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Kong WY, Oh NL, Kennedy KL, Carlson RB, Liu A, Ozawa S, Brewer NT, Gilkey MB. Identifying Healthcare Professionals With Lower Human Papillomavirus (HPV) Vaccine Recommendation Quality: A Systematic Review. J Adolesc Health 2024; 74:868-877. [PMID: 38231146 PMCID: PMC11031337 DOI: 10.1016/j.jadohealth.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE Strengthening healthcare professionals' (HCPs) communication is an evidence-based approach to increasing human papillomavirus (HPV) vaccine uptake among adolescents. To better target future interventions, we sought to synthesize evidence on HCP subgroups who most need to improve their HPV vaccine recommendation quality. METHODS We searched five databases for quantitative studies published from 2012 to 2022 on HPV vaccine recommendation quality, including recommendation consistency and strength, for United States adolescents. Two coders independently abstracted data from each eligible study, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We summarized variation in recommendation quality by clinical and HCP characteristics. RESULTS The 28 eligible studies indicated that relatively low proportions of HCPs used higher-quality recommendation practices (median: 61% across 30 measures) and that recommendation quality varied across HCP subgroups. The most consistent findings were that more pediatric HCPs used higher-quality recommendations than family medicine HCPs (8 of 11 studies, 2-60 percentage point difference) and that HPV-related knowledge was associated with higher recommendation quality (four of seven studies). Most studies observed no differences in recommendation quality by clinical role (e.g., provider vs. nurse) or HCP demographics (e.g., gender, age, race/ethnicity). DISCUSSION Studies suggest a substantial need to improve HCPs' recommendation quality, with opportunities for targeting future interventions.
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Affiliation(s)
- Wei Yi Kong
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Nul Loren Oh
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn L Kennedy
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rebecca B Carlson
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Amy Liu
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sachiko Ozawa
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Melissa B Gilkey
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Ryan GW, Miotto MB, McReynolds C, Lemon SC, Pbert L, Trivedi M. Pediatricians' perspectives on COVID-19 and HPV vaccine hesitancy. Hum Vaccin Immunother 2023; 19:2225388. [PMID: 37347712 PMCID: PMC10288893 DOI: 10.1080/21645515.2023.2225388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023] Open
Abstract
Rises in parental vaccine hesitancy, observed during the COVID-19 pandemic, threaten public health. This is especially concerning for vaccines not typically required for school-entry, such as the vaccines for COVID-19 and human papillomavirus (HPV), both of which also have much lower rates of completion compared to other adolescent vaccines. Pediatricians are well-positioned to address vaccine hesitancy and can offer insights into parents' perspectives in this area. There is evidence that pediatricians' sharing their own vaccine stories may help to address parents' concerns; yet we have little information on pediatricians' or their children's COVID-19 vaccine uptake. To address these gaps, we conducted a cross-sectional survey about Massachusetts pediatricians' behaviors and perspectives on vaccines that face significant resistance: HPV and COVID-19 vaccines. A total of 144 people initiated the survey, and 109 participants were eligible and completed the survey. Participants reported high levels of COVID-19 vaccine uptake for themselves (97%) and their children (98%). Similarities in parents' resistance toward both vaccines were identified: fear of side effects; general vaccine resistance. Pediatricians reported a rise in vaccine hesitancy since the beginning of the COVID-19 pandemic. Future research should focus on identifying strategies to build overall vaccine confidence and streamline these efforts for pediatricians.
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Affiliation(s)
- Grace W. Ryan
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Mary Beth Miotto
- Mattapan Community Health Center, Boston, MA, USA
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | | | - Stephenie C. Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Lori Pbert
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Michelle Trivedi
- Division of Pulmonology, Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Child Health Equity Center, Department of Pediatrics, UMass Chan Medical School, UMass Memorial Children’s Medical Center, Worcester, MA, USA
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Staras SAS, Salloum RG, Osegueda E, Bylund CL, Chi X, Mohan V, Sage E, Huo T, Young A, Thompson LA. North-Central Florida Clinicians' Human Papillomavirus Vaccine Recommendation Priorities and Practices for 11- to 12-Year-Olds: A Discrete Choice Experiment. J Adolesc Health 2023; 73:172-180. [PMID: 37029049 DOI: 10.1016/j.jadohealth.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 01/20/2023] [Accepted: 02/01/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE Within the United States, human papillomavirus (HPV) vaccination rates remain low. We examined HPV vaccine recommendation practices among Florida clinicians by assessing variability in: (1) recommendation priorities by patient characteristics and (2) concordance with best practices. METHODS In 2018 and 2019, we conducted a cross-sectional survey incorporating a discrete choice experiment among primary care clinicians (MD/DO, APRN, and PA). We used linear mixed-effects models to determine the importance of patient characteristics (age, sex, time in practice, and chronic condition) and parental concerns. We compared clinician endorsement of predetermined constructs with reported vaccine recommendation statements. RESULTS Among 540 surveys distributed, 272 were returned and 105 reported providing preventive care to 11- to 12-year-olds (43% response rate). Among completing clinicians, 21/99 (21%) did not offer the HPV vaccine. Among clinicians offering the vaccine (n = 78), 35%-37% of each decision to recommend the vaccine was based on the child's age (15 vs. 11 years). For closed-ended questions, most clinicians endorsed best practices including emphasizing cancer prevention (94% for girls and 85% for boys; p = .06), vaccine efficacy (60% both sexes), safety (58% girls and 56% boys), importance at 11-12 years (64% both sexes), and bundling vaccines (35% girls and 31% boys). When clinicians reported their typical recommendation, fewer clinicians incorporated best practices (59% cancer prevention, 5% safety, 8% the importance at 11-12 years, and 8% bundling vaccines). DISCUSSION HPV vaccination recommendation strategies among Florida clinicians somewhat aligned with best practices. Alignment was higher when clinicians were explicitly asked to endorse constructs versus provide recommendations.
