Health Care Providers Impact on HPV Vaccination Rates

Study results showed some health care providers do not favor the CDC’s urgent HPV vaccine recommendations.



Human papillomavirus (HPV) causes about 65% of vaginal cancers, according to Although HPV vaccine is known to reduce the incidence of infection, actual vaccination rates continue to fall “well below the national goal of 80%,” according to researchers from University of Washington in Seattle, Harvard in Boston Massachusetts, and University of Minnesota in Minneapolis. One of the main barriers, they say, is that many health care practitioners (HCPs) don’t understand or don’t accept the guidelines.

Related: More Evidence of HPV’s Role in Cancer

In 2 surveys, the researchers questioned HCPs in Minnesota and Washington about their views of the time line (real or imagined) for vaccinating adolescents. In the first, the researchers conducted semistructured, face-to-face interviews with 27 HCPs in Minneapolis and St. Paul. The interviews included 2 questions: “How do you counsel patients and their parents about HPV vaccine?” and “How do you discuss the vaccine with a parent who might be hesitant to get their son or daughter vaccinated against HPV?” In the Washington study, the researchers held telephone interviews with 17 HCPs and asked them: “At what point do you worry that your patients won’t complete the HPV vaccine series?”

In general, the HCPs felt there was an “age gradient” for allowable vaccination and timely vaccination. The CDC recommends beginning\vaccinations in patients aged 11 or 12 years, but to the respondents, aged 12 years was not a hard-and-fast rule. In fact, they tended to view increasing age as a “gradually pressing prompt” toward recommending the vaccine. Aged 16 years was the earliest at which respondents reported feeling any urgency to initiate or complete the series. Ssome reported not feeling any urgency until their patients were in their 20s. One HCP said, “you’re supposed to be able to finish it anytime, I think.” Another said, “I delay pretty much everybody. To me it’s not a problem.”

Related: HPV Vaccination Coverage of Male Adolescents

The providers mostly guided their decisions about when to broach the topic according to whether they thought their patients would have consistent access to care or whether they were likely to be sexually active. Many reported a relaxed approach for younger patients because they “knew” they’d see them again.

Another reason some HCPs favored a nonurgent attitude was that they wanted to build long-term trust with the parents. So they opted to give less strong recommendations to give parents “time to think about it.”

Related: HPV Vaccine Uptake Low Among Native Americans

HCP recommendation of the vaccine is the “strongest, most consistent influence on parents’ decisions” about vaccination, the researchers say. But research suggested that parents prefer clear, unambiguous messages that HPV vaccination is important. ”Softer or deferred” HPV advice, they warn, may actually undermine vaccine recommendations.

Henrikson NB, Tuzzio L, Gilkey MB, McRee A-L. Prev Med Reports. 2016; 4: 94-97. doi:10.1016/j.pmedr.2016.05.002.

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