HPV Vaccine Delivery Practices by Primary Care Physicians
- 30 September 2019
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in Pediatrics
- Vol. 144 (4)
- https://doi.org/10.1542/peds.2019-1475
Abstract
BACKGROUND AND OBJECTIVES: To examine, among pediatricians and family physicians (FPs) (1) human papillomavirus (HPV) vaccine delivery practices, (2) delivery experiences, and (3) attitudes regarding new 2-dose HPV vaccination schedules. METHODS: We surveyed nationally representative networks of pediatricians and FPs by Internet or mail from July 2018 to September 2018. Multivariable regression was used to assess factors associated with refusal or deferral rates of >= 50% among 11- to 12-year-old patients. RESULTS: The response rate was 65% (302 pediatricians and 228 FPs included). Pediatricians who strongly recommended the HPV vaccine ranged from 99% for patients >= 15 years old (female) to 83% for those 11 to 12 years old (male); FPs ranged from 90% for patients >= 15 years old (female) to 66% for those 11 to 12 years old (male) (P < .0001 between specialties). Sixty-five percent of pediatricians and 42% of FPs always or almost always used presumptive style when discussing the HPV vaccine (P < .0001). Overall, 40% used standing orders and 42% had electronic alerts. Among pediatricians, the proportion reporting a refusal or deferral rate >= 50% was 19% for female patients and 23% for male patients 11 to 12 years old; FPs reported 27% and 36%, respectively. In the multivariable regression (both sexes), refusal or deferral was associated with physicians not strongly recommending the HPV vaccine to 11- to 12-year-old patients, not using a presumptive style, perceiving less resistance when introducing the HPV vaccine to a 13-year-old patient versus an 11- or 12-year-old patient, and anticipating an uncomfortable conversation when recommending the HPV vaccine to an 11- or 12-year-old patient. Eighty-nine percent of pediatricians and 79% of FPs reported that more adolescents CONCLUSIONS: Although most physicians strongly recommend the HPV vaccine to 11- to 12-year-old patients, our data reveal areas for improvement in recommendation and delivery methods. Most physicians perceive that the 2-dose schedule is resulting in higher HPV completion rates. In this article, we report current HPV delivery practices by primary care physicians, demonstrating areas for improvement in style and strength of recommendations and practice-based delivery methods.Keywords
This publication has 63 references indexed in Scilit:
- Annual Report to the Nation on the Status of Cancer, 1975–2009, Featuring the Burden and Trends in Human Papillomavirus (HPV)–Associated Cancers and HPV Vaccination Coverage LevelsJNCI Journal of the National Cancer Institute, 2013
- The role of human papillomavirus in nongenital cancersCA: A Cancer Journal for Clinicians, 2012
- An update on human papillomavirus vaccine uptake among 11–17 year old girls in the United States: National Health Interview Survey, 2010Vaccine, 2012
- Tracking the impact of the National Institutes of Health Clinical and Translational Science Awards on child health research: developing and evaluating a measurement strategyPediatric Research, 2012
- Timing of Adolescent Meningococcal Conjugate Vaccination: Attitudes and Practices of Pediatricians and Family Medicine PhysiciansAmerican Journal of Preventive Medicine, 2011
- HPV vaccine decision making in pediatric primary care: a semi-structured interview studyBMC Pediatrics, 2011
- Vaccine Attitudes, Concerns, and Information Sources Reported by Parents of Young Children: Results From the 2009 HealthStyles SurveyPublished by American Academy of Pediatrics (AAP) ,2011
- Knowledge of Interim Recommendations and Use of Hib Vaccine During Vaccine ShortagesPublished by American Academy of Pediatrics (AAP) ,2010
- Adoption of Rotavirus Vaccination by Pediatricians and Family Medicine Physicians in the United StatesPublished by American Academy of Pediatrics (AAP) ,2009
- Human papillomavirus and HPV vaccines: a reviewPublished by WHO Press ,2007