Despite its proven success at preventing cancer, many adolescents still aren’t getting the vaccine for the human papillomavirus (HPV), according to the University of Colorado School of Medicine. Researchers at its Anschutz Medical Campus say that physicians’ delivery and communication practices must improve to boost vaccination rates.
Plus, the researchers say, healthcare providers also must learn to deal with parents who are hesitant to get their children vaccinated against HPV. Their study is the first to examine pediatricians and family physicians’ delivery practices for the vaccine since the new two-dose schedule was announced for children and 11 and 12.
“A physician recommendation is one of the most important factors in vaccine acceptance by parents. However, we’re seeing a lack of understanding from healthcare providers about the need for vaccination early in adolescence and high rates of refusal on the part of parents,” said Allison Kempe, MD, MPH, lead author and professor of pediatrics at the school.
“The vaccine is underutilized, with less than half of American adolescents completing the vaccination. We need to maximize methods of introducing the vaccine that we know to be more effective, as well as the use of reminder and delivery methods at the practice in order to improve this rate,” Kempe said.
Each year, HPV causes more than 33,500 cases of cancer including oral cancer in women and men in the United States, according to the Centers for Disease Control and Prevention.
“The earlier someone is vaccinated, the better the immune system responds. It also increases the chances of being vaccinated before having exposure to HPV strains,” said Kempe. “If we can increase the rate of vaccination in early adolescence, then we can prevent cancers that develop in later years.”
The study surveyed 588 pediatricians and family physicians and found that refusal rates from parents remain high, especially for 11- to 12-year-olds, the target population for vaccination. Patients who use a “presumptive style” approach have higher acceptance rates.
“Presumptive style” means physicians introduce the HPV vaccine and recommend it in the same manner and as strongly as the other recommended adolescent vaccines for meningitis and Tdap. For example, the doctor could say, “We’ve got three vaccines today: Tdap, HPV, and meningitis,” rather than isolating HPV as an option that isn’t as important.
Still, the researchers said, the survey found some encouraging signs:
- Despite a high refusal rate, pediatricians who strongly recommend the vaccine increased from 60% in 2013 to 85% in 2018 for 11- or 12-year-old females and from 52% to 83% for 11- to 12-year-old males.
- Some 89% of pediatricians and 79% of family pediatricians reported more adolescents under the age of 15 are completing the HPV series now that only two doses are recommended.
Along with improving physician communication styles, the researchers said, HPV delivery also could be optimized by increased use of standing orders and alert systems in the medical record to remind providers of the need for vaccination at the point of care.
The study was published by Pediatrics.