Pediatricians' Intention to Recommend Human Papillomavirus (HPV) Vaccines to 11- to 12-Year-Old Girls Postlicensing

The Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Journal of Adolescent Health (Impact Factor: 3.61). 11/2008; 43(4):408-11. DOI: 10.1016/j.jadohealth.2008.06.012
Source: PubMed


We surveyed 105 pediatric clinicians following Human papillomavirus (HPV) vaccine licensure to identify factors associated with intention to recommend the vaccine to 11- to 12-year-old girls. Pediatricians who were early adopters of medical technologies had fewer concerns about HPV vaccine safety/efficacy, and who anticipated parental vaccine safety/efficacy concerns reported higher intention to recommend the vaccine.

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    • "For 11-and 12-year-old patients, physicians indicated that they endorsed HPV vaccine less strongly than Tdap or meningococcal vaccines and often discussed it last. These findings add to a growing literature which suggests that, although physicians generally support HPV vaccination (Perkins et al., 2014; Feemster et al., 2008; Kahn et al., 2007), they discuss it in ways that likely discount its value (Perkins et al., 2014; Hughes et al., 2011; McRee et al., 2014; Hamlish et al., 2012). To the extent that physicians' strong endorsements of Tdap or Fig. 1. "
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    ABSTRACT: Low human papillomavirus (HPV) vaccination coverage stands in stark contrast to our success in delivering other adolescent vaccines. To identify opportunities for improving physicians' recommendations for HPV vaccination, we sought to understand how the communication context surrounding adolescent vaccination varies by vaccine type. A national sample of 776 U.S. physicians (53% pediatricians, 47% family medicine physicians) completed our online survey in 2014. We assessed physicians' perceptions and communication practices related to recommending adolescent vaccines for 11- and 12-year-old patients. About three-quarters of physicians (73%) reported recommending HPV vaccine as highly important for patients, ages 11-12. More physicians strongly recommended tetanus, diphtheria, and acellular pertussis (Tdap) (95%) and meningococcal vaccines (87%, both p<0.001) for this age group. Only 13% of physicians perceived HPV vaccine as being highly important to parents, which was far fewer than perceived parental support for Tdap (74%) and meningococcal vaccines (62%, both p<0.001). Physicians reported that discussing HPV vaccine took almost twice as long as discussing Tdap. Among physicians with a preferred order for discussing adolescent vaccines, most (70%) discussed HPV vaccine last. Our findings suggest that primary care physicians perceived HPV vaccine discussions to be burdensome, requiring more time and engendering less parental support than other adolescent vaccines. Perhaps for this reason, physicians in our national study recommended HPV vaccine less strongly than other adolescent vaccines, and often chose to discuss it last. Communication strategies are needed to support physicians in recommending HPV vaccine with greater confidence and efficiency. Copyright © 2015. Published by Elsevier Inc.
    Preventive Medicine 06/2015; 77. DOI:10.1016/j.ypmed.2015.05.024 · 3.09 Impact Factor
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    • "On voit ici l'impact des campagnes d'information qui accompagnent la mise sur le marché de tout nouveau vaccin sur l'amélioration des connaissances et le changement d'attitude des pédiatres et des médecins généralistes [14]. Lors des premières enquêtes faites auprès des médecins, la principale objection e ´tait l'a ˆge jeune (11–12 ans) préconisé par l'Advisory Committee on Immunization Practices (ACIP) pour la vaccination des filles, mais cette attitude s'est modifiée par la suite : a ` Philadelphie, 78 % des pédiatres se déclaraient prêts a ` recommander ce vaccin quelques mois après sa commercialisation [15]. Notre enquête, effectuée quatre ans plus tard au Vietnam, révèle un assez bon niveau de connaissances chez les pédiatres et ne compte que 5 % de "
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    ABSTRACT: Background: Cervical cancer (CC) is almost always induced by some oncogenic types of human papillomavirus (HPV). In Vietnam, it is the first leading cause of cancer in women, with highest prevalence in Ho Chi Minh City (HCMC). Since 2006, prevention of the CC has been improved by licensure of recombinant vaccines directed against HPV 16 and 18, effective when administered before the age of first sexual intercourse. A national program for routine immunization of pre-adolescent girls in addition to cytological screening of adult women would greatly reduce the impact of CC in Vietnam but vaccines remain expensive and it is unclear how this strategy would be accepted by the target population. The aim of this study was to assess the acceptability of HPV vaccination by pediatricians, mothers with a daughter aged 9-15 years and young women aged 16-26 years in HCMC. Methods: Between March and June 2010, a cross-sectional survey of knowledge and attitudes was administered to 115 pediatricians in the pediatric hospital, 210 mothers and 400 young women attending the gynecology department of the University Hospital. Results: Pediatricians generally had a good perception of the risk but they still lacked knowledge about HPV vaccination, given by 66% of them. Among mothers, 18% knew the relationship between HPV infection and CC, 43% had heard of HPV vaccination and 40% agreed to vaccinate their daughter. Among young women, 35% knew the risk, 49% knew the vaccine and 38% wanted to be vaccinated. Level of education, amount of income and celibacy were positively related to intention to be vaccinated. The lack of information on HPV vaccination and the high cost of vaccines were the main causes of refusal or indecision. Conclusion: Routine HPV vaccination of girls in HCMC will be well accepted by the population if a large campaign of health education is implemented by the government and if the affordability of vaccines is facilitated.
    Revue d Épidémiologie et de Santé Publique 11/2012; 60(6). DOI:10.1016/j.respe.2012.03.010 · 0.59 Impact Factor
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    • "Trust in HCPs was also correlated with more information seeking from HCPs [35]. Among HCPs, an early adopter of a new intervention generally has a higher intention of recommending the HPV vaccine [36,37]. Physicians’ practices [38,39] and their beliefs and attitudes towards the HPV vaccine [37,40] were also found to affect their propensity to recommend the HPV vaccines to their patients. "
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    ABSTRACT: Background Human papillomavirus (HPV) vaccine recommendation by a health care provider (HCP) is an important predictor of vaccine receipt. We examined whether being of a minority race/ethnicity, having lower income and education, and the lack of health insurance and a regular HCP are each associated with a lower likelihood of a discussion on HPV vaccine occurring between a woman and her HCP. Methods A sample of 1,631 women aged 18 years and older was drawn from the 2007 Health Information National Trends Survey. Given that only a subgroup of women who were aware of the HPV vaccine were asked if they had a discussion with their HCPs, we estimated a probit model correcting for sample selection. Results Among those aware of the HPV vaccine, 17.3% of respondents reported having discussions on the vaccine with their HCPs. Compared with Whites, African Americans were less likely to be aware of the HPV vaccine but more likely to have discussions with their HCPs concerning the vaccine. A statistically significant association between lower income and education levels and a lower likelihood of HPV vaccine awareness was observed, but low levels of income and education did not appear to affect the probability of having HPV vaccine discussions with HCPs. Conclusions Socioeconomically disadvantaged women did not show a lower propensity to have vaccine discussions with their HCPs, suggesting that HCPs can be a major catalyst in increasing vaccine receipt among the higher risk group. The results of the study suggest a two-pronged approach that seeks to raise vaccine awareness among socioeconomically disadvantaged women at the population level and encourages HCPs to intensify discussions about the HPV vaccine with patients.
    BMC Women's Health 10/2012; 12(1):33. DOI:10.1186/1472-6874-12-33 · 1.50 Impact Factor
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