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Affiliation(s)
- Stephanie A S Staras
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida; The Institute for Child Health Policy, University of Florida, Gainesville, Florida.
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
| | - Eduardo Osegueda
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida; Health Services Research, Management & Policy, College of Public Health & Health Professions, University of Florida, Gainesville, Florida
| | - Carma L Bylund
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
| | - Xiaofei Chi
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
| | - Vikasni Mohan
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
| | - Emily Sage
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
| | - Tianyao Huo
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
| | - Alyson Young
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
| | - Lindsay A Thompson
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida; The Institute for Child Health Policy, University of Florida, Gainesville, Florida; Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida
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Ellingson MK, Bednarczyk RA, O’Leary ST, Schwartz JL, Shapiro ED, Niccolai LM. Understanding the Factors Influencing Health Care Provider Recommendations about Adolescent Vaccines: A Proposed Framework. J Behav Med 2023; 46:356-365. [PMID: 35194726 PMCID: PMC8862696 DOI: 10.1007/s10865-022-00296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 02/03/2022] [Indexed: 11/17/2022]
Abstract
Health care provider recommendations are among the most important factors influencing parents' decisions to vaccinate their adolescents. However, delivery of high-quality health care provider recommendations for vaccination is not universal. There is wide variation in the strength, timeliness and consistency of the delivery of recommendations for all adolescent vaccines. The factors that influence health care providers' recommendations are multi-level and can be conceptualized in much the same way as vaccine acceptance among parents. Health care providers are influenced by their own attitudes and beliefs about a vaccine and also by the patient they are treating and by the community in which they practice as well as state and national level vaccine policy. We propose a multi-level framework for understanding the factors that influence health care providers' recommendations at the individual, interpersonal and community level to both develop and adapt interventions to improve providers' recommendations.
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Affiliation(s)
- Mallory K. Ellingson
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, 60 College St, New Haven, CT 06520 USA
| | - Robert A. Bednarczyk
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
- Emory Vaccine Center, Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, GA USA
- Cancer Prevention and Control Program, Winship Cancer Institute, Emory University, Atlanta, GA USA
| | - Sean T. O’Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, CO USA
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | - Jason L. Schwartz
- Department of Health Policy and Management, Yale University School of Public Health, New Haven, CT 06520 USA
| | - Eugene D. Shapiro
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, 60 College St, New Haven, CT 06520 USA
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520 USA
| | - Linda M. Niccolai
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, 60 College St, New Haven, CT 06520 USA
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Alkhaldi RO, Alzahrani HA, Metwally LA. Awareness Level About Cervical Cancer, Human Papillomavirus (HPV) and Corresponding Vaccine Among Women Living in the Western Region of Saudi Arabia. Cureus 2023; 15:e37512. [PMID: 37193479 PMCID: PMC10182381 DOI: 10.7759/cureus.37512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/18/2023] Open
Abstract
Background In this study, we aimed to evaluate the knowledge and awareness about cervical cancer, human papillomavirus (HPV) and its vaccine among women living in the western region of Saudi Arabia. Methodology Using a cross-sectional online survey, this study assesses the knowledge and awareness level of HPV and the risk factors of cervical cancer among women living in the western region of Saudi Arabia. The design of the questionnaire is based on several earlier studies in different populations. Results The total completed responses include a sample of 624 that was subjected to statistical analysis; the analysis showed that only 34.6% were aware of HPV. Participants who belonged to the 21-30 and 31-40-year-old groups had comparatively more awareness than other age groups (p<0.001). Most (83.8%) believed that it would cause cervical cancer. Less than half (45.8%) knew that there is a vaccine against HPV infection. When we assessed the willingness to receive the vaccine, it was found that 75.8% were willing to take it. Conclusions The study found that women in the western region of Saudi Arabia have limited knowledge of cervical cancer and HPV and its vaccine. There is a need to educate and promote awareness of HPV and its complications for women in the western region of Saudi Arabia.
