New research suggests that most U.S. mothers who have a daughter between 9 and 12 years old do not intend to have her vaccinated against human papillomavirus (HPV), the cause of almost all cases of cervical cancer.

The first vaccine against HPV, Gardasil, was approved for use in the U.S. in 2006. Vaccination is now recommended as a key means of preventing cervical cancer and national guidelines specifically target 11- to 12-year-old girls.

According to the report in the journal of Pediatrics, less than half — 48 percent — of mothers planned to have their 9- to 12-year-old daughter vaccinated against HPV. This contrasts with their willingness to vaccinate 68 and 86 percent of girls 13 to 15 and 16 to 18 years of age, respectively.

"Parental attitudes about HPV vaccines will be key determinants of adolescent vaccination, but previous studies have demonstrated that some parents have specific concerns about vaccinating their daughters. Additional information about HPV vaccine acceptability in U.S. mothers is needed," Dr. Jessica A. Kahn, from Cincinnati Children's Hospital Medical Center, Ohio, and co-researchers note.

The new findings stem from a study of 10,521 mothers, all nurses, who were surveyed from June 2006 through February 2007. A total of 8,832 mothers (84 percent) completed the survey, of whom 7207 had a daughter.

In addition to assessing the subjects' intentions to vaccinate a daughter, the researchers examined their own willingness to undergo HPV vaccination. In this regard, just 48 percent of mothers said they would be immunized if recommended.

The authors identified several beliefs that significantly influenced the intention to vaccinate a 9- to 12-year-old daughter, including the knowledge that regular Pap smears are important, that the vaccine offers the best protection against cervical cancer, and vaccination does not lead to riskier sex.

The study findings suggest that patient education designed to affect mothers' willingness to vaccinate their daughters against HPV should focus on the effectiveness of HPV vaccine, the behavioral impact of vaccination, the perceived risk of HPV, and physicians' support for the vaccine, the authors conclude.