To Increase HPV Vaccinations, Enhance Provider Communications

A key factor influencing adolescent human papillomavirus (HPV) vaccination is if, and how, healthcare professionals recommend the vaccine, says new research published in JAMA. 

In this randomized clinical trial of healthcare professionals HPV vaccine communication interventions, there were substantial and sustained increases in HPV vaccine series initiation.

Among 43,132 patients at 16 practices participating in this study, a 5-component intervention significantly increased HPV vaccine series initiation, stopped the decline of completion, and was effective for both boys and girls.

Two specific intervention components, communication training, and customized HPV fact sheets were the most used and useful, based on healthcare professionals’ report.

This enhanced communications training package contained 5 elements:

• HPV fact sheets,
• A parent education website,
• Images depicting diseases associated with HPV,
• A decision aid for HPV vaccination, and
• Communication training for healthcare professionals interventions

This study found that in both unadjusted and adjusted models, these increases were significantly larger in the intervention group (11.3%) compared with the control group (1.8%).

Additionally, provider interventions with a patient delivered higher odds of completing the series than control practices.

The researchers found a greater effect of the intervention was seen for pediatric practices versus family medicine practices and in private practices versus public ones.

Highly effective vaccines against HPV have been available in the United States since 2006 for girls and 2009 for boys, yet are largely underused.

As of 2016, only 60.4% of children aged 13 to 17 years had started the HPV vaccination series, and only approximately two-thirds of those starting the series completed it.

Additionally, the CDC approved a two-dose schedule for adolescents under age 15 instead of the traditional three-dose schedule. Teens starting at age 15 or later still need three doses.

The Gardasil 9 vaccine immunizes against nine genotypes of HPV known to cause cervical cancer, as well as vulvar, vaginal, and anal cancers and genital warts caused by HPV.

The CDC Vaccine Price List provides HPV vaccine prices for general information.

And vaccine discounts can be found here.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.

This new study’s findings are similar to previous research, which reported respondents who had previously spoken to a healthcare professional about the HPV vaccine had 80% higher odds of willingness to vaccinate than those who did not speak to a provider about the vaccine.

The Corresponding Author for this study is Amanda F. Dempsey, MD, Ph.D., MPH, Division of General Pediatrics, Department of Pediatrics, University of Colorado Denver. ([email protected]).

Conflict of Interest Disclosures: Dr. Dempsey reported serving on advisory boards for Merck, Pfizer, and Sanofi Pasteur and reported being a consultant to Pfizer. Dr. Dempsey reported that she does not receive any research funding from these agencies and that they had no role in the research described herein.

Funding/Support: This project was funded by grant U01P000801 from the Centers for Disease Control and Prevention.