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Cunningham-Erves J, Hull PC, Wilkins CH, Edwards KM, Davis M, Jones J, Graham J, Adekunle A, Dempsey AF. Healthcare providers' practice protocols, strategies, and needed tools to address parental HPV vaccine hesitancy: An exploratory study. Hum Vaccin Immunother 2022; 18:2136862. [PMID: 36375029 DOI: 10.1080/21645515.2022.2136862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Parental hesitancy related to human papillomavirus (HPV) vaccines has increased during the pandemic, and there is a call to action by the National HPV Vaccination Roundtable to improve vaccination rates. While there are evidence-based strategies available to address parental hesitancy, there are few clear guidelines on how to engage parents to build confidence in the HPV vaccine within the clinical settings. The purpose of this investigation is to explore practice protocols, individual provider strategies, and perceived tools needed to address HPV vaccine hesitant parents from the perspective of providers during the COVID-19 pandemic in the United States. Fifteen healthcare providers participated in qualitative, semi-structured interviews between May 2021 and March 2022. An inductive, qualitative content analysis approach was used to analyze the data. Five themes were described: 1) Provider experiences engaging with HPV vaccine hesitant parents; 2) Existing protocols in the clinics to address HPV vaccine hesitant parents; 3) Strategies used by providers to address parental HPV vaccine hesitancy; 4) Sample message content used by providers to address parental HPV vaccine concerns; and 5) Perceived strategies and tools needed to address parental vaccine hesitancy. Recommendations to address parental hesitancy include recommending HPV vaccinationat 9 years, using a strong recommendation and continued discussion, applying evidence-based approaches and/or promising strategies, linking parents to credible outside sources, and ongoing follow-up if delayed or declined. These findings can be used by researchers and clinicians to improve strategies and messages to inform the development of a protocol to standardize encounters and communication for patient-parent-provider encounters that can influence parental decision-making around HPV vaccine uptake.
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Affiliation(s)
| | - Pamela C Hull
- College of Medicine Department of Behavioral Science, Department of Behavioral Science, Markey Cancer Center, University of Kentucky, Lexington, KY, USA
| | - Consuelo H Wilkins
- Office of Health Equity, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kathryn M Edwards
- Department of Pediatrics, Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Megan Davis
- School of Medicine, Vanderbilt University, Nashville, TN, USA
| | | | - Jenee Graham
- Meharry Medical College, School of Medicine, Nashville, TN, USA
| | - Abiola Adekunle
- Meharry Medical College, School of Medicine, Nashville, TN, USA
| | - Amanda F Dempsey
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.,Adult & Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO, USA.,Merck and Company, Wales, PA, USA
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Hecht ML, BeLue R, Ray A, Hopfer S, Miller-Day M, Mckee F. HPV Vaccine Intent among Adult Women Receiving Care at Community Health Centers. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1186-1193. [PMID: 33400206 DOI: 10.1007/s13187-020-01937-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
Human papillomavirus (HPV) is a disease that exacts substantial costs in human life and public health expenditures. Fortunately, a vaccine exists that can mitigate these costs. This study reports the development and evaluation of the intervention designed to overcome these barriers by using culturally grounded narratives to promote HPV vaccination. Women's Stories (WS) targets women over the age of 18 and was originally successfully validated for use among college students resulting in NCI recognition. WS was adapted for touch pad delivery in Planned Parenthood clinics where a randomized clinical trial was conducted in 8 clinics in 3 cities. Two hundred seventeen women were randomly assigned to treatment and control, completing pretest and posttest surveys. This study examined data from the immediate posttest. An intent to treat analysis was conducted using a generalized linear mixed modeling approach using a multinomial link and accounting for repeated measures by site. Results demonstrate significant short-term effects on vaccine intentions and vaccine self-efficacy. When compared to control group participants, women in the treatment condition more likely to intend to get the shot today/the day of interview (p < 0.01), as well as in 1 (p < 0.01) and 6 (p < 0.01) months and had greater self-efficacy to receive the HPV vaccination (B = 0.54; p = 0.0002). These results are promising for the potential impact of the intervention in clinical settings as well as providing a model for overcoming lack of awareness and vaccine resistance in other segments of the population.
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Affiliation(s)
- M L Hecht
- REAL Prevention LLC, Clifton, NJ, USA
| | - R BeLue
- Health Management and Policy, Saint Louis University, St Louis, MO, USA.
