What Affects Human Papillomavirus Vaccination Rates? A Qualitative Analysis of Providers' Perceptions
ABSTRACT To define factors that providers perceive as affecting their administration of human papillomavirus (HPV) vaccination in their clinical practices.
We conducted in-depth, qualitative interviews with 34 pediatric and family medicine providers in four community health centers to explore providers' perceptions of factors that either enabled or impeded their ability to vaccinate their patients against HPV.
Providers' self-reported vaccination rates ranged from 25 to 95% (median, 75%) of the 11- to 26-year-old females in their practices. Factors that enabled vaccination included providers' beliefs that HPV vaccines were safe and would provide important health benefits, structured visits that promoted vaccination, and coadministration of HPV with other recommended vaccines. Factors that impeded vaccination included safety concerns, a low perceived severity of HPV disease, lack of school mandates, and policies against coadministration of HPV and meningococcal vaccines. Providers who described more enabling factors than impeding factors reported vaccinating more of their patients.
Provider perceptions around the ease or difficulty of providing HPV vaccination may influence their behavior when offering HPV vaccines to their patients.
[Show abstract] [Hide abstract]
ABSTRACT: OBJECTIVE: The goal of this study was to identify the rationale by parents/guardians and providers for delaying or administering human papillomavirus (HPV) vaccination to girls. METHODS: Qualitative interviews were conducted with parents/guardians accompanying their vaccine-eligible 11- to 17-year-old daughters to medical visits. Interviews were conducted in 1 public clinic and 3 private practice settings to ascertain why girls did or did not receive HPV vaccination. Questions probed vaccine decision-making from the point of view of parents/guardians and providers. RESULTS: A total of 124 parents/guardians and 37 providers participated. The most common reasons parents reported for not vaccinating their daughters was the lack of a physician recommendation (44%). Both parents and providers believed that HPV vaccination provided important health benefits, but the timing of vaccination with relation to sexual activity was an important theme related to vaccine delay. Providers with lower self-reported vaccination rates delayed vaccine recommendations in girls perceived to be at low risk for sexual activity, and several parents reported that their providers suggested or supported delaying vaccination until their daughters were older. However, parents/guardians and providers agreed that predicting the timing of sexual debut was extremely difficult. In contrast, providers with high vaccination rates presented HPV vaccination as a routine vaccine with proven safety to prevent cancer, and parents responded positively to these messages. CONCLUSIONS: Although most parents and providers believe that HPV vaccination is important, missed opportunities result from assumptions about the timing of vaccination relative to sexual activity. Routinely recommending HPV vaccination as cancer prevention to be coadministered with other vaccines at age 11 years can improve vaccination rates.Pediatrics 08/2014; 134(3). DOI:10.1542/peds.2014-0442 · 5.30 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Aims: The study targeted the HPV vaccine knowledge and perceived risk of cervical cancer among female college students in Taiwan as well as the relationship between knowledge of the HPV vaccine and perceived risk of cervical cancer. Materials and Method: The results of this study on female college students are described using descriptive and correlation designs. A convenience sampling approach was employed with a self-filling structured questionnaire. Results: A total of 150 students completed the questionnaire. Values were 7.49 for the mean HPV vaccine knowledge scale and 18.0 for their mean perceived risk of cervical cancer scale. HPV vaccine knowledge was positively correlated with perceived risk of cervical cancer. Conclusions: The findings of this study can serve as a reference for future HPV prevention in Taiwan.Asian Pacific journal of cancer prevention: APJCP 12/2013; 14(12):7371-4. DOI:10.7314/APJCP.2013.14.12.7371 · 1.50 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: IMPORTANCE Since licensure of the human papillomavirus (HPV) vaccine in 2006, HPV vaccine coverage among US adolescents has increased but remains low compared with other recommended vaccines. OBJECTIVE To systematically review the literature on barriers to HPV vaccination among US adolescents to inform future efforts to increase HPV vaccine coverage. EVIDENCE REVIEW We searched PubMed and previous review articles to identify original research articles describing barriers to HPV vaccine initiation and completion among US adolescents. Only articles reporting data collected in 2009 or later were included. Findings from 55 relevant articles were summarized by target populations: health care professionals, parents, underserved and disadvantaged populations, and males. FINDINGS Health care professionals cited financial concerns and parental attitudes and concerns as barriers to providing the HPV vaccine to patients. Parents often reported needing more information before vaccinating their children. Concerns about the vaccine's effect on sexual behavior, low perceived risk of HPV infection, social influences, irregular preventive care, and vaccine cost were also identified as potential barriers among parents. Some parents of sons reported not vaccinating their sons because of the perceived lack of direct benefit. Parents consistently cited health care professional recommendations as one of the most important factors in their decision to vaccinate their children. CONCLUSIONS AND RELEVANCE Continued efforts are needed to ensure that health care professionals and parents understand the importance of vaccinating adolescents before they become sexually active. Health care professionals may benefit from guidance on communicating HPV recommendations to patients and parents. Further efforts are also needed to reduce missed opportunities for HPV vaccination when adolescents interface with the health care system. Efforts to increase uptake should take into account the specific needs of subgroups within the population. Efforts that address system-level barriers to vaccination may help to increase overall HPV vaccine uptake.11/2013; 168(1). DOI:10.1001/jamapediatrics.2013.2752