Utility Analysis of a HPV Vaccine Mandate for Public School Enrollment

Monday, July 11, 2011

Heather K. Hardin, BSN, RN
School of Nursing, University of Louisville, Louisville, KY

Learning Objective 1: The learner will be able to list 3 reasons parents of minor females oppose HPV vaccination.

Learning Objective 2: The learner will be able to describe 2 methods for use in influencing a parent's decision to vaccinate their daughter against HPV.


The human papilloma virus (HPV) is the most common sexually transmitted infection in the US.  Eighty percent of the population will be exposed to HPV in their lifetime.  Two high risk strains of HPV, 16 and 18, are the cause of 70% cervical cancers.  Two vaccines have been developed to inoculate against these cancer causing viruses.  Inoculation will only be successful if the vaccine is received prior to exposure to HPV 16 and HPV 18, thus it is important to vaccinate girls prior to sexual debut.  The controversy surrounding these vaccines concerns several issues, including parental autonomy, vaccine safety, moral/religious beliefs and cost. 

In 2007, 24 states and the District of Columbia introduced legislation regarding HPV vaccine mandates.  Only Virginia and the District of Columbia currently have made the HPV vaccine a requirement for public school enrollment.  Significant opposition to vaccinating 12 year-old females against HPV exists. 

The research question for this analysis is:  How does parental/guardian utility affect use of the HPV vaccine for 12 year-old females when the vaccine is mandated or not mandated for public school admission? 

The purpose of this poster is to present a visual model of American parent's preferred outcomes for HPV prevention in their minor aged daughters.


A review of literature was completed to identify utility measures from American, adult females.  Utilities for HPV vaccination, HPV treatment and cervical cancer were obtained.  TreeAge software was used to build and analyze a decision tree using utility measures of parent/guardian utilities of HPV vaccination, HPV infection treatment and cervical cancer.


Results of this analysis depict the current parental utility of HPV vaccination of 12 year-old females. 


Parents/guardians of 12 year-old females do not prefer HPV vaccine outcomes over the disutility of mandating the HPV vaccine in the US.