| | - A Ray
- Public Health, University of Kentucky, Lexington, KY, USA
| | - S Hopfer
- Public Health, UC Irvine, Irvine, CA, USA
| | - M Miller-Day
- Communication Studies, Chapman University, Orange, CA, USA
| | - F Mckee
- St. Andrew Development, Inc., Philadelphia, PA, USA
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Boyce TG, Christianson B, Hanson KE, Dunn D, Polter E, VanWormer JJ, Williams CL, Belongia EA, McLean HQ. Factors associated with human papillomavirus and meningococcal vaccination among adolescents living in rural and urban areas. Vaccine X 2022; 11:100180. [PMID: 35755142 PMCID: PMC9218554 DOI: 10.1016/j.jvacx.2022.100180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/01/2022] Open
Abstract
Background Studies have shown that adolescent vaccination rates with human papillomavirus (HPV) and quadrivalent meningococcal conjugate (MenACWY) vaccines are lower in rural areas of the U.S. than in urban areas. We sought to determine factors associated with vaccine acceptance in these two settings. Methods We conducted a cross-sectional survey of 536 parents or guardians of teens age 13 through 15 years in select rural and urban counties of Minnesota and Wisconsin. We collected information on demographic variables, receipt of adolescent vaccines, and attitudes toward HPV vaccine in particular. Multivariable logistic regression models were used to assess associations between covariates and outcomes of interest (HPV vaccine receipt and MenACWY receipt). Results Of the 536 respondents, 267 (50%) resided in a rural county. Most respondents were female (78%) and non-Hispanic White (88%). About half (52%) of teens of the surveyed parents received the three vaccines recommended specifically for adolescents: 90% received tetanus-diphtheria-acellular pertussis (Tdap), 84% received MenACWY, and 60% received one or more doses of HPV vaccine. Rural and urban parents surveyed differed on several covariates relating to teen's health services, parent's demographics, and household characteristics. Parent's perception of the importance that their healthcare providers placed on vaccination with HPV and MenACWY were independently associated with receipt of each of those vaccines (odds ratio [OR] 6.37, 95% confidence interval [CI] 2.90-13.96 and OR 2.15, 95% CI 1.07-4.31, respectively). Parents of vaccinated teens were less likely to report concerns about potential harm from the HPV vaccine or having heard stories about health problems caused by the HPV vaccine. Conclusion Teen receipt of HPV vaccine and MenACWY appears to be influenced by parents' perception of vaccine importance, provider recommendations, and concerns regarding potential harm from the HPV vaccine. Continued education of providers and parents of the importance of adolescent vaccinations is warranted.
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Key Words
- Adolescent
- CDC, Centers for Disease Control and Prevention
- CHIAS, Carolina HPV Immunization Attitudes and Beliefs Scale
- HPV, human papillomavirus
- Human papillomavirus
- IIS, immunization information system
- IRB, Institutional Review Board
- MCRI, Marshfield Clinic Research Institute
- MDH, Minnesota Department of Health
- MIIC, Minnesota Immunization Information Connection
- MenACWY, quadrivalent meningococcal conjugate vaccine
- Rural population
- Tdap, tetanus-diphtheria-acellular pertussis vaccine
- UIC, Urban Influence Codes
- Vaccinations
- WIR, Wisconsin Immunization Registry
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Affiliation(s)
- Thomas G Boyce
- Marshfield Clinic Research Institute, Marshfield, WI, USA
| | | | - Kayla E Hanson
- Marshfield Clinic Research Institute, Marshfield, WI, USA
| | - Denise Dunn
- Minnesota Department of Health, St. Paul, MN, USA
| | | | | | - Charnetta L Williams
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Huong Q McLean
- Marshfield Clinic Research Institute, Marshfield, WI, USA
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Fields EJ, Hopfer S, Warren JR, BeLue R, Lebed J, Hecht ML. Motivators and Barriers to HPV Vaccination: A Qualitative Study of Underserved Women Attending Planned Parenthood. Vaccines (Basel) 2022; 10:vaccines10071126. [PMID: 35891290 PMCID: PMC9317585 DOI: 10.3390/vaccines10071126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 12/10/2022] Open
Abstract
Human papilloma virus (HPV) is the most common sexually transmitted infection in the United States. Disease-associated strains of HPV can cause genital warts and six cancer types. HPV-associated cervical cancer disproportionately impacts medically underserved women including Black and Latina women with respect to incidence, prevalence, and mortality rates. Although safe and effective vaccines are available, HPV vaccination rates remain low among low-income individuals and women of color. The current study examined individual and structural motivators and barriers to HPV vaccination among medically underserved women utilizing a Planned Parenthood health center in Southeast Pennsylvania. Guided by narrative engagement theory (NET), qualitative interviews (N = 24) were used to elicit HPV vaccine decision stories from both vaccinated and unvaccinated women. Using a phronetic iterative data analysis approach, we identified three motivators to vaccinate against HPV: (1) receiving an explicit vaccine recommendation from a healthcare provider (a structural determinant), (2) feeling empowered to take control of one’s health (an individual determinant), and (3) knowing someone infected with HPV (an individual determinant). Among unvaccinated participants, barriers to HPV vaccination included: (1) not receiving an explicit vaccine recommendation from a healthcare provider (a structural determinant), (2) low perceived risk for acquiring HPV or that HPV is not severe (an individual determinant), and (3) lack of maternal support to vaccinate (a structural determinant). Healthcare providers are optimally positioned to fill the gap in prior missed vaccine opportunities and empower women by recommending HPV vaccination.
