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Why hesitation over the HPV vaccine threatens public health and equity

Ayesha Khan
Conditions
October 18, 2025
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In the quiet that follows a routine pediatric check-up, a single word, “vaccines,” can suddenly change the air. Where vaccines were once a simple part of childhood, they have become something parents scrutinize, debate, and sometimes outright resist. The shift is palpable, and it is increasingly showing up in clinic rooms every day.

As a medical student training in New York City, I am constantly struck by a paradox: We live in one of the most medically advanced cities in the world, yet basic tools for disease prevention remain underused. Few examples illustrate this better than the HPV vaccine.

The HPV vaccine is one of the most powerful cancer-prevention measures ever developed. Human papillomavirus (HPV) is a common infection that can lead to cervical, vaginal, vulvar, anal, penile, and throat cancers. Gardasil, the HPV vaccine, protects against the most dangerous HPV strains and has been in use for nearly two decades. Studies have found that in countries with strong vaccine rollouts, like Australia, Sweden, and the U.K., cervical cancer rates among young women have plummeted by as much as 87 percent. In the U.S., HPV infections from cancer-causing strains dropped 88 percent among teen girls after the vaccine became available, with herd immunity extending protection even to those who were unvaccinated.

This is a public health success story. And yet, in the United States, its promise is being undercut by hesitation and stigma.

Here in New York City, one in four adolescents have not completed their HPV vaccination series. Nationwide, Hispanic and Black adolescents often lead in HPV vaccine initiation, but dramatic gaps remain in completion rates; for example, one health system found completion among Black females at just approximately 28.7 percent, compared to approximately 49.5 percent among Asian patients. These disparities echo in New York State data, where Hispanic and Black young people have higher initiation rates but still lag in completing the series.

This gap translates into real harm. In New York City, research found that women living in the lowest-income neighborhoods, mostly Black and Hispanic communities, face cervical cancer rates about 73 percent higher than those in wealthier areas. Across New York State, Black and Hispanic women are also more likely to get and die from cervical cancer than White women. The underuse of the HPV vaccine is not just a medical issue; it is an equity issue.

In my clinical rotations, I have seen parents hesitate or outright refuse HPV vaccination for their children. Dr. Ilana Stein, a Bronx pediatrician, has noticed the same trend: “Vaccine hesitancy among parents has definitely been increasing over the years,” she told me. “In my opinion, this is largely due to misinformation about vaccines and vaccine safety being presented on social media platforms and even misinformation being spread by our current government.”

National political rhetoric has only added fuel to the fire. Figures like RFK Jr., who now leads the Department of Health and Human Services, have spent years spreading debunked claims about Gardasil, calling it “dangerous” and “defective.” When misinformation comes from both fringe social media accounts and the highest levels of government, the result is confusion and mistrust.

One of the persistent myths brought up in clinic visits is that the HPV vaccine encourages risky sexual activity. This misconception has been disproven repeatedly, with research showing no link between vaccination and earlier or riskier sexual behavior. But stigma runs deep. Dr. Stein often reframes the conversation: “I try to counsel parents that the HPV vaccine is a cancer prevention vaccine. Not only does it prevent cervical and vaginal cancers, but also anal, penile, and oropharyngeal cancers.” In her experience, this shift in framing often helps parents see the vaccine for what it really is: a shield against cancer, not a commentary on their child’s future choices.

Every unvaccinated child increases the risk of cancers that cost millions to treat in safety-net hospitals. Misinformation is creating a two-tiered system: some kids are protected, while others are left exposed. And while NYC lags, countries like Australia and Sweden are on track to nearly eliminate cervical cancer through high vaccination coverage, proving that this is a solvable problem.

But there is hope. Studies show that when pediatricians strongly recommend the HPV vaccine, up to 90 percent of parents eventually agree to vaccinate. Community-centered education campaigns, school-based health programs, and culturally tailored outreach can also close gaps in access and trust. In a city like New York, with its wealth of public health expertise, we have the tools to make that happen.

The story of Gardasil is simple: It works. The tragedy is that misinformation has worked harder. As we face the rise in vaccine skepticism, it is up to clinicians, researchers, and communities to tell the truth clearly. New York City must lead the way in ensuring that this life-saving protection reaches every child, in every neighborhood.

Ayesha Khan is a medical student.

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