Overcoming barriers to adherence to HPV vaccination recommendations.
ABSTRACT Human papillomavirus (HPV) is a critical factor in the development of cervical cancer and can lead to genital warts and other clinical sequelae. Two vaccines against HPV have been developed recently that have shown to be safe and effective. The use of HPV vaccines holds promise for alleviating the burden of illness related to HPV infection. However, barriers specific to HPV vaccines, as well as barriers related to adolescent vaccination in general, may pose challenges to widespread implementation. Among these are: (1) lack of knowledge among the US population about HPV transmission and its relation to cervical cancer and other anogenital diseases; (2) parental concerns about vaccines in general and about vaccinating minors against sexually transmitted diseases; (3) financing by the government and private insurers for newly recommended vaccines; (4) challenges related to adolescents' healthcare-seeking behavior and health insurance coverage; and (5) barriers related to the dynamics of HPV infection (eg, protection against only certain types of HPV, duration of immunity, immunization schedules). Addressing these concerns will be critical in effective implementation of HPV vaccines and, potentially, vaccines, against other sexually transmitted diseases.
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- "A fourth potential barrier to HPV vaccine provision is parents who are unaware of the HPV vaccine or their daughters' eligibility for the VFC or other healthcare service programs. For example, some parents of VFC-eligible adolescents may be unaware that they can receive low-cost and free vaccines . A fifth potential barrier is parents' lack of motivation to have their adolescents vaccinated against HPV. "
ABSTRACT: Potential barriers to widespread vaccination of adolescent girls against human papillomavirus (HPV) infection are poorly understood. We provide an overview of potential barriers to provision of HPV vaccine and empirical data on the concerns of medical practices that may inhibit HPV vaccine provision. We conducted phone interviews with medical practices in rural areas in southeastern North Carolina with high rates of cervical cancer to assess 10 potential concerns about HPV vaccine provision. Concerns most commonly reported by medical practices (N = 71) were inadequate reimbursement (68%), high cost of the vaccine to patients (66%), and burden of determining insurance coverage (66%). Practices that were not providing the vaccine reported more concerns about HPV vaccine provision on average than practices providing the vaccine (6.0 vs. 4.5 concerns, p < .05). Medical practices' concerns about the HPV vaccine may be barriers to stocking it and, thus, to providing it to adolescents. Even providers who stock the vaccine reported concerns. Research is needed to address ways to ameliorate these medical practices' concerns and also to understand other potential barriers to vaccine coverage.Journal of Adolescent Health 10/2008; 43(4 Suppl):S61-7. DOI:10.1016/j.jadohealth.2008.06.015 · 2.75 Impact Factor
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ABSTRACT: This study's main research asked which combination of predictors, including type of health provider, type of state policy initiative, overall barriers scores, and overall supports scores, is most predictive of HPV vaccination rates for providers serving girls ages 9-17? Data was collected from May to October 2008 from health providers in four states. Using a proportionate stratified random sample, 1490 potential participants were sent a mail survey. The final sample included 227 respondents. Results indicated that health providers are vaccinating older females at significantly higher rates than younger teens and pre-adolescents in three of the four states. Of the four predictors, fewer barriers were predictive of increased vaccination rates for providers vaccinating girls 9-12 and girls 13-17. Important barriers to consider are financial burden and negative perception of parents about vaccination. Type of health provider, specifically being a pediatrician, was also predictive of HPV vaccination for girls ages 13-17.