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Affiliation(s)
- Emilia J. Fields
- Department of Health, Society, and Behavior, Program in Public Health, University of California-Irvine, Irvine, CA 92697, USA;
| | - Suellen Hopfer
- Department of Health, Society, and Behavior, Program in Public Health, University of California-Irvine, Irvine, CA 92697, USA;
- Correspondence: ; Tel.: +1-(949)-824-6996
| | - Jennifer R. Warren
- Department of Communication, Women and Gender Studies, African and African American Studies, George Mason University, Fairfax, VA 22030, USA;
| | - Rhonda BeLue
- Department of Public Health, University of Texas San Antonio, San Antonio, TX 78249, USA;
| | - Joel Lebed
- Planned Parenthood Southeastern Pennsylvania, Philadelphia, PA 19107, USA;
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Brennan LP, Rodriguez NM, Head KJ, Zimet GD, Kasting ML. Obstetrician/gynecologists' HPV vaccination recommendations among women and girls 26 and younger. Prev Med Rep 2022; 27:101772. [PMID: 35321213 PMCID: PMC8935521 DOI: 10.1016/j.pmedr.2022.101772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/10/2022] [Accepted: 03/13/2022] [Indexed: 11/27/2022] Open
Abstract
Background Obstetrician/gynecologists (OB/GYNs) are well poised to vaccinate girls and young women against HPV, however little is known about if and how they recommend the HPV vaccine. This study aims to understand factors associated with strong and frequent HPV vaccine recommendations among OB/GYNs for patients 26 years and younger. Methods 224 practicing U.S. OB/GYNs were surveyed for how strongly and frequently they recommend the HPV vaccine to patients 26 and younger. Provider beliefs, knowledge, and preferences surrounding the vaccine, as well as clinic and patient-level variables were examined as covariates. We then examined the relationships using multivariable logistic regression analyses. Results Of the 224 respondents, 205 were included in the analysis, with 57% (n = 116) reporting strongly and frequently recommending the HPV vaccination to eligible patients 26 and younger. The regression showed two provider beliefs and two clinic-level attributes to be strongly associated with strong and frequent recommendations. Being a strong and frequent recommender was positively associated with believing other gynecologists frequently recommend the vaccine (aOR 24.33 95%CI[2.56-231.14]) and believing that 50% or more of their patients are interested in receiving the vaccine (aOR 2.77 95%CI[1.25-6.13]). The clinic-level attributes were having the vaccine stocked (aOR 2.66 95%CI[1.02-6.93]) and suburban (aOR 3.31 95%CI[1.07-10.19]) or urban (aOR 3.54 95%CI[1.07-11.76]) location versus rural. Conclusions These findings suggest that OB/GYN peer support and educating OB/GYN about patients' interest in HPV vaccination may improve HPV vaccination. This work can inform clinic-level interventions including stocking the vaccine and focusing improvement efforts on rural clinics.
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Affiliation(s)
- Luke P Brennan
- Weldon School of Biomedical Engineering, Purdue University, 206 S Martin Jischke Dr, West Lafayette, IN 47907, USA
- Indiana University Medical Scientist/Engineer Training Program, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Natalia M Rodriguez
- Weldon School of Biomedical Engineering, Purdue University, 206 S Martin Jischke Dr, West Lafayette, IN 47907, USA
- Department of Public Health, Purdue University, Matthews Hall, 812 W State St, West Lafayette, IN 47907, USA
- Cancer Prevention and Control Program, Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Katharine J Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, 425 University Blvd, Indianapolis, IN 46202, USA
| | - Gregory D Zimet
- Department of Pediatrics, Indiana University School of Medicine, 410 W. 10th Street, Indianapolis, IN 46202, USA
- Cancer Prevention and Control Program, Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Monica L Kasting
- Department of Public Health, Purdue University, Matthews Hall, 812 W State St, West Lafayette, IN 47907, USA
- Cancer Prevention and Control Program, Indiana University Simon Comprehensive Cancer Center, Indianapolis, IN, USA
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11
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Adolescent COVID-19 Vaccine Decision-Making among Parents in Southern California. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074212. [PMID: 35409893 PMCID: PMC8998887 DOI: 10.3390/ijerph19074212] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 01/12/2023]
Abstract
Adolescent COVID-19 vaccination has stalled at 53% in the United States. Vaccinating adolescents remains critical to preventing the continued transmission of COVID-19, the emergence of variants, and rare but serious disease in children, and it is the best preventive measure available to return to in-person schooling. We investigated parent–adolescent COVID-19 vaccine decision-making. Between 24 February and 15 March 2021, we conducted surveys and 12 focus groups with 46 parent–adolescent dyads in Southern California. Parents and adolescents completed a survey prior to participation in a focus group discussion, which focused on exploring COVID-19 vaccine acceptance or uncertainty and was guided by the 5C vaccine hesitancy model. Parents uncertain about vaccinating adolescents expressed low vaccine confidence and high COVID-19 disease risk complacency. Parents who accepted COVID-19 vaccination for adolescents expressed high confidence in health authority vaccine recommendations, high perceived COVID-19 risk, and collective responsibility to vaccinate children. Additionally, unique pandemic-related factors of vaccine acceptance included vaccinating for emotional health, resuming social activities, and vaccine mandates. Among parents, 46% were willing to vaccinate their adolescent, 11% were not, and 43% were unsure. Among adolescents, 63% were willing to vaccinate. Despite vaccine availability, 47% of adolescents remain unvaccinated against COVID-19. Factors associated with vaccine uncertainty and acceptability inform health care practitioner, school, community, and public health messaging to reach parents and adolescents.
