sneijder P, Klarenbeek A, Laan E. Communication practices in conversations about sexual health in medical healthcare settings: A systematic review. Patient Education and Counseling 2022;105(4):858-68.
- Opel DJ, Mangione-Smith R, Robinson JD, et al. The influence of provider communication behaviors on parental vaccine acceptance and visit experience. American Journal of Public Health 2015; 105(10). p. 1998-2004.