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Efua Sackey M, Markey K, Grealish A. Healthcare professional's promotional strategies in improving Human papillomavirus (HPV) vaccination uptake in adolescents: A systematic review. Vaccine 2022; 40:2656-2666. [PMID: 35367068 DOI: 10.1016/j.vaccine.2022.03.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 03/08/2022] [Accepted: 03/22/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Human papillomavirus (HPV) vaccination coverage remains suboptimal with a global vaccination rate ranging from 12 to 90%. This review examined the approaches used by healthcare professionals in improving the uptake of HPV vaccine and reducing vaccine misconceptions among adolescents. METHODS A systematic review of literature between 2007 and 2021 was conducted using five databases: CINAHL, MEDLINE, PsycInfo, Scopus and ASSIA. Studies that examined healthcare professional's promotional strategies in improving the HPV vaccine uptake in adolescents were included. Two researchers independently reviewed study selection, data extraction, and study methodological quality. Results were analysed and synthesised using narrative synthesis. RESULTS Twelve studies met the inclusion criteria. Studies reported on effective approaches used by healthcare professionals to improve vaccine uptake including the use of multi-settings to target hard-to-reach vulnerable adolescents; consistently recommending the vaccine; and initiating the vaccine before the age of eleven. In addressing vaccine misconceptions, open-communication, motivational approaches, and sexual health education were effective strategies used. CONCLUSION This review found that healthcare professionals need to be better informed and educated on HPV vaccine to reduce their own vaccine hesitancy. Uptake of HPV vaccine can be improved by adopting better communication, engagement, supportive information resources, and training for healthcare professionals.
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Affiliation(s)
- Margaret Efua Sackey
- Department of Nursing and Midwifery, University of Limerick, Limerick V94 T9PX, Ireland.
| | - Kathleen Markey
- Department of Nursing and Midwifery, University of Limerick, Limerick V94 T9PX, Ireland
| | - Annmarie Grealish
- Department of Nursing and Midwifery, University of Limerick, Limerick V94 T9PX, Ireland; King's College London, London, UK
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13
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Barello S, Maiorino G, Palamenghi L, Torri C, Acampora M, Gagliardi L. Exploring the Motivational Roots of Getting Vaccinated against COVID-19 in a Population of Vaccinated Pediatric Healthcare Professionals: Evidence from an Italian Cross-Sectional Study. Vaccines (Basel) 2022; 10:vaccines10030467. [PMID: 35335099 PMCID: PMC8952861 DOI: 10.3390/vaccines10030467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 02/05/2023] Open
Abstract
Health care professionals (HCPs) working in pediatric and perinatal settings have a strong influence on parental vaccine decision making. Furthermore, HCPs’ motivations behind vaccine acceptance are associated with their likelihood of recommending vaccines to their patients. Understanding these motivations in the context of the COVID-19 vaccination campaign may aid in the development of interventions that improve pediatric practitioners’ vaccine confidence and prescription. We aimed at studying the motivations affecting COVID-19 vaccination behavior among a sample of vaccinated Italian HCPs working in pediatric settings. A sample (n = 162) of HCPs completed an online self-reported survey exploring motivations behind getting vaccinated against COVID-19. Emotions of HCPs at the moment of COVID-19 vaccination injection were also recorded to collect data about the main feelings connected to the vaccination decision-making process. Data were collected between 19 March 2021 and 21 April 2021. The most effective motivational incentives were the beliefs that vaccination helped protect vulnerable members of the community (97.5% agreement), could protect one’s own health (93.7%), health authorities could be trusted (58.7%), and the vaccine had been rigorously tested (53.8%). Actual personal exposure to COVID was less important (reported importance agreement 16–24%), and the influence of news and social media was still lower (4–6%). Differences between physicians’ and other HCPs’ ratings were also found. Finally, emotional status at vaccination showed high ratings for positive emotions surrounding the vaccination act. This study provided additional evidence about the multifaceted motivations behind COVID-19 vaccine acceptance and showed the potential of understanding the psychosocial roots of vaccine behaviors for shaping public communication campaigns. The highly emotionally charged response obtained underscores the importance of strengthening the community feeling among HCPs.
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Affiliation(s)
- Serena Barello
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (L.P.); (C.T.); (M.A.)
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
- Correspondence:
| | - Giuseppe Maiorino
- Division of Neonatology and Pediatrics, Ospedale Versilia, 54027 Viareggio, Italy; (G.M.); (L.G.)
| | - Lorenzo Palamenghi
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (L.P.); (C.T.); (M.A.)
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Via Milano 24, 26100 Cremona, Italy
| | - Chiara Torri
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (L.P.); (C.T.); (M.A.)
| | - Marta Acampora
- EngageMinds HUB–Consumer, Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (L.P.); (C.T.); (M.A.)
| | - Luigi Gagliardi
- Division of Neonatology and Pediatrics, Ospedale Versilia, 54027 Viareggio, Italy; (G.M.); (L.G.)
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14
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Reno JE, Dempsey AF. Promoting HPV vaccination among Latinx: an application of the extended parallel processing model. J Behav Med 2022; 46:324-334. [PMID: 35178652 DOI: 10.1007/s10865-022-00293-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/17/2022] [Indexed: 10/19/2022]
Abstract
Vaccine hesitancy is a substantial barrier to increasing HPV vaccination rates among Latinx in the US who experience disproportional rates of HPV-related cancers. The current research tests the effectiveness of culturally-targeted, fear-appeal messages designed using the Extended Parallel Processing Model (EPPM). We compared differences among Latinx young adults and parents of adolescents of the effectiveness of messages that highlight HPV-related cancers, genital warts, or a control condition to promote online information seeking about the HPV vaccine-a known precursor to vaccination intention. Results found messages containing EPPM messaging elements produced significantly higher self-reported intention to seek information about HPV vaccines in comparison to a control message group. However, participants who received control messages had the highest percentage of hyperlink clicks to more information about HPV (a novel measure of information seeking). Findings suggest that fear appeals may be effective for promoting information seeking about HPV vaccination, which in turn could increase vaccine utilization, among Latinx participants. Clinical trial registration number (NCT05206669) retrospectively registered January 25, 2022.
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Affiliation(s)
- Jenna E Reno
- University of Colorado School of Medicine, 13199 E. Montview Blvd, Suite 210-16, Aurora, CO, 80045, USA.
| | - Amanda F Dempsey
- University of Colorado School of Medicine, 13199 E. Montview Blvd, Suite 210-16, Aurora, CO, 80045, USA
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15
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Jäger L, Senn O, Rosemann T, Plate A. Awareness, Attitudes and Clinical Practices Regarding Human Papillomavirus Vaccination among General Practitioners and Pediatricians in Switzerland. Vaccines (Basel) 2021; 9:vaccines9040332. [PMID: 33915931 PMCID: PMC8065954 DOI: 10.3390/vaccines9040332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 11/16/2022] Open
Abstract
In Switzerland, the human papillomavirus vaccination (HPVv) coverage rate lies below a desirable threshold. General practitioners (GPs) and pediatricians have been recognized as important providers of the HPVv, but there is little known about their self-attributed role and its relationship with their actual HPVv behavior. Therefore, the objective of this study was to explore the awareness, attitudes, and clinical practices of Swiss GPs and pediatricians concerning HPVv by means of a web-based questionnaire. We analyzed the responses of 422 physicians (72% GPs, 28% pediatricians). A substantial proportion of respondents considered the HPVv “absolutely essential” (54.2% of pediatricians, 30.6% of GPs). GPs indicated spending more time and effort on HPVv counseling for female rather than male patients more often compared to pediatricians (44.0% versus 13.9%, p < 0.001). The weekly number of patients aged 18–26 years seen in practice (p = 0.002) and whether the HPVv was deemed “absolutely essential” (adjusted odds ratio 2.39, 95% confidence interval 1.12–5.08) were factors associated with GPs administering HPVv in their practice. Shortcomings in terms of awareness, effort in the identification of potential vaccination candidates, and the role of male patients were revealed. By addressing these gaps, Swiss primary care providers could contribute to an increase in the national HPVv coverage rate.
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Affiliation(s)
- Levy Jäger
- Correspondence: ; Tel.: +41-44-255-75-06
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16
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Butterfield R, Dhanani S. The Development of Human Papillomavirus (HPV) Vaccines and Current Barriers to Implementation. Immunol Invest 2021; 50:821-832. [PMID: 33724139 DOI: 10.1080/08820139.2021.1897612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The identification of the human papillomavirus (HPV) as the causative agent of multiple cancers allowed for the development of vaccines and immunization strategies to prevent cancers caused by HPV infection. The public health ramifications of reduction of HPV disease burden are momentous in scope. Vaccine hesitancy has impacted widespread vaccination, but strategies have been identified to combat vaccine safety and efficacy misinformation and promote immunization.
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Affiliation(s)
| | - Salimah Dhanani
- Department of Pediatrics, Albany Medical Center, Albany, New York, USA
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17
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Jenssen BP, Kelly MK, Faerber J, Hannan C, Asch DA, Shults J, Schnoll RA, Fiks AG. Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping. Acad Pediatr 2021; 21:129-138. [PMID: 32730914 PMCID: PMC7785572 DOI: 10.1016/j.acap.2020.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/08/2020] [Accepted: 07/22/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Message framing can be leveraged to motivate adult smokers to quit, but its value for parents in pediatric settings is unknown. Understanding parents' preferences for smoking cessation messages may help clinicians tailor interventions to increase quitting. METHODS We conducted a discrete choice experiment in which parent smokers of pediatric patients rated the relative importance of 26 messages designed to increase smoking cessation treatment. Messages varied on who the message featured (child, parent, and family), whether the message was gain- or loss-framed (emphasizing benefits of engaging or costs of failing to engage in treatment), and the specific outcome included (eg, general health, cancer, respiratory illnesses, and financial impact). Participants included 180 parent smokers at 4 pediatric primary care sites. We used latent class analysis of message ratings to identify groups of parents with similar preferences. Multinomial logistic regression described child and parent characteristics associated with group membership. RESULTS We identified 3 groups of parents with similar preferences for messages: Group 1 prioritized the impact of smoking on the child (n = 92, 51%), Group 2 favored gain-framed messages (n = 63, 35%), and Group 3 preferred messages emphasizing the financial impact of smoking (n = 25, 14%). Parents in Group 2 were more likely to have limited health literacy and have a child over age 6 and with asthma, compared to Group 1. CONCLUSIONS We identified 3 groups of parent smokers with different message preferences. This work may inform testing of tailored smoking cessation messages to different parent groups, a form of behavioral phenotyping supporting motivational precision medicine.
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Affiliation(s)
- Brian P Jenssen
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (BP Jenssen, J Faerber, and AG Fiks), Philadelphia, Pa; PolicyLab and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia (BP Jenssen, MK Kelly, C Hannan, and AG Fiks), Philadelphia, Pa.
| | - Mary Kate Kelly
- PolicyLab and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia (BP Jenssen, MK Kelly, C Hannan, and AG Fiks), Philadelphia, Pa
| | - Jennifer Faerber
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (BP Jenssen, J Faerber, and AG Fiks), Philadelphia, Pa
| | - Chloe Hannan
- PolicyLab and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia (BP Jenssen, MK Kelly, C Hannan, and AG Fiks), Philadelphia, Pa
| | - David A Asch
- Department of Medicine, Perelman School of Medicine at the University of Pennsylvania (DA Asch), Philadelphia, Pa
| | - Justine Shults
- Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania (J Shults), Philadelphia, Pa
| | - Robert A Schnoll
- Department of Psychiatry and Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania (RA Schnoll), Philadelphia, Pa
| | - Alexander G Fiks
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (BP Jenssen, J Faerber, and AG Fiks), Philadelphia, Pa; PolicyLab and the Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia (BP Jenssen, MK Kelly, C Hannan, and AG Fiks), Philadelphia, Pa
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18
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Understanding How Adolescents Think about the HPV Vaccine. Vaccines (Basel) 2020; 8:vaccines8040693. [PMID: 33218156 PMCID: PMC7711578 DOI: 10.3390/vaccines8040693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 01/07/2023] Open
Abstract
Despite educational efforts, Tennessee human papillomavirus (HPV) vaccination rates are 43%, among the lowest in the United States. This study examined how adolescents think about the HPV vaccine to identify patterns and misconceptions to enhance educational efforts. Adolescents (ages 11–12) (N = 168) responded to open-ended questions regarding their thinking about the HPV vaccine. Data were analyzed and interpreted using qualitative thematic analysis. Three domains of themes emerged from responses: (1) characteristics of HPV vaccination, (2) knowledge-related themes, and (3) beliefs-related themes. Prevention of HPV and cancer was the most referenced characteristic of HPV vaccination followed by HPV vaccine rates and HPV vaccine efficacy. Student inquiries were mostly centered on HPV vaccine composition, administration, duration and how the vaccine interacts with the body. Some responses indicated a desire for more information about HPV not specific to the HPV vaccine. Overall, adolescent attitudes were positive towards the HPV vaccine. This study highlights specific questions adolescents have about the vaccine that can be used to tailor future HPV educational efforts, empowering adolescents with the knowledge to be more active students in the decision-making process. In addition, the potential for adolescents to serve as community advocates for the vaccine should be considered for future interventions.
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19
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Saslow D, Andrews KS, Manassaram-Baptiste D, Smith RA, Fontham ETH. Human papillomavirus vaccination 2020 guideline update: American Cancer Society guideline adaptation. CA Cancer J Clin 2020; 70:274-280. [PMID: 32639044 DOI: 10.3322/caac.21616] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/19/2020] [Indexed: 01/12/2023] Open
Abstract
The American Cancer Society (ACS) presents an adaptation of the current Advisory Committee on Immunization Practices recommendations for human papillomavirus (HPV) vaccination. The ACS recommends routine HPV vaccination between ages 9 and 12 years to achieve higher on-time vaccination rates, which will lead to increased numbers of cancers prevented. Health care providers are encouraged to start offering the HPV vaccine series at age 9 or 10 years. Catch-up HPV vaccination is recommended for all persons through age 26 years who are not adequately vaccinated. Providers should inform individuals aged 22 to 26 years who have not been previously vaccinated or who have not completed the series that vaccination at older ages is less effective in lowering cancer risk. Catch-up HPV vaccination is not recommended for adults aged older than 26 years. The ACS does not endorse the 2019 Advisory Committee on Immunization Practices recommendation for shared clinical decision making for some adults aged 27 through 45 years who are not adequately vaccinated because of the low effectiveness and low cancer prevention potential of vaccination in this age group, the burden of decision making on patients and clinicians, and the lack of sufficient guidance on the selection of individuals who might benefit.
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Affiliation(s)
- Debbie Saslow
- Human Papillomavirus and Gynecologic Cancers, American Cancer Society, Atlanta, Georgia
| | - Kimberly S Andrews
- Guideline Development Process, American Cancer Society, Atlanta, Georgia
| | | | - Robert A Smith
- Cancer Screening, American Cancer Society, Atlanta, Georgia
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20
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Zimet GD, Osazuwa-Peters N. There's Much Yet to be Done: Diverse Perspectives on HPV Vaccination. Hum Vaccin Immunother 2020; 15:1459-1464. [PMID: 31365327 PMCID: PMC6746479 DOI: 10.1080/21645515.2019.1640559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Gregory D Zimet
- a Department of Pediatrics, School of Medicine, Indiana University , Indianapolis , IN , USA
| | - Nosayaba Osazuwa-Peters
- b Department of Otolaryngology-Head and Neck Surgery, Saint Louis University , St Louis , MO